Minutes of a meeting of the Board of the Accident Compensation Corporation held at
ACC Boardroom, Level 11, PwC Tower, 188 Quay Street, Auckland on Thursday, 27
November 2019 at 9.00 am.
Present
Dame Paula Rebstock
Chair
Ms Anita Mazzoleni**
Member
(until 5.00 pm)
Mr James Mil er
Temporary Deputy Chair
Mr David May
Member
Ms Kristy McDonald QC
Member
Dr Tracey Batten
Member
Mr John Brabazon
Member
In attendance
Mr Scott Pickering
Chief Executive
Mr Mike Tully
Chief Operating Officer
Mr Peter Fletcher
Chief Technology & Transformation Officer
Ms Deborah Roche
Chief Governance Officer
Mr Herwig Raubal**
Chief Actuarial and Risk Officer
Mr John Healy
Chief Financial Officer
Ms Emma Powell
Chief Customer Officer
Ms Sharon Champness
Chief Talent Officer
Ms Gabrielle O’Connor**
Head of Client Service Delivery
Item 4.1
9(2)(a)
Head of Privacy
Item 4.1
9(2)(a)
Head of Actuarial Services
Items 5.2 & 5.3
9(2)(a)
Head of Provider Service Delivery
Item 6.2(b)
9(2)(a)
Enterprise Advisor – Health Sector Strategy Item 5.4
9(2)(a)
Head of Injury Prevention
Item 5.5
9(2)(a)
Strategic Advisor, Governance
Item 6.2
9(2)(a)
Senior Policy Advisor
Item 6.2
9(2)(a)
Senior Policy Advisor
Item 6.2
Ms Ainsley Simmonds
Acting General Counsel and Company
Secretary
9(2)(a)
Manager Corporate Secretariat
9(2)(a)
Senior Associate Company Secretary
** Attended via telephone / videoconference
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Procedural Business
Apologies
There were no apologies received for the meeting.
Register of Members’ Conflicts of Interest Arising
For item 5.6, Mr May declared that he knew the manager of Tenzing Limited very well. Mr Mil er
noted that he had retired from St Cuthbert’s Trust Board.
CONFIRMED: The Board reviewed the Register of Members’ Conflicts of Interest Arising and
confirmed that it was not aware of any other matters (including matters reported to, and decisions
made by, the Board at this Meeting) which would require disclosure.
Committee Updates
Health Sector Strategy Advisory Committee
Dr Batten updated the Board on the key matters from the first Health Sector Strategy (HSS)
Advisory Committee meeting held on 26 November 2019:
• The first meeting had been positive, setting the background to the HSS and its renewed focus.
• The independent members had demonstrated engagement and their depth of understanding.
Dr Batten would revert to the Board if the member who had been absent from the meeting was
now unable to be on the Committee.
• The workplan for the first six months of next year had been discussed. The first meeting for
2020 would focus on the health outcomes framework and engagement strategy.
The Committee Chair noted that the establishment of the Committee had been well received in the
sector, as evidence of ACC partnering with the provider network. The Board discussed its
expectations about the role to be played on the Committee by the independent members, and the
effective communication Mr Pickering had undertaken with providers about the problems with the
HSS. The Committee Chair clarified that the independent Committee members had received an
induction pack but asked that Corporate Secretariat check whether the Committee needed any
further information. She also asked that Management provide the Committee papers two weeks in
advance of meetings. The Board agreed that IQA reports on the HSS should be included as Agenda
Items for the Committee.
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Risk Assurance and Audit Committee
Prior to the Board meeting, Ms Mazzoleni had sent the Board the following summary of the papers
for the Risk Assurance and Audit Committee (RAAC) meeting to be held the following day:
• In general, there was a consistency of poor findings in ICIP benefit realisation, HSS and the
provider area. The latest ICIP portfolio assurance had been completed and did not yet have
Management’s response, which wil be completed and considered at the February 2020 RAAC
meeting, along with a response to the outstanding HSS initial assessment in May which
identified significant gaps. Of the $75 million HSS benefits, there were no benefit realisation
plans for $46 million. A big focus going forward wil be on benefit shortfalls.
• The status reports and plans to get to best practice on information management capability
development, information security capability development and technology business continuity
and disaster recovery improvement show there is stil work to do, but there is progress.
• The Risk Mitigation Report following the risk reset contained much more focused plans and
timeframes. The Committee wil review the treatment plan to manage claims costs growth at its
next meeting in February.
• The workplan responding to the risk culture survey would be amended to add that the Board
needed to be visible and show leadership in risk management. It is expected to call on
Members to attend the CEO’s quarterly briefings to staff.
• The PBE papers address a few but persistent financial control environment weaknesses and
suggests early ideas for low carbon reporting in the Annual Report.
Board Only Session
Board Investment Committee Discussion
RESOLVED: The ACC Board resolved to:
Note the discussion.
Board Code of Conduct
RESOLVED: The ACC Board resolved to:
(a)
Note the State Services Commissioner is seeking feedback from the Board on a Code of
Professional Conduct for Crown Entity Board Members (the Code).
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(b)
Note the Code does not impact any statutory provisions or limit the ability of an entity or
statutory officer to act independently.
(c)
Note Compliance with the Code is not mandatory, but the State Services Commissioner
would have the power to become involved in an investigation of a breach of the code and
advise and report to the responsible Minister.
(d)
Note the Code is broadly consistent with the way that ACC operates under the Board Code
of Conduct, ACC Governance Manual and the CE Act, and only minor administrative
changes would be required to the Board Code of Conduct and the ACC Governance Manual.
(e)
Agree that ACC wil provide a letter from the Board Chair to the State Services
Commissioner in support of the Code.
Chief Executive’s Report
Items raised by Mr Pickering were:
• Half year staff Pulse survey. High level results.
• Property updates. Hamilton (current premises and proposed new site) Dunedin (proposed new
site) and Albany (proposed new site). Discussions/next steps.
• ICIP Cabinet Paper. Progress update and next steps for Board engagement.
• NGCM technology go live. Progress update on client payments (CP) and supporting
technology for NGCM.
• Investments Team update.
• Surgical mesh briefing with Mike Tully, Dr John Robson and Simon Beattie.
