TIAN News - Autumn 2023

Introduction

Welcome to our sixth edition of TIAN News. This edition spans another wide range of articles on important risk and governance issues, including:

• The outcome of a comparison of NHS Board Assurance Frameworks identifying a number of areas requiring further focus.
• Results of a recent IIA survey on the current and emerging risk landscape facing all organisations.
• Case studies on value-adding audit work relating to key risk areas, including learning lessons arising from the recent Pandemic and the safe management of Oxygen Cylinders.
• Plus briefings and guidance regarding compliance with recently updated NHS standards over Pre-Employment Checks, and developments soon to impact on all Procurement activity.

Louise Cobain, Executive Director of Assurance, MIAA.

 

NHS Board Assurance Frameworks (BAF)

MIAA recently published a new ‘Insight’ briefing providing information to help audit committees review their organisation’s approach to the BAF. An efficient and effective Board Assurance Framework (BAF) is a fundamental component of good governance, providing a tool for the Board to identify and ensure that there is sufficient, continuous and reliable assurance, organisational stewardship and the management of the major risks to organisational success.

Horizon Scanning - Institute of Internal Auditors (IIA) ‘Risk in Focus’ 2024

Risk in Focus is an annual thought leadership research project undertaken by the European IIA which analyses the top risks faced by organisations across Europe covering all sectors. It is a barometer of what Chief Audit Executives (CAEs) and others perceive as their organisations’ risk priorities for 2024 and beyond, and designed to be a reference tool to inform both internal auditors and audit committees.

This year’s Risk in Focus 2024 involved a collaboration between 16 European Institutes of Internal Auditors, spanning 17 countries including the UK and Ireland - the highest number of European countries involved so far. The survey elicited 799 responses from CAEs across the continent. The report was also informed by five roundtable discussions organised with 46 CAEs on each of the key risk areas covered in the report, plus 11 one-to-one interviews with subject matter experts that included CAEs, Audit Committee Chairs and industry experts to provide deeper insights into how these risks are manifesting and developing.

NHS Procurement Briefing: A fundamental change in approach?

Procurement is a key function within every organisation – and these are busy times for all public sector Procurement teams. To highlight this, Heather Tierney-Moore, Chair of NHS Supply Chain, asked in an article last year: “When was the last time your board discussed procurement and its role in your strategy for improving health outcomes?”

 

Learning from the COVID-19 Epidemic and Trusts’ Preparations for the National Public Inquiry

This article summarises the results of ASW Assurance (ASW) reviews of NHS provider Trusts’ response to the COVID-19 pandemic which has been undertaken across a number of their clients.

ASW has developed and undertaken work to assess the impact and effectiveness of our NHS provider Trusts’ response to the exceptional arrangements implemented during the pandemic, including identifying lessons learnt ahead of publication of the national Public Inquiry’s results. ASW’s internal audit specialists considered key issues within 3 important areas with the scope tailored for each client based on their particular needs and number of audit days available.  

Audit Case Study: A picture tells a thousand words - presenting audit findings visually

The Audit Yorkshire (AY) team recently delivered audit assurance over the management and storage of Oxygen Cylinders at one of their NHS Trust clients.

On 6th January 2023 NHS England issued all providers with best practice guidance on the “Safe use of Oxygen Cylinders” via the Patient Safety Specialist and Emergency Preparedness, Resilience and Response (EPRR) Networks. This was followed by a Patient Safety Alert Notice, which was issued on 10th January 2023 regarding “Use of Oxygen Cylinders where patients do not have access to medical gas pipeline systems”. AY considered both these documents as part of a recent audit at one of their NHS provider clients – and also included a physical inspection at the Trust’s main hospital to confirm how well it stores oxygen cylinders across the site.

Audit Case Study: Permits to Work

Permits to work form part of an essential safety culture and are given to contractors once they have been inducted and provided with relevant safety information. The permit process is there to ensure that contractors and relevant Trust personnel maintain safe practices while completing works and that the Trust knows which contractors are working onsite, where they are working and that necessary safety controls are in place. The permits to work should be issued by authorised persons and/or project managers prior to any work commencing and apply to specific tasks, areas and named personnel. 

The ASW audit team review focused on the ‘Permit to Work – General’ and ‘Permit to Penetrate’. The Permit to Penetrate is used for works that alter or penetrate fire compartmentation - such as drilling through walls to install cables. The aim of the permit is to ensure that the integrity of fire compartmentation is always safeguarded and maintained.

NHS Pre-Employment Checks - Checklist

The standards relating to Pre Employment Checks were reviewed and updated earlier this year, culminating in their being re-issued by NHS Employers in April. In addition to the updated standards NHS Employers have also issued new e-learning resources, available here.

MIAA have issued a Checklist designed to assist NHS bodies to comply with the risks and requirements in this important area.  Robust and rigorous checks over prospective employees are an essential part of managing both people risks and helping ensure delivery of safe and effective care to patients.

Events Round Up

TIAN members organise and facilitate a number of Groups and Forums across the country to support and develop NHS governance. e.g. Regional Audit Committee Chair meetings. A wide range of other education, training and networking events are also run, with many of these sessions now held virtually and being accessible to all TIAN member’s NHS clients. These include:

• Hewitt Review, 17th November 2023 - This NW Collaborative Masterclass run by MIAA will delve into how the NHS can best leverage opportunities within Integrated Care Systems.
• Provider Collaboratives, 5th December 2023 - This half-day virtual event organised by Audit Yorkshire and 360 Assurance will consider the progress made in working across new partnerships to deliver health and social care in an equitable and sustainable way.

Watch Back

You can watch back recordings of MIAA NW Collaborative Masterclasses or read about all the previous sessions by visiting the North West Collaborative YouTube channel. Similarly, details of past events organised by Audit Yorkshire and 360 Assurance, including recent half-day session on NHS Procurement held on 11th September are available here and here.

 

And Finally….. TIAN Shortlisted for a National Award!

Recognition of the high quality of work being delivered across the country by our NHS-based audit teams came recently when TIAN were shortlisted by CIPFA for their 2023 Public Finance Awards within the “Excellence in Public Sector Audit” category. The award nomination related to all the work done last year supporting NHS England and clients with assurance around Financial Sustainability - including the national benchmarking of audit results, and working with the HFMA to share lessons learned.

Congratulations are also due separately to the MIAA team who have also been shortlisted in the same category! We are in great company, with stiff competition coming from the National Audit Office amongst others. Fingers-crossed that either TIAN or MIAA will pick up the win at the awards dinner in London on 28th November – which would then make it 2 years in a row for the NHS following Barts Assurance winning it last year! 

 

Read the full newsletter here