HSE audit finds no client signature on 301 homecare invoices from private companies

The audit in September assessed the HSE’s oversight of outsourced homecare hours.

An internal HSE audit of homecare in Cork and Kerry found no client signature on 301 invoices submitted by private companies under contract to the HSE despite a requirement for this to happen.

The audit in September assessed the HSE’s oversight of outsourced homecare hours. It also criticised the lack of formal review meetings between the local HSE and private providers.

The documents show non-pay expenditure in Cork and Kerry for homecare came to €13.2m in 2021. During January to May last year, this came to €4.7m.

Invoices should be signed by the homecare client to confirm the visit took place.

“Proof of service delivery by means of a signature from the client or their representative is not currently in place, with the requirement suspended during the Covid-19 pandemic,” the report states.

The workaround involved declaration letters from senior staff. Four of six invoices reviewed for this had the letters attached. Local HSE offices were asked to ensure private companies get this client sign-off.

Invoice verification

All invoices are processed in either Tralee or Cork city, but the audit found these sites have two different invoice verification processes.

The team found this means there is a risk private companies could be paid for unapproved hours.

Creation of a standard process was recommended and to be implemented once a long-standing vacancy at the Cork office was filled.

In terms of broader oversight, the audit team found regular formal review meetings have been replaced by informal online meetings, where no minutes are kept. This creates a risk the HSE is unaware of potential problems, the audit states.

The audit, released to the Irish Examiner under the Freedom of Information Act, recommends formal meetings should begin “as a matter of priority”.

It adds: “All review meetings held should have a formal agenda and be documented and minuted.” 

Invoices audit

Meanwhile, an internal HSE audit of Tusla Mid-West found one-quarter of invoices assessed had a purchase order created after the invoice date among other issues.

This agency delivers care across Limerick, Clare, and Tipperary.

The audit had a narrow focus on one element of procurement, asking whether the Tusla Financial Regulation 01 Purchase to Pay was being followed.

Among a sample of 20 invoices from 2021, amounting to a total of €260,912, the audit team found just one had evidence of receipt of services or goods. They were told this was because of the cyberattack in May of that year.

The four invoices where purchase orders were later created amounted to €52,691, and a further two showed no evidence of an appropriate procurement process, coming to €35,000.

Managers were recommended to make staff aware of procurement rules. Managers were also asked to review the processes and find out why these errors were happening.

The internal audit was carried out last August.