RESOLVED: The ACC Board resolved to:
Note the Chief Executive’s Report.
Operational Reporting
4.1 (a) ICIP Reporting
Mr Fletcher highlighted the following from the ICIP Report:
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• November had been the best month so far for ICIP. The Portfolio was tracking well to the cost
profile and Management’s focus was shifting to benefits realisation.
• Delivery of CP2 and NGCM through a joint release process had required ACC to deliver seven
significant changes over eight weekends, with the seventh having been successfully delivered
over the past weekend:
o CP2 was running successfully. A small issue regarding file sizes would have a fix deployed
on 4 December 2019.
o The new capability for NGCM was implemented on Monday 25 November 2019 in the
Southern region. The results were significant, even after only two days.
• For HSS, the focus was on capability building to execute the strategy, and progressing ECP.
• The Investments Team’s technology issues were coming to a close. The spreadsheets issues
were now being dealt with. Remote access capability would be rolled out for the Investments
Team which was important also for business continuity.
Ms O’Connor briefed the Board on the key statistics for performance under the new capability for
NGCM over the first two days. Comparing productivity against the average from the previous
week, 12% more tasks were completed on Day 1, and 16% more on Day 2. The new tool set was
proving to be very effective for managing staff workloads.
The Board’s discussion focused on the following:
• Whether there had been any unexpected issues with the NGCM and CP2 release process, and
how well staff had kept up with the changes. Ms O’Connor described the small issues that had
arisen, and reported that nothing had prevented staff from achieving their work. She explained
the daily staff/team check-ups used by leaders to determine how to support staff. Ms O’Connor
reported confidence in the engagement with staff who needed extra support.
• Whether the standard of the result for the Investments Team would be state of the art.
Mr Fletcher explained that the focus to date had been on achieving desktop and services that
were robust and supported work requirements. Under that view, it would be as good as for
peers. The question remained as to an appropriate level of technology investment for the
Investments Team. The systems would stil rely to some extent on the in-house built
spreadsheets, so these needed to run well before other technology solutions were considered.
• The extent to which the Investment Team’s analysts accepted the changes to spreadsheets.
Mr Fletcher explained that they were relatively accepting, but there was some resistance to
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having secure boundaries on the spreadsheets. However, the analysts, including in the front
office, were positively engaged with the changes. Mr Healy reported on his recent
engagements with the front office on a longer-term technology strategy, and that9(2)(a)
would determine the next priority after the spreadsheets.
• Whether the Investments Team would have migrated off spreadsheets by year end.
Mr Fletcher explained that some spreadsheets were appropriate and would be retained, albeit
with tighter controls. Migrating off all spreadsheets was not the right target.
• Whether the reduced WC days paid targets could achieve Amber status. Mr Fletcher
acknowledged the difficulty, but confirmed Management’s confidence that NGCM and CP
would have a positive impact.
RESOLVED: The ACC Board resolved to:
(a)
Note the ICIP October 2019 Monthly Update.
(b)
Note the Investments Technology Issues Report.
4.1 (b) Operational and Financial Performance including Claims Costs
Mr Healy reported that Injury Prevention (IP) would be below target for at least the next quarter.
Ms Powell explained the reasons for the fluctuations in ROI for IP, including ACC’s investment with
WorkSafe. She described the pipeline of programmes underway. There would be a report to the
Board around March 2020 on how IP was progressing.
The Board noted that ACC could not afford to miss the IP target, especial y since ACC had
considerable control over IP, and encouraged Management to challenge WorkSafe. The Board’s
discussion focused on the following:
• Progress with the Government’s gun buyback and its costs. Mr Healy reported on a recent
conversation
• with the Head of Finance at Police, who had explained that the funding went directly to
Treasury.
• Whether Management was aware of the level of sophistication of the Police anti-terrorism unit’s
approach to social media, and what the level of communication was between Management and
Police. Ms Powell briefed the Board on her meeting with the Deputy Commissioner: National
Operations, and the communications between IP staff and Police.
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• The level of investment with WorkSafe. Ms Powell reported that it was $10-15 mil ion per year.
She explained the agreement with WorkSafe to allow it to run the investment as a portfolio
while its internal capability was developed, and that she had regular meetings with the CEO of
WorkSafe and discussed opportunities to make improvements.
• The forecast impact of use of investments cash income to cover claims costs, noting that this
reflected that ACC was not receiving enough in levies. Mr Healy reported that, although the
Ministers supported an increase to the NEA appropriation, it would not be as much as was
needed to get back to ful funding. The Board asked Management to work out how far below
New Year costs plus Pay-as-you-go the result would be. [Management reported later in the day
that the result would be $300 mil ion above Pay-as-you-go.]
Mr Healy drew the Board’s attention to the additional information relating to changes in forecast
results submitted for HYEFU compared to BEFU 2019. Board discussion focused on the following:
• The extent to which the Scheme was at a tipping point, as New Year costs were being covered
by taking the money out of investments. This needed to be better highlighted to the Board and
should be in the CEO’s Report.
• The need to present the current situation more starkly, to enable Treasury to better support
ACC. Mr Healy would write a succinct explanation for the Treasury, to highlight the urgency of
the problem.
• The extent of the un-funded cash outflow for operational performance. Mr Healy explained that,
excluding investments income, the bottom line had been negative for the last couple of years.
The Board would be updated when the Cabinet decision was made, but the forecast assumed
levies would increase in line with the Funding Policy.
• The extent to which it was appropriate to use investments income for current Scheme costs.
Mr Raubal explained that, if everything was in a steady state, investment income should be
used to meet part of the claims costs. Care needed to be taken to not confound two separate
issues—the solvency position was the key issue. The Board referred to the need to clearly
explain to Government the problem of levy income being below New Year costs.
• The extent to which the Accounts would be under or over solvency target under the new
Funding Policy. The Board agreed that Mr Healy should add further insight to the explanation
of the financial position and coverage of New Year costs. Subject to that, the Board would
agree to the release of the additional information.
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ACTION: Management to provide Board training on key accounting points of the HYEFU/BEFU.
RESOLVED: The ACC Board resolved to:
(a)
Note the Claims Cost performance.
