The Audit and Performance Committee met on Wednesday 23rd September 2020 to discuss immunisation programmes, financial performance, and housing standards. Key decisions included noting the contents of the immunisations report and inviting NHS England to provide a further update, noting the Finance and Performance reports, and noting the overview report on contracts.

Immunisation Programmes in Westminster

The committee received a report from Dr Catherine Heffernan, Principal Advisor for Commissioning Early Years, Immunisations and Vaccination Services at NHS England, regarding vaccination rates in Westminster. It was noted that Westminster's uptake of vaccinations at age 5 was around 60%, significantly below the World Health Organization's recommended 95%. While childhood immunisation rates had dropped due to COVID-19, they had recovered by September 1st. Dr Heffernan highlighted work being done to address health inequalities and collaborate with local authorities, Clinical Commissioning Groups (CCGs), and the Greater London Authority (GLA) to ensure sufficient workforce, capacity, and vaccine stocks. Innovative measures by GP practices to see patients were also discussed.

Lucy Rumbellow, Immunisation Commissioning Manager at NHS England, provided further detail specific to Westminster, observing that affluent areas had lower uptakes, potentially due to foreign residents and private GP practices. Despite these rates, the expected level of outbreaks had not occurred. Concerns were raised about the implications of the government's announcement to disband Public Health England (PHE) and the resulting uncertainty. The committee also discussed the accuracy of vaccination uptake data, how NHS England works with the local authority to map uptake at ward level, strategies to counter anti-vax messaging, and the delivery of any future COVID-19 vaccine outside the standard immunisation programme.

Dr Heffernan noted that more timely data had become available during COVID-19, with information usually accessible one to two weeks after vaccination. Ms Rumbellow explained mitigation strategies for hesitancy or refusal, including work with school teams, year-round clinics, and both granular and blanket communications. The committee expressed concern that vaccination levels in Westminster had been consistently low over the past decade with little apparent progress. The suggestion of using health visitors to administer vaccinations was raised. Dr Heffernan stated that while health visitors had administered vaccines in the past, they are commissioned by local authorities, not NHS England. She also highlighted acute issues such as the inability to proceed with commissioning initiatives in September, alongside chronic issues like population turnover and data complexity. Natalia Clifford, Deputy Director of Public Health, observed that pilot schemes had been conducted elsewhere and that Westminster would welcome being a locus for a pilot scheme.

Decision: The committee resolved to note the contents of the report, continue to monitor immunisation rates, and invite NHS England to return to present an update.

Action: The committee agreed to write to local MPs, inform the Chief Executive and the Leader of the Council about the discussions, and invite NHS England to a future meeting for a further update, which will be added to the work programme.

Finance and Performance Business Plan Monitoring Report

The committee received the Period 4 Finance Report 2020/2021, presented by Gerald Almeroth, Executive Director of Finance and Resources, and Rikin Tailor, Head of Corporate Finance. The report detailed the forecast outturn for revenue and capital by Cabinet Portfolio, along with projected expenditure, key risks, and opportunities.

The report projected a year-to-date variance of £23.3 million and an adverse gross variance of £50 million by year-end, resulting in a net deficit of £30.291 million. This net deficit did not include potential reimbursements under the government's income reimbursement scheme. The Housing Revenue Account (HRA) forecast indicated an overspend of £4.435 million, with £4.2 million of this deficit attributed to pressures arising from COVID-19. It was noted that eleven schemes accounted for 68% of the capital provision of £85 million, and over 50% of the HRA was related to six regeneration schemes, with slippage due to COVID-19 constraints. The committee was assured that variances, risks, and opportunities within Cabinet Portfolios were being closely monitored.

Discussions covered grants for small businesses, year-to-date variances due to COVID-19 financial pressures, key income streams from parking and planning, and capital underspend, including the Piccadilly underpass.

The committee also received the Quarter 1 Performance Report, summarising the City Council's performance against its City for All priorities at the end of the first quarter of the 2020/2021 financial year. The report detailed progress towards deliverables and targets within departmental business plans, along with commentary on outstanding and poor performance and remedial actions.

Challenges were discussed regarding the availability of data for targets and the difficulty in identifying specific issues due to the impact of COVID-19. The impact of COVID-19 on the Evening and Night-Time Economy and potential enforcement issues were also debated, particularly in a context where voluntary compliance might decrease. The committee questioned whether the City was adequately resourced and raised the issue of inspections of bars, restaurants, and pubs. It was clarified that inspection figures related to Quarter 1. The committee requested COVID-19 specific Key Performance Indicators (KPIs), which would be discussed with Executive Directors.

