Governance of Scotland's ballooning telehealth centre "largely absent," says leaked report

The Scottish Government has also committed to providing an annual budget of £2m to the centre.

Now an independent review, by international auditing firm PricewaterhouseCoopers, has raised serious questions about how the centre has been overseen. Their report, leaked to The Herald, says: "NHS 24 governance of SCTT direction and performance has been largely absent in an effective manner since 2012."

It later adds that "no governance process" has been "exercised over the growth in SCTT headcount and payroll costs" over the same time frame.

The report raises questions about whether the seniority of a number of staff is justified and says the ultimate benefits of some of the projects the centre is working on are not clear to some outsiders.

SCTT supports innovations in the NHS such as hospital appointments via video conference for people living in isolated communities and devices to help those with long term health problems monitor themselves at home.

It also engages with European health projects on behalf of Scotland.

NHS 24 is primarily a health service helpline which takes calls to GPs when surgeries are shut, but it has been responsible for SCTT in different forms since 2010.

NHS 24 is already under scrutiny because a new IT system for handling phone calls and patient information which should have been introduced two years ago has still not gone live and is expected to run £23m over budget.

The report talks about this fiasco receiving an "extreme level" of executive focus since 2012.

A request for a new management structure within SCTT - including some promotions - appears to be among the triggers for the PwC probe.

Their experts said the document proposing the shake-up did not give enough information to allow it to be properly considered.

Already, PwC found "there is a perception that a number of (SCTT) posts may hold a higher grading than that operationally required". The auditors note that a "limited review" of this issue has been carried out by a human resources professional whose name has "not been shared" and go on to recommend a comprehensive, "preferably independent" review to ensure the payroll costs are clearly justified.

A number of European projects have been won by the SCTT bringing investment of 4.8m Euros to Scotland. However, the report which is dated May 2015, says there are some concerns over the delivery of projects and suggest there is a risk money from NHS 24's core budget may need to be used to meet SCTT's obligations.

NHS 24 managers stress there will be no impact on their emergency care services.

In a statement NHS 24 said: "SCTT operates within a 'Governance Framework' for Scottish Government funding and for European Commission funding. Like all expanding organisations NHS 24/SCTT continuously reviews the robustness of these arrangements and updates them as appropriate. During 2014/15, NHS 24 further invested in appointing an experienced Finance Manager to support the governance arrangements for EC and other grant-funded activity."

The health board added that the EC recently audited one of their European projects and this report was "extremely positive, evidencing the good management and control in place at NHS 24 for these projects."

Earlier this year The Herald revealed corporate credit cards had been withdrawn from managers at NHS 24 after a review found some spending was not backed by receipts.

The extent of foreign travel, in connection with the SCTT, was also revealed including 87 oversees trips between April 2014 and the end of February 2015. This included five people attending an eHealth forum in Athens.

A Scottish Government spokeswoman said: “Scotland is highly regarded in Europe for its work in and around telehealth & telecare, and the Scottish Centre for Telehealth & Telecare has been instrumental in building up this reputation. The SCTT have been successful over the last few years at attracting several million pounds of inward investment, estimated by NHS 24 to be around 4.8 million Euros.

“NHS 24 has taken the right step in commissioning an external review of their governance arrangements over the Scottish Centre for Telehealth and Telecare and we would expect them to carefully consider the report and take action to address the findings.

“The Scottish Government will also consider the findings of the report in detail and look at what more can be done to effectively oversee the work of the SCTT, particularly work commissioned on its behalf.”