(b)
Note the Operational and Financial Performance.
(c)
Note the additional information for October 2019.
(d)
Approve the release of section 5 (high level analysis of the key changes in forecast results
submitted for HYEFU 2019 compared to BEFU 2019) to the Treasury.
4.1 (c) Customer Dissatisfaction and Complaints Reporting – Quarter 1, 2019/20
Ms Powell highlighted the information that had been included in response to Board requests at the
previous quarterly report. Board discussion focused on the following:
• The outstanding recommendation from the OAG’s 2014 report on ACC’s management of
complaints, regarding the publishing of complaints information. The Board indicated a
preference for commencing publication of information as soon as possible. Management
confirmed that a report would be ready for publishing by the time of the March 2020 review.
• The serious impact that some of the issues highlighted in the report have had on people,
especially regarding WC payments; this was likely due to so many people living hand to mouth.
• Whether the privacy issues described in the Severity 2 complaints were included in the Privacy
Breach reporting numbers. Ms Powell confirmed that they were.
• The extent to which complaints to the Associate Minister and via other channels were captured
in the report’s statistics. Ms Powell explained that the complaints that went to Resolution
Services were captured in the statistics; the goal was ultimately to capture all complaints in one
place, to ensure complete reporting.
• Why systemic issues were not identified in the case studies. Ms Powell explained that new staff
had recently been appointed to undertake root cause analysis for reporting.
RESOLVED: The ACC Board resolved to:
(a)
Note the key insight themes, contributing factors, and actions being taken by the
organisation as outlined within the Quarter 1, Customer Dissatisfaction and Complaints
report.
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(b)
Note that there were 21 Severity two and two Severity three customer complaint cases
(including those escalated to the Customer Resolutions team and those dealt with by the
Issues Management and Media teams) during Quarter 1, and that management has taken
the appropriate actions (outlined in
Appendix 2, Board Dossier of Complaints and Issues –
Quarter 1) to address them.
(c)
Note that the three actions (outlined in Section 3.1) arising from the Board meeting in August
2019 have been actioned accordingly.
4.1(d) Privacy Assurance Dashboard – Quarter 1, 2019/20
9(2)(a)
drew the key highlights of the Report to the Board’s attention.
RESOLVED: The ACC Board resolved to:
(a)
Note that we have changed our quarterly reporting, and have not provided a Compliance
Dashboard this quarter. Metrics in the Dashboard have consistently shown a high level of
compliance, and therefore consider that it no longer needs to be brought to your attention.
However, we wil continue to monitor performance across the full range of measures and wil
raise any emerging concerns through this memo that accompanies the KRI report.
(b)
Note that we are continuing to see a reduction in the number of reported breaches from Q3
and compared to this time last year
(c)
Note that continued focus is required on two of the KRIs (number of staff completing privacy
training and breaches from a failure to follow process) to bring them within our self-imposed
target
(d)
Note that the Privacy Team’s focus is on the implementation of the NGCM, including an
increased level of visibility in all Tranche One sites and maintaining ACC’s strong privacy
culture. The KRIs focussed on breaches, and the cause of breaches wil be good indicators
of any change.
4.1(e) Quarterly Enterprise Risk and Compliance Report
Mr Raubal drew the highlights of the Report to the Board’s attention. The Board’s discussion
focused on the following:
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• The Zero Carbon Bil , noting that it created a significant strategic risk for the Fund and the way
investment is undertaken. The Board asked that the significance be reflected in the risk
register. The Chief Executive reported that a programme of work would be provided to the
Board to support the approach to the Bil , and a similar programme for taking a health and
safety position in investments.
• The target date for the target risk ratings. Mr Raubal explained that June 2020 was the target
date and that and each risk rating had a lead Executive owner. This information was shown
fully in the RAAC papers. Mr Fletcher explained the quantum and meaning of ACC’s ‘technical
debt’, and Mr Raubal assured the Board it was being managed appropriately.
• The trending down of the business interruption risk. Mr Raubal explained that this was due to a
management plan being in place for it.
• In terms of controlling the OCL, giving a higher priority to, and visibility to the Board of,
Management’s OCL Management Group. Mr Raubal explained that the Mitigation Report to
RAAC reported on the Group’s actions. However, the Group had not yet had an impact on the
trend; the RAAC would receive a report in February 2020. Mr Healy noted that the Group had
achieved a clearer understanding of what was driving the OCL. Ms Powell noted that this was
also discussed at ACC’s Quarterly Business Review (QBR) meetings.
• Whether the 25% of letters not being sent via the automated claims process had been sent via
manual intervention. Mr Tully reported on the work in place to improve the data capture, and
that people had been sent the letters where their address was known.
ACTION: Management to report to the Board on work programmes for the Zero Carbon Bil and
taking a health and safety position in investments.
RESOLVED: The ACC Board resolved to:
Note the Quarterly Enterprise Risk and Compliance Report.
Board Papers
Options for Risk-based Levying of E-Mobility Services
Ms Powell introduced the paper. She reported that each option identified in the paper required
legislative or regulatory change and that public engagement would test the appetite for levying.
The paper recommended a trip-based levy on the rider.
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The Board discussed the expectation that e-scooters in particular, and mobility devices in general,
would quickly expand into new areas, and noted the importance for ACC to position itself for this.
The Board suggested that, in Management’s engagement with policy officials, referring to the
scooter companies’ own growth trajectory information would help to highlight the likely burgeoning
of the problem. While the immediate focus was e-scooters, e-bike rentals were also on the rise.
Management would seek bike usage data from the courier companies.
The Board agreed that the preferred recommendation of the paper proposed the right way forward,
and should be pitched broadly at e-mobility devices; Management needed to ensure that any levy
data relied upon was properly auditable. Further Board discussion focused on the following:
• The fact of insurance costs being priced-in overseas, which provided a supporting argument for
levying for ACC.
• The differing degrees of responsibility taken by the various e-scooter business owners, which
could be reflected through a risk-rating type of approach to levies whereby those who, e.g.,
provided helmets, would pay a lower levy. There was also discussion on how to incentivise
good practices such as providing helmets, limiting operating hours, and speed limiters.