Decision: The committee resolved to note the Finance and Performance reports.

Actions:

• Future reports will include COVID-19 specific KPIs and commentary in the Appendix, with service representatives available.
• Officers will advise the committee on the amounts claimable through the government's income reimbursement scheme, which would reduce the HRA deficit.
• Information on the Piccadilly Underpass scheme will be provided.

Annual Contracts Review and Procurement Update

Graham Collins, Head of Procurement and Supply Chain, provided an overview of contracts performance for 2019/2020 and an update on the implementation of the new operating model for the Procurement and Commercial Service. The committee received a review of contract awards, waivers, and performance, alongside an update on the new operating model and its performance indicators.

The committee raised concerns about the accessibility of contracts via e-capital sourcing. It was noted that 43 out of 76 contracts had been extended or awarded without competition, and the committee queried whether any contractors had been cited for poor performance. Questions were also raised about which GPH contracts were performing below target. The committee was informed that the new procurement system, intended to replace capital sourcing (CapE), would require training but would offer greater ease of use. A new team is expected to be in place in 2021.

Simon Sluys, from Travel Care Commissioning, provided an update on the Travel Care Minibus Contract. He highlighted the contract's higher environmental standards, social value, continuity, and positive feedback prior to COVID-19. The service was subsequently used for COVID-19 provision, including the delivery of school meals and computers. The committee discussed instances of routes overrunning and how managers had identified these issues. Mr Sluys explained that additional workers and crews had been engaged, and the provider was working to identify issues more quickly. He referred the committee to paragraph 2.3 of the report, noting that the current provider had taken over a failing contract from a previous provider that had gone into administration with only two weeks' notice.

Decision: The committee resolved to note the overview report.

Action: Officers are to provide updates on the Ove Arup contract at Lisson Grove and below-target GPH contracts.

Westminster's Housing Performance 2020

Neil Wightman, Director of Housing, presented an overview of the standards and delivery of improvements in the housing service, considering the context of the COVID-19 pandemic.

The committee discussed significant reductions in repairs during the pandemic, communications with tenant residents, the handling of anti-social behaviour, and engagement related to tenancy fraud. It was noted that major works had to be halted as residents were on-site due to COVID-19 restrictions, and a larger number of people were claiming Universal Credit Benefit.

Further discussion involved the work of a scrutiny task group committee in 2018, which had examined City West Homes (CWH), its corporate culture, staff turnover, and the council's resourcing for dealing with tenancy fraud. Mr Wightman advised the committee that the City Council was sufficiently resourced, and David Hughes observed that the Fraud Team worked closely with the Housing team.

Internal Audit Progress Report and Revised Audit Plan

The committee received the Internal Audit Progress and Revised Audit Plan reports from David Hughes, Tri-borough Director, Audit, Fraud, Risk Management and Insurance.

It was noted that the COVID-19 pandemic had slightly delayed the start of the 2020/21 Internal Audit work, a situation common across audit teams in London boroughs. As no audits had been finalised since the previous report, this report provided an update on ongoing work, without offering an opinion on the adequacy and effectiveness of the Council's governance, risk management, and controls. The Audit Plan for 2020/21 had been revised to account for the impact of COVID-19 on services, changes in service delivery, and personnel changes.

Decision: The committee resolved to note the revised audit plan and the status of audits currently in progress.

Internal Audit Charter and Strategy 2020-2021

The committee received a report concerning the Council's Internal Audit Charter and Strategy for 2020/21. It was advised that this was in accordance with the Public Sector Internal Audit Standards (PSIAS), which require the Council to have an Internal Audit Charter maintained by the Shared Services Director for Audit, Fraud, Risk & Insurance, and that the Charter be reviewed annually.

Decision: The committee resolved to note the Internal Audit Charter report for 2020 in accordance with PSIAS requirements.

Redmond Review on Local Authority Audits and Financial Reporting

Gerald Almeroth, Executive Director of Finance and Resources, provided a verbal update on the Redmond Review. This included the Review's recommendation for the introduction of an independent member to audit committees. The committee welcomed this recommendation and requested a note on the implementation of the Review's recommendations, including potential appointments and a requirement for candidates to have knowledge of public sector accounts.

Decision: The committee resolved to note the update on the Redmond Review and approved the recommendation for the introduction of an independent member.

Action: A note was requested on the implementation of the Redmond Review recommendations, including suggested potential appointees who must have knowledge of public sector accounts.