Key NHS Publications - September 2023
Introduction
MIAA is a member of the Internal Audit Network (TIAN) which comprises the eight NHS internal audit consortiums and in house teams operating in England. These organisations collaborate across a number of areas to leverage their collective knowledge and expertise and drive efficiency and effectiveness. The monthly insight report highlights key publications and is intended as a useful update and reference tool. This report is produced by TIAN and shared by MIAA.
HFMA briefing: financial sustainability – understanding the terms used
This HFMA briefing looks at why financial sustainability is so important, what the options are for individual organisations and systems, how it is achieved.
2023/24 is expected to be a difficult financial year for NHS bodies. There are many ways that the response to this challenge is discussed and some phrases, such as financial sustainability and productivity, are being used more often.
However, there is inconsistency in the language used, particularly in relation to efficiency, productivity and value. This can be a problem when discussions include clinical colleagues, wider organisations and systems.
This briefing is intended to provide definitions for some of the more commonly used terms. It is intended as a reference document for finance teams and their stakeholders when required to establish a common understanding and consensus. Read more
For information
System risk management: Key considerations for evolving arrangements – HFMA briefing
Integrated care systems (ICSs) are developing their approach to system risk management following the enactment of the Health and Care Act 2022. NHS organisations and their partners are working to understand system risks, accountability and the impact on partnership decision-making.
The fundamentals of good risk management are the same for both organisations and systems. But system risk management is more complex in that it requires partners to align their strategic understanding, risk appetite and risk management processes.
This joint briefing from the Good Governance Institute (GGI) and the HFMA aims to support systems as they work on system risk management. It includes two case studies and sets out the key challenges, opportunities and considerations involved in effective system risk management. Read more
For consideration within systems
HFMA briefing: Charity regulators – update for NHS charities (August 2023)
This paper provides an update on recent guidance from the three charity regulators and other relevant bodies. It identifies guidance that may have an impact, or relate to, the financial management and governance of NHS charities. The update is based on the information that is available from their websites.
This paper provides an update on recent guidance from the three charity regulators and other relevant bodies. It identifies guidance that may have an impact, or relate to, the financial management and governance of NHS charities. The update is based on the information that is available from their websites. Read more
For information and application as required
Urgent and emergency care winter incentive – operational measurement guidance
The NHS winter letter published on 27 July introduced the incentive scheme for providers with a Type 1 A&E to achieve even better performance over the second half of the year in return for receiving a share of a £150 million capital fund in 2024/25. Read more
For information and action as appropriate by providers
Changes to cancer waiting times from 1 October 2023
An update has been provided on changes to cancer waiting times standards that have been agreed between NHS England and the Department of Health and Social Care (DHSC), and which will come into effect from 1 October 2023. Read more
For information
Operational Pressures Escalation Levels (OPEL) Framework 2023/24
This framework aims to provide a unified, systematic and structured approach to detection and assessment of acute hospital urgent and emergency care (UEC) operating pressures; provide a consistent framework for the proportional representation of each acute trust hospital’s OPEL score toward the corresponding integrated care system (ICS), NHS England regions, and NHS England nationally; provide guidance to acute hospital trusts, ICS and NHS England regions that supports an effective, integrated and coordinated response to acute trust operational pressures and provide guidance on the alignment of, and interaction between, the OPEL Framework 2023/24 and the national Emergency Preparedness, Resilience and Response (EPRR) framework. Read more
For information
NHS enforcement guidance
This guidance outlines how NHS England intends to exercise its enforcement powers for both integrated care boards (ICBs) and providers, by setting out how it would use these powers to direct an ICB and the licence enforcement mechanisms that apply to foundation trusts, NHS trusts, licensed independent providers of NHS services and licensed NHS controlled providers. It explains the regulatory and statutory processes in the event of enforcement action and the subsequent rights of appeal. Read more
For information
Creating better health value: understanding the economic impact of NHS spending by care setting
The NHS Confederation has produced a report exploring which of a range of care settings can deliver the most economic output when funding is increased. It examines local variations in NHS spend and identifying which of a range of care settings can deliver the most economic output when their funding is increased, including acute, primary, community and mental health care. This differentiation is increasingly important, with the Hewitt review making clear that ‘health value’ is a core part of embedding long-term strategic change and the shift to prevention. Read more
For information
The state of integrated care systems 2022/23: Riding the storm
This NHS Confederation (CF) report examines the progress that local systems have made, and opportunities for further development.
The report shows that ICSs have got off to a strong start in a difficult operating environment – one that has been marked by one of the most challenging winters on record, rising demand for care, a cost-of-living crisis, ongoing industrial action, and reductions in the running costs of ICBs that materialised just seven months into their existence as statutory bodies.
This report makes a number of recommendations to policymakers in government and national bodies:
- Social care workforce plan: The CF welcome the NHS Long Term Workforce Plan and call on the government to demonstrate its commitment to supporting the social care sector by developing an equivalent plan for the social care workforce.
- Capital spending review: The CF support the government’s commitment to reviewing the entire NHS capital regime in response to the Hewitt review. They call on the government to include in this review the amount of capital funding as well as the complex allocation process, which is resulting in delays in accessing funding that could be used to enhance productivity.
- New commissioning functions: NHS England (NHSE) should work closely with ICBs to ensure that they have access to the data and the capacity they need to effectively discharge their new commissioning functions and responsibilities.
- Devolve to evolve: CF encourage the government and NHSE to commit to their intention to set a small number of core targets based on outcomes and to give ICSs the autonomy to innovate in how they deliver against these targets.
- Co-production: CF support a shift whereby co-production of national policy and guidance with ICSs becomes the norm, reflecting the planned changes to NHS England’s operating model. This should help to ensure that the support provided through NHSE’s regional and national teams is aligned with what ICSs need.
Read more
For information
Disclaimer: This briefing paper is intended to highlight recent developments and issues within the NHS that may be of interest to non-executive directors, lay advisers and NHS managers and teams working in the NHSE. It is not exhaustive, and TIAN cannot be held responsible for any omission.