• The statistics for alcohol-related injuries; an alcohol levy charged to liquor companies would be
appropriate and already had a precedent in the petrol levy. Ms Powell responded that this was
something ACC was thinking about.
RESOLVED: The ACC Board resolved to:
(a)
Note that the cost of ACC claims associated with e-mobility is currently recovered primarily
via the Motor Vehicle, Earners’ and Non-Earners’ Accounts, and therefore is not contributed
to by the e-mobility industry.
(b)
Note that planned public engagement on 2021/23 ACC levy rates offers a chance to signal
possible future levying directions to ACC’s customers and the e-mobility industry.
(c)
Note that the Minister for ACC has directed ACC to work with MBIE officials on any levying
options developed.
(d)
Note that all options for levying e-scooters require changes to the current legislative or
regulatory settings. These are either:
• changes to ACC’s legislation which fall outside the scope of the regulation-making
powers exercised in the biennial levy-setting process, and which therefore require
separate consideration by Parliament, or
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• withdrawal by NZTA of the gazette notice declaring e-scooters not to be motor vehicles
(followed by a change to Schedule 2 of the ACC Motor Vehicle Account regulations).
(e)
Agree that ACC wil use the 2020 levy engagement round to test public appetite for
legislative reform to enable levying of e-mobility services.
Draft Financial Condition Report 2019
The Board took the Report as read. The Board Chair explained for the benefit of newer Board
Members that, although the Board could make suggestions, this was an independent report
produced by Mr Raubal’s team. Board discussion focused on the following:
• Whether there were sufficient recommendations from past reports to capture the investigation
of the OCL strain. Mr Raubal responded that Management had already committed to undertake
a number of actions and these were listed in the Report, including a feedback loop on them.
These promised activities seemed appropriate, so no specific recommendations were made
regarding them.
• Whether the OCL Management Group and the new outcome measures could be given greater
prominence in the report (and that the Board be given regular reporting on the progress of the
OCL Management Group).
• Whether there was any ‘sugar coating’ of the issues. Mr Raubal and 9(2)(a)
confirmed that
they had not toned down for the public audience of the Report anything that the Board needed
to know about; the report was factual.
• Whether the historical levels of levies could be shown, as against the present day, and the
impact of only a 7.5% increase in levies. Mr Raubal responded that he would look at this but
needed to ensure that the structural change (to levy for full funding) was presented correctly.
• The impact of the ‘ordinary consequences’ litigation. Mr Raubal reported that, given there was
a large range for the potential impact, he was wary of including any estimate in the Report.
• To clarify that the ‘claims prevented’ count on page 6 of the Report was an estimate.
Mr Raubal noted that he would consider the Board’s feedback for the final version of the Report
which he would provide in tracked changes to Mr May, and that if there was any significant
feedback from officials the Board would be advised.
ACTION: Management to provide regular reporting to the Board on the progress of the OCL
Management Group, including the action plan.
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RESOLVED: The ACC Board resolved to:
(a)
Note there is one new recommendation in this year’s report to develop a strategic
organisation-wide outcomes framework.
(b)
Note the predominant messages in the report are
i.
ACC’s financial position is under pressure – large impact from falling interest rates and
increasing claim volumes and costs.
ii.
Requested increases in levies and appropriations have not been approved. This is
putting extra pressure on the financial position, and is not sustainable in the long term.
iii. The organisation is focused on the delivery of better outcomes and experience for our
customers. More is needed to ensure spend is achieving outcomes for clients, at a cost
that is reasonable and sustainable for levy and tax payers.
(c)
Note the final FCR wil be sent to Treasury, MBIE and DPMC following Board review. The
FCR wil be presented to the Minister for ACC as soon as practicable following finalisation in
December.
OCL Strain Deep Dive – Performance Over the Last Five Years
Mr Raubal briefed the Board on the highlights of the paper. The Board requested that the monthly
performance report include data on claims of more than five years’ duration. Ms Powell noted that
the customer base would need to be segmented by those who were clearly serious injuries versus
those in active claims management. Mr Tully confirmed that clients who are with ACC for life are
also regularly assessed to ensure they are achieving rehab expectations.
In response to a Board query regarding the extent to which the paper guided the work of the OCL
Management Group, Mr Raubal confirmed that the Group had been involved in developing the
analysis in the report. The Board requested that Management provide an action plan for the OCL,
showing issues, actions, timeframes and the Executive lead. The plan should identify the actions
that Management had prioritised to actively work on. After discussion with Management as to the
best way to present this information, the Board agreed with Mr Pickering’s suggestion that the
information be built into the QBR reporting.
RESOLVED: The ACC Board resolved to:
Note the information in this paper on the drivers of the five years of OCL strain.
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5.4(a) Integrated Service for Sensitive Claims (ISSC)
Mr Tully introduced the paper. Board discussion focused on the following:
• The extent to which funding levels were sustainable for providers, balanced against ensuring
providers did not make super-profits. Mr Tully responded that providers had high workloads,
but he was confident there was no manipulation of the system.
• Whether, given the level of underreporting of sensitive claims, the forecast growth of 14% was
accurate. Mr Tully noted that the numbers were based on the information available, but future
budget setting would carefully forecast the growth of the portfolio.
• The extent to which client satisfaction data could be built into the contract. Ms Powell explained
that often the suppliers were NGOs who did not have the capacity to provide that information.
However, better measures of trust and confidence between provider and client, and client
outcomes, were being sought for the service and ultimately to be added to the contract.
• Whether high caseloads for staff had been addressed. Ms Powell responded that, under
NGCM increased FTE had been put into sensitive claims throughout the country. In order to
deal with the stress of the role, special provisions were in place for these staff.
RESOLVED: The ACC Board resolved to:
(a)
Note that the Integrated Services for Sensitive Claims (ISSC) contract has been in place
since 2014, and that since that time the context this service operates in has changed.
Significant changes include the formation of the Family Violence and Sexual Violence Joint
Venture, increased emphasis on prevention efforts, changes in the external climate and
significant growth in claim numbers by an average increase of 25% per annum.
(b)
Note that ACC has exercised all right of renewals on the current contract which expires in
November 2020.
