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. 

Department of Health and Social Care - Independent investigation of NHS performance: terms of reference

The Secretary of State for Health and Social Care, Wes Streeting, has commissioned an immediate and independent investigation of the NHS across England. Professor Ara Darzi, Baron Darzi of Denham, has been appointed to lead the investigation, which will report in September 2024. Read more

For information

Department of Health and Social Care - UK Covid-19 Inquiry; Module 1: the resilience and preparedness of the United Kingdom

This report contains the results of the first investigation into the nation’s resilience and preparedness for the Covid-19 pandemic. Key recommendations include a simplification of civil emergency preparedness and resilience systems, holding a UK-wide pandemic response exercise at least every three years, and the creation of a single, independent statutory body responsible for whole-system preparedness and response. Read more

For information

 
Department of Health and Social Care - Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

This is a review of data provided by NHS England (NHSE) on suicides by young patients of the gender services at the Tavistock and Portman NHS Foundation Trust, based on an audit at the trust. The specific aim of the review (undertaken by Professor Louis Appleby) was to examine evidence for a large rise in suicides claimed by campaigners. Among other findings, it found that the data does not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock. Read more

For information

Department of Health and Social Care - Review into the operational effectiveness of the Care Quality Commission: interim report

In May 2024, Dr Penny Dash was asked to conduct a review into the operational effectiveness of the CQC. The purpose of the review was to examine the suitability of the CQC’s new single assessment framework methodology for inspections and ratings of health and care providers. This interim report provides a high-level summary of the emerging findings of the review in order to inform the changes needed to start the process of improving the CQC. It makes five recommendations. Read more

For information

NHS England - Improving the management of physical deterioration following implementation of Martha’s Rule

This new approach, ‘prevention, identification, escalation, response’ (PIER), views deterioration as a whole pathway which is supported by systems rather than advocating a single strategy for identification. It will apply to all conditions, clinical settings and specialities and will be essential to ensure that Martha’s Rule is effective. Read about the PIER approach. Read more

For information and implementation by all NHS bodies

NHS England - Emergency preparedness, resilience and response (EPRR)

The EPRR assurance process for 2024/25 asks organisations to complete the assurance process by Friday 27 December. It provides information about the theme of this year's deep dive questions and highlights changes from 2025/26.  Following recent incidents and common health risks raised as part of last year’s annual assurance process, the 2024/25 EPRR annual deep dive will focus on responses to cyber security and IT related incidents. Read more

For information and implementation by all NHS bodies

NHS England - Framework for managing the response to pandemic diseases

This document provides a framework for NHS England when managing the response to a pandemic. Its purpose is to outline the pandemic-specific roles and responsibilities of NHS England, with a focus on the command, control, co-ordination, communication and governance arrangements for the NHS. Read more

For information

NHS England - Updated Integrated Care Board constitution and governance guidance

This guidance, with the ICB model constitution, has been updated to reflect developments since the establishment of ICBs. It removes establishment-specific content, includes requirements for managing conflicts of interest and supports ICBs to update their constitutions. Read more

For information and guidance of ICBs

Financial Reporting Council - market study into the NHS audit market

The FRC has announced the launch of a comprehensive market study into the audit market for NHS providers and integrated care boards (ICBs) in response to concerns over the difficulties NHS bodies are facing appointing and retaining auditors. The study will explore: the supply of auditors, including barriers to entry and expansion for audit firms; demand for audit, including the audit tendering process and engagement by NHS bodies; the regulatory framework, including unique features of NHS provider and ICB audits; and capacity constraints and potential impacts on the wider local audit market. Comments for the study should be submitted by 17 October. Read more

For information of all NHS Audit Committees

NHS Employers - New legal duty to prevent sexual harassment

From October there will be a new duty on employers to take reasonable steps to prevent sexual harassment. NHS Employers provides further detail and signposts to further resources. Read more

For information and guidance

Patient Safety Commissioner - Annual Report 2023/24

This report summarises the work of the Patient Safety Commissioner during the 2023/24 financial year. It is aimed at all those with an interest in patient safety. Read more

For information

 
National Guardian - Listening to the silence: what does the Staff Survey tell us about speaking up in the NHS?

Analysis of the 2023 NHS Staff Survey by the National Guardian’s office reveals a decline in workers feeling secure raising concerns about unsafe clinical practice for the second consecutive year. Read more

For information and guidance of all NHS organisations

 
The Guardian Service - Ambulances running on adrenaline: speaking up in ambulance trusts

This report makes recommendations to ambulance services to help transform their organisational culture through speaking up. It was written in response to NHS England's Culture review of ambulance trusts, which was published in February 2024. Read more

For information and guidance - of Ambulance Trusts in particular
 

National Audit Office - NHS financial management and sustainability

This report sets out: the NHS’s current financial position and operating context; whether NHS England’s financial management processes allow accurate and timely decision-making and support for NHS bodies that are struggling; the relationship between financial management and NHS performance, productivity and efficiency; and the challenges to the NHS’s financial sustainability in the longer term. Read more

For information
 

The King’s Fund - Realising the Potential of Integrated Care Systems

This report assesses ICSs' efforts to develop system-wide approaches to recruitment, training and retention of staff, suggesting clear progress is being made but raising concern that ICSs may not achieve their full potential unless more is done to create an environment conducive to their success. Read the report.

For information and guidance of ICS/ICBs

The Health Foundation - Priorities for an AI in health care strategy

This long read argues that a dedicated strategy for artificial intelligence (AI) in health care is needed to co-ordinate current fragmented efforts in the NHS in England. It sets out six priorities this strategy should address and some of the steps to do so. Read more

For information

NHS Providers - Making sense of health inequalities

This resource, produced as part of NHS Providers’ Health Inequalities programme, looks at the current state of the nation in relation to health inequalities and the role that NHS trusts have to play in addressing them. Read more

For information

 
NHS Providers - System working in the NHS: how trusts work in partnership to improve care and outcomes for people

This resource looks at the role of system working in the NHS and how trusts can work in partnerships to improve outcomes. Read more

For information

NHS Providers - Keeping your integrated care system safer from cyber attacks

This briefing, from NHS Providers' Digital Integrated Care System (ICS) programme, shares five top tips and poses a series of questions to help ICS leaders ensure that they are prepared and able to respond to cyber threats. Read more

For information and guidance of ICS/ICBs
 

Rise Associates - The Nursing and Midwifery Council independent culture review

The NMC commissioned Nazir Afzal OBE and Rise Associates to carry out this review after concerns were raised about the organisation’s culture, including racism and fear of speaking up. More than 1,000 current and former NMC colleagues, and more than 200 panel members who sit on fitness to practise hearings, shared their lived experiences as part of the review. The NMC accepts the report’s recommendations. Read more

For information
 

The Patients Association - Beyond the breaking point: patient survey highlights NHS challenges 

A survey of a sample of 1,000 nationally representative UK respondents (aged 16+) and 210 respondents from the Patients Association's newsletter (conducted by Censuswide and commissioned by the Patients Association) revealed significant challenges in accessing care, reinforcing the charity's calls to fix the crisis in health care and improve patients’ access to the services they need to live well. 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.