(c)
Approve a new ISSC contract, in order to ensure continuity of service while ACC positions
for changes in the strategic environment, for an initial period of two years and seven days
from 24 November 2020 to 30 November 2022, with two rights of renewal of one year each
(2+1+1).
(d)
Note that the Whole of Life Cost (WoLC) of the service is estimated to be no more than
$514.1 mil ion for the period 24 November 2020 to 30 November 2024.
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(e)
Note that the OCL impact due to contractual improvements is estimated at no more than $70
million
.
(f)
Note that Board approval is required due to WoLC being above the authority level delegated
to the Chief Executive.
(g)
Note that, instead of tendering the new service, the new ISSC contract wil be offered to
incumbent suppliers, once due diligence is completed, and opened to new suppliers where
service gaps have been identified, in accordance with the Government Procurement Rules
and ACC procurement policy.
(h)
Note that ACC procurement policy states that where an exemption from or opting out of
applying the Rules does not apply, approval is required by the delegated authority, being the
Board.
(i)
Approve the new contract on the basis that no exemption from or opt out of the Government
Procurement Rules (the Rules) can be applied to the proposed procurement approach.
(j)
Delegate authority to the Manager Health Procurement and Contracting to approve:
i. the issue of contracts to successful incumbent suppliers at the conclusion of due
diligence activities;
ii. the Recommendation to Select and subsequent contract award, as a result of the open
application process for service gaps during the term of the contract.
5.4(b) Clinical Services Contract Renewal
Mr Tully introduced the paper, noting that the purpose of the changes was to make it simpler for
stakeholders. The Board acknowledged the logic of rol ing six contracts into one, but queried how
commissioning for outcomes under the HSS was included. Mr Tully explained that there was some
crossover between Clinical Services and ECP. After further questioning from the Board, Mr Tully
agreed that ACC would get commissioning for outcomes in this contract.
RESOLVED: The ACC Board resolved to:
(a)
Note that the current contract for Clinical Services expires on 30 June 2020.
(b)
Note that feedback from stakeholders indicates that having multiple versions of the Clinical
Services contract is administratively burdensome and that contract consolidation wil make it
is easier for both ACC and contract holders to manage.
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(c)
Approve a new Clinical Services contract commencing 1 July 2020 for an initial three-year
term with two rights of renewal of two years each (3+2+2).
(d)
Note that the Whole of Life Cost (WoLC) of the service including renewals is $793.4 mil ion.
(e)
Note that Board approval is required due to WoLC being above the authority level delegated
to the Chief Executive.
(f)
Note that the current contract for Clinical Services consists of six contract versions, with
approximately 300 unique contract holders.
(g)
Note that a fixed term trial of a Sports and Exercise version of the contract wil end on 30
June 2020, and any relevant review findings wil be incorporated into the new contract.
(h)
Note that scope changes are not proposed for the contract at this stage.
(i)
Note the current
Clinical Services contract is open and wil remain open so new suppliers
can apply at any time during the life of the contract.
(j)
Note that it is planned to undertake incumbent supplier due diligence checks in early 2020
prior to awarding new contracts to those suppliers that pass.
(k)
Note the term of the Clinical Services contract aligns with the Elective Surgery Contract and
Escalated Care Pathways programme. This wil ensure we can apply learnings from the
Escalated Care Pathways programme at the appropriate stages of contract renewal.
(l)
Note the proposed new Clinical Services contract has no material impact on the Outstanding
Claims Liability, Levies or the Non-Earners’ appropriation.
(m)
Note that the proposed tender process is compliant with the Government Procurement Rules
and ACC’s Procurement Policy.
5.4(c) Vocational Rehabilitation Service – Return to Market and New Contract
Mr Tully introduced the paper, noting that ACC was undertaking an evaluation to ensure it was
getting the right outcomes through the service, which was likely to result in some negative
response from providers. The Board’s discussion focused on the following:
• Why there had been problems with the last procurement process, and how the new model was
being benchmarked against best practice. Mr Tully explained the past problems with the
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process and that these had been resolved for this round. He confirmed that the sector would
be involved in the co-design of the new contract.
• The extent to which individual provider performance was being monitored. Mr Tully responded
there were currently no individual performance measures against providers but that HSS
technology improvements would enable this, including the ability to provide feedback to
suppliers as to how they compared with others.
• The factors behind the forecast savings of $44 million. Mr Tully explained that this related to
changing the gateway into the service, and Mr Pickering added that part of it was also a
change to the business model. The Board noted that paragraph 6.2 of the paper should have
attributed the savings partly to the contract and partly to the change to the gateway change.
• Management’s proposals for ameliorating provider unrest. Mr Tully explained that he and
9(2)(a)
would engage with providers, and that providers would have input into the co-
design of the contract.
RESOLVED: The ACC Board resolved to:
(a)
Note that the current contract for Vocational Rehabilitation Services (VRS) has been in place
since 29 August 2017 and is due to expire on 31 August 2020.
(b)
Approve a new VRS contract commencing 1 September 2020 for an initial term of three-
years, plus two rights of renewal, each for one year (3+1+1).
(c)
Note that the Whole of Life Cost from 1 September 2020 to 31 August 2025 for this service is
estimated at $403.25M.
(d)
Note that Board approval is required due to WoLC being above the authority level delegated
to the Chief Executive.
(e)
Delegate authority to the Head of Provider Service Delivery (PSD) to approve the
recommendation to select and award contracts, following an open tender process.
(f)
Note the proposed new VRS contract has a $23M positive impact on the Outstanding Claims
Liability, Levies or the Non-Earners’ appropriation.
(g)
Note that the proposed tender process is compliant with the Government Procurement Rules
and ACC’s Procurement Policy.
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5.4(d) Health Sector Strategy Update
Mr Tully took the Board through the HSS presentation. Board discussion focused on the following:
• The disparity that Mr Tully had referred to, between those in the consortium who wanted
technology funding and those that did not. Mr Tully explained that four of the consortia were on
the same platform, while the two large ones were on their own separate platforms.
• The extent to which the project was being driven by ACC employees. Mr Tully explained that
the role of contractors was limited to rallying the thinking and providing validation.
• The cost savings and reporting for HSS under ICIP. Mr Tully confirmed that reporting would
come through the HSS Advisory Committee and up to the Board, and that it would be clear well
before the end of the financial year if the targets were at risk; there was no expectation that
HSS benefits would increase beyond the forecast $75 mil ion.
• The meaning of ‘regularisation’ in the slides, and the savings attributed to it. Mr Tully explained
that it related to savings on home and community support following the pay equity deal. Further
information would be provided to the Board on this.
• The reduced results of the HTI Proof of Concept (POC) and the questions this raised regarding
Gravel Road’s modelling for the POC. Mr Tully explained that, although it was not clear why,
GPs were under-utilising the service. Mr Tully explained that the Board had previously
approved the rollout of the model to eight further providers, but Management was unwil ing to
undertake the rollout until the benefits realisation was achieved, and that was looking unlikely.
He reported on the improved access for Māori and Pasifika under the POC, and that, although
it was much less than projected, the POC still generated benefits of $2 mil ion per annum. After
further discussion, Mr Pickering proposed a reframing of the issues, e.g., the POC might be
rolled out only in Auckland. The Board suggested that the POC needed to lead to better
outcomes.
ACTION: Management to provide an explanation for the Board of the poor results with the HTI
POC.
RESOLVED: The ACC Board resolved to:
Note the Health Sector Strategy update.
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Falls and Fractures Business Case
Ms Powell explained the background to the funding request, supported by 9(2)(a)
who was
calling in from Australia. Board discussion focused on the following:
• The extent to which ACC had invested money with the DHBs without being involved in the
control mechanisms. Ms Powell confirmed that ACC’s involvement related to partnering with
DHBs to build system-level/population-level measures. Some DHBs had finished the
programme. Management was now asking the Board to agree to extending the programme to
enable all DHBs to go through to the end. This was not a straightforward IP investment, as
ACC was not in control. The Board cautioned Management to probe beneath the data DHBs
were providing regarding their success rates.
• The extent to which the programme should be focused solely on DHBs. 9(2)(a)
explained
the DHBs’ role being to coordinate services across stakeholders at the local level, creating
cross-sector alliances. He explained that the Australian Injury Prevention Conference he was
attending had a dedicated workstream on falls and fractures and that the current collaborative
cross sector approach seemed to be the best investment.
• The difficulties of making a system-level change. The Board noted that Appendix 3 to the paper
showed the quantum change that had already been achieved in how DHBs were managing
falls. Since only another few months were required to obtain the necessary data, on balance it
made sense to continue. Moreover, ACC would lose credibility if it dropped out now, and
particularly for this older demographic for whom the consequences of a fall were so high.
RESOLVED: The ACC Board resolved to:
(a)
Note falls and fractures in people over the age of 65 cost ACC $195m PA (up 47% on 2013),
and the annual cost of claims is growing faster than population growth for this cohort.
(b)
Note that in 2015, ACC entered into a partnership with Ministry of Health (MoH), Health
Quality & Safety Commission (HQSC) and health system leaders to collectively resource the
design, establishment and delivery of an evidenced-based falls and fracture prevention
system targeting over 65-year-olds.
(c)
Note that in 2016, the Board approved a 3-year, whole-of-life investment contribution of
$31.7m in the Live Stronger for Longer Falls and Fracture Prevention Programme; $27.2m of
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which has already been invested in the following areas, with the remaining approved
investment contractually committed.
(d)
Note the 2016 investment case forecast claims savings of $80.6m ($2.36 ROI) by year 10.
(e)
Note unexpected delays in some health systems/DHB’s commencing the Live Stronger for
Longer Programme mean we are no less than 9-months behind where we expected to be in
terms of system maturity.
(f)
Note that ending the Live Stronger for Longer Falls and Fracture Prevention Programme now
wil limit claims savings to $43m ($1.10 ROI) due, in a large part, to health systems/DHB’s
not being able to sustain the current level of falls prevention services provided across local
health systems without continued ACC investment.
(g)
Note additional investment of $7.3m between now and 31 December 2020 wil enable the
Live Stronger for Longer Falls and Fracture Prevention Programme to increase forecast
claims savings to $63m ($1.34 ROI), determine whether the system established can be
transitioned to a sustainable delivery state that is materially less dependent on ACC, and
assist in making a more informed decision on the future of the Live Stronger for Longer
Programme and related health system partnership.
(h)
Note that the Live Stronger for Longer investment and resulting system wide collaboration is
providing valuable insights and learning that wil improve ACC’s ability to drive whole-of-
government and strategic injury prevention programmes that “address the barriers to long-
term, sustainable reductions in injury and severity across the life course” by influencing “at a
system level”.
(i)
Note that the success of Live Stronger for Longer is dependent upon the wil ingness and
ability of local health systems/DHB’s to deliver on our requirements. DHB’s have indicated
they are wil ing and able to continue participating in the programme provided ACC continues
to invest.
(j)
Note that Injury Prevention believes it can off-set the impact of reducing the Live Stronger for
Longer ROI from $2.36 to $1.34 and achieve Injury Prevention’s 2019-20 ROI target.
(k)
Note that Board approval is required in accordance with Corporate Delegations Schedule B,
as the whole-of-life investment exceeds $30 mil ion.
(l)
Approve $7.3m additional investment to continue delivery of the Programme until 31
December 2020.
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Tenzing Contract
Mr May noted the conflict he had raised at the start of the meeting. The Board Chair suggested he
participate in the discussion but not vote on the Resolution.
Mr Fletcher briefed the Board on the proposed changes to the contract. He confirmed to the Board
that there were no risks that needed to be drawn to the Board’s attention. In response to a Board
query, Mr Fletcher explained that Tenzing’s work for ACC was so unique to ACC that there was no
real opportunity to monetise the intel ectual property.
RESOLVED: The ACC Board resolved to:
(a)
Approve the execution of the new Service Schedule for the value of $55.5 mil ion for the
duration of the new Schedule (an initial term of three years with a right of extension for two
further periods of three years each), if both rights are exercised.
(b)
Approve Variation 2 to the Master Services Agreement dated 04 August 2016 which
changes the per claim aggregate limit to align with ACC standards.
(c)
Note that Legal Services has reviewed the new Service Schedule and the amended Master
Services Agreement.
(d)
Note that approval for the revised Service Schedule is required from the Board because the
whole of life cost exceeds the Chief Executive’s delegations.
(e)
Delegate authority to the Chief Executive to sign the new Service Schedule.
Hamilton Consolidated Accommodation Approval
Mr Healy introduced the paper and reported on his meeting the previous day with a representative
from Tainui Group Holdings. The meeting had indicated Tainui’s commitment to the deal, and it
appeared that resolution of the rent review mechanism was close. Mr Healy referred the Board to
the hardcopy design concept that had been distributed.
Board discussion focused on the following:
• Whether there had been external assurance / probity on the development proposal—there had.
• Who was handling the deal on the Investments side—9(2)(a)
for both Hamilton and Dunedin.
Due to the information barriers operating under the probity arrangements, no announcement
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would be made yet. 9(2)(h)
• The risk to ACC if the development was delayed—there was no financial risk (it rested with the
developer). However, ACC did need the rental space.
• The reasons for the reduction in rental area under the matured proposal, as compared to the
draft the Board had seen in August 2019—Mr Healy explained that there was flexibility in the
design, in that an additional wing may be added to the build. Mr Pickering added that ACC’s
current use of space was not efficient, and the new build better utilised the available space.
• Whether clients would be coming to the building for appointments, and if so, whether there
were sufficient carparking spaces—Mr Pickering confirmed that clients would come to the
building and that there would be challenges, especially for staff, given the smaller number of
carparks by comparison with the current Te Rapa site (which had an unusually large number of
carparks). Offsetting the reduced number of carparks was the central city location of the build.
• Whether ACC had a person on the ground micro-managing the details of the build—it did.
• Ensuring the partnership with Tainui was represented in the final design and fitout.
• The strategic importance of the decision for ACC in undertaking the project.
The Board acknowledged the work of Mr Healy and the Property Team in achieving the outcome.
RESOLVED: The ACC Board resolved to:
(a)
Note that on 29 August 2019 the Board approved for the Project Team to enter final
negotiations with the intention of entering into a Development Agreement with Tainui Group
Holdings [Tainui] for the supply of a new-build leased accommodation solution in Hamilton;
(b)
Note that a commercial position has now been agreed with Tainui and the financial
delegation levels require ACC Board approval, based on the whole-of-life-costs;
(c)
Note that the key commercial terms are:
i. 8,500m2 of office area leased, with a further 387m2 available on the ground floor for
private retail tenants such as a café and/or health-related providers;
ii. 9(2)(ba)(ii)
;
iii. 9(2)(ba)(ii)
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9(2)(ba)(ii)
9(2)(ba)(ii)
9(2)(ba)(ii)
9(2)(ba)(ii)
9(2)(ba)(ii)
9(2)(ba)(ii)
9(2)(ba)(ii)
Gross rent per annum
9(2)(ba)(ii)
Gross rent / m2
9(2)(ba)(ii)
Seismic standard
45 – 70% NBS**
~133% NBS
+63% - +88% NBS
**
45% planned to be remediated to 80% in near term
(i)
Note that there is signing ceremony of the Development Agreement provisionally booked for
17 December 2019 in Hamilton, and that there is expected to be VIP and media interest in
the announcement;
(j)
Approve the existing two delegated Board members to resolve any final negotiation matters;
and
(k)
Approve the delegation to execute the Development Agreement to the Chief Executive,
expected to be done in conjunction with Tainui on 17 December 2019.
Performance Reports
Health, Safety and Wellbeing Report
Mr Mil er chaired this Item, as the Board Chair had to leave the room. Ms Champness highlighted
the section in the Report on ACC’s HS&W innovation fund. 9(2)(a)
briefed the Board on the
applications that had been made for grants from the fund and indicated the range of ideas that
would be funded, noting the strong cultural elements that supported diversity and inclusion.
RESOLVED: The ACC Board resolved to:
(a)
Note progress toward becoming a leader in heath, safety and wellbeing.
(b)
Note there were no notifiable events in October 2019.
(c)
Note the health, safety and wellbeing performance indicators.
Legal Report and Policy Update
(a)
Legal Report – LEGALLY PRIVILEGED
The Acting General Counsel reported on progress with the
Larkin and
Ng cases. The Board
discussed the backlog of District Court appeals awaiting a hearing, and encouraged Management
to ensure everything possible was being done to resolve the issue. The Board agreed with
Ms Roche’s suggestion to add the issue to the Weekly Report to the Minister, to bring it to his
attention. Ms Simmonds would report further to the Board on strategy for dealing with the backlog.
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RESOLVED: The ACC Board resolved to:
(a)
Note the legal team is reviewing recent or proposed legislation that potentially impacts on
ACC.
(b)
Note the Court has reallocated the February hearing date in Ng (treatment injury) and the
parties are seeking another date.
(c)
Note the increasing backlog in the District Court due to insufficient judicial resources and the
resulting access-to-justice concerns.
(b)
Policy Update
Ms Roche briefed the Board on a recent meeting with the Minister regarding the future of
ambulance services. She reported that there would be no radical changes.
The Board discussed with whom (NASO or the MoH) the funding and service agreement should
be. There was also discussion about the governance arrangements with NASO, and ACC’s limited
ability to influence outcomes through those arrangements, particularly since the reporting line was
to the MoH. The Board encouraged Management to keep asserting ACC’s voice on NASO.
There was discussion about St John Ambulance’s response to the review of its performance.
9(2)(a)
explained that ACC had very limited influence in the day to day operations of the service;
ACC monitored the KPIs and service expectations of providers. However, the service was too
important to fail, so there were limited options for ACC when KPIs were not met. The Board noted
that a new Chair with financial qualifications was being appointed to the St John Board and that
this was likely to support improvements. The Board encouraged Management to arrange a
meeting with the new Chair to talk through service improvements.
Ms Roche briefed the Board on the other matters covered in the Policy Update, particularly with
respect to the Public Service Bil . Ms Roche would provide written advice to the Board on the
changes that had been made to the Bil .
RESOLVED: The ACC Board resolved to:
Future of ambulance services and proposed Budget 2020 bid
(a)
Note that the Minister for ACC and Minister of Health met on 13 November 2019 to discuss a
first-principles approach to the future of ambulance services.
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(b)
Note that Ministers requested advice about initiatives that wil address known risks,
particularly to improve integration within the health and emergency systems, rather than
large-scale structural reform in the first instance.
(c)
Note that Cabinet has agreed to the release of $8.6 mil ion, for the first of three tranches of
sustainability funding for road ambulance providers.
(d)
Note that the release of further sustainability funding to road ambulance providers wil be
subject to St John delivering and following a financial and performance delivery plan.
(e)
Note that, on 19 November 2019, Management sought the Board’s in principle endorsement
for the ACC portion of a joint Ministry of Health and ACC Budget 2020 bid for St John and
Wellington Free Ambulance.
(f)
Note that, on 20 November 2019, Board members requested further information about the
impact on the Levied Accounts.
(g)
Delegate authority to the Board Chair, Dr Batten and Mr May, or to the Board Chair and one
or two other Board Members (as determined by the Board Chair) to make decisions through
the Budget 2020 process on issues related to the funding and future direction of ambulance
services, should out of cycle decisions be required.
Other proposed Budget 2020 initiatives
(h)
Note that Management wil work with the Ministry of Health on the implications for ACC of
several of their Budget 2020 bids, where consistency across the ACC and public health
systems may be required, including consideration of Non-Earners’ Account and Levied
Accounts impact.
(i)
Note that MBIE has recommended that the Minister for ACC submit Budget bids for those
Ministerial priorities for legislative change that have identified cost impacts on the
Non-Earners’ Account, and Management wil also consider Levied Accounts impacts.
(j)
Note that the Budget bids recommended by MBIE wil be subject to later decisions on the
Government’s 2020 legislation programme, and on the specific policy proposals, and would
likely not have cost impacts until Budget 2021.
Regulated payments to treatment providers
(k)
Note that Cabinet has agreed to consult publicly on proposed changes to regulated
payments to treatment providers, and that MBIE intends to conduct this consultation between
22 November and 13 December 2019.
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Cross-government reviews and initiatives
(l)
Note that the National Strategy for eliminating violence – te Hau Tangata – wil be lodged for
Cabinet consideration in December 2019.
(m)
Note that the Public Service Legislation Bil was introduced on 18 November 2019, and
several changes have been made to the Bil that reflect ACC’s previous feedback to the
State Services Commission.
(n)
Note that work is underway to assess the implications of the Climate Change Response
(Zero Carbon) Amendment Act as it affects ACC.
(c)
Health and Disability Review
Ms Roche briefed the Board on the background to the paper, including the work that had been
done across ACC as il ustrated in Appendix 1 of the paper. The Board considered the extent to
which the options set out in Appendix 1 might be discussed with the Review Secretariat. The
Board’s discussion focused on the following:
• The extent to which the Working Together option would be appropriate and would allow
customers to go from one part of the system to another without barriers. Although it appeared
appealing on its face, the Board noted that ACC’s approach to buying quality products may
conflict with constraints on actors in the rationed health system.
• Regarding the Joint Purchasing option, whether removing the Commerce Act barrier would
have solely upside consequences. The Board queried whether ACC obtains drugs at the
subsidised price, and suggested that this be confirmed to inform decision-making if ACC were
to go further into these options. None of the options should be pursued without further
information; even the apparently innocuous proposal of having a single shared assessment for
clients may be problematic, as ACC would need to be able to trust the thoroughness of an
assessment undertaken by another agency, when ACC’s purposes would often be very
different.
• Regarding the Case Study (
c.60 children per annum with neo-natal encephalopathy) and how
that might operate under the options in Appendix 1, the Board expressed concerns about the
likelihood of ACC being expected to fund the increased services that would be provided for the
non-ACC funded children. A similar concern arose in respect of the Joint Funding option.
The Board requested more analysis of risks and benefits before a decision could be made on its
risk appetite for pursuing any of the options. Ms Roche explained the tight timeframe, with Board
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decisions being required by February 2020 at latest. After further discussion about whether
undertaking cost benefit analysis of the options would be an efficient use of time, it was agreed to
instead change the conversation with the Secretariat to a discussion of how ACC could collaborate
on commissioning for outcomes and IP.
RESOLVED: The ACC Board resolved to:
(a)
Note that ACC is developing future-focused approaches to prevent injury and provide
rehabilitative services that can be shared with the Health and Disability Review.
(b)
Note that Management wil signal to the Health and Disability Review ACC’s wil ingness to
work with other health sector entities on developing shared approaches to commissioning for
outcomes and prevention initiatives.
Board Administration
Minutes of Meeting held on 31 October 2019
APPROVED: the ACC Board approved the minutes of the meeting held on 31 October 2019,
subject to the following changes being made:
• Omitted Procedural Business Items (Apologies and consideration of the Register of Members’
Conflicts of Interest) be included.
• 9(2)(h)
• The final sentence of Item 3.1 ACC Engagement Strategy: delete the word “
each” and change
the word “
build” to “
built”, so that the sentence reads:
The Board expressed that the Team had
the Board’s support, particularly in ensuring that the foundation of the strategy was built first,
and asked that the Board’s feedback on provider and business be taken on board”.
• Management Actions be added to Items:
o 3.1 ACC Engagement Strategy: Management to ensure that future reporting to the Board
incorporates ROI into the KPIs; and
o 3.3 Accredited Employers Programme Redesign: Management immediately explore
means to escalate poor audit performance to Boards and Governance Committees.
Schedule of Matters Arising
The Board
noted the Schedule of Matters Arising.
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Confirmation of Decisions Made Out of Cycle
RESOLVED: the ACC Board resolved to:
Confirm the one decision made out of cycle for the period of 25 October 2019 to 21 November
2019.
Annual Work Programme
NOTED: The ACC Board
noted the annual work programme.
General Business
There was no General Business.
Confirmation of Next Meeting
To be held via video/audio conference on Thursday, 19 December 2019 at 9.00 am.
Closure
The meeting closed at 5.15 pm.
Approved
Chair ………………………………………………………….
Date ………………………………
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