MIAA is a member of the Internal Audit Network (TIAN) which comprises the seven 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. 

NHS England - Strategic commissioning framework

As set out in the Medium Term Planning Framework, this Strategic Commissioning Framework sets out the expectations of ICBs as strategic commissioners, and what ICBs and providers can expect from NHSE, as part of a step-by-step guide with an updated commissioning cycle. Read more

NHS Providers have published a summary of the new framework, highlighting what providers need to know. It also sets out their view on what is being proposed, including key questions and challenges that remain.
Read more

For adoption by all ICBs as part of the NHS planning process for 2026/27

UK Covid-19 Inquiry - Core decision-making and political governance

The UK Covid-19 Inquiry was set up to examine the UK’s response to and impact of the Covid-19 pandemic, and learn lessons for the future. The second report, which looked into core political and administrative governance and decision making, has now been published. It includes initial response, central government decision making, political and civil service performance as well as the effectiveness of relationships with governments in the devolved administrations and local and voluntary sectors. Volume 1 of the report looks at key events from January 2020 to May 2022. Volume 2 describes key themes, lessons and recommendations. Read more

For information

NHS Confederation - The state of integrated care systems 2024/25: delivering through change

This annual report on the state of integrated care systems (based on a survey of ICS leaders) examines systems’ progress, how they are responding to the changing policy landscape and their role in implementing the 10 Year Health Plan. Read more

The NHS Confederation has also published a report on “Towards integrated health organisations: considerations for policy and NHS leaders”.  This report presents considerations for local leaders and the government to develop integrated health organisations across four components: contract; structure; governance; and behaviour and leadership. Read more

For information

Nuffield Trust - District nursing: understanding the decline and mapping the future

District nurses, who provide care to people in homes all over the country and operate all hours of the day, are fundamental to the government’s plans to shift more care from hospital to the community. But this new research report shows those plans are unlikely to be achievable unless action is taken to address the state of the district nursing profession. As demand for their care rises, and is set to rise further, an estimated one in four district nurses are leaving the profession and there has been a 43% decline in overall numbers since 2009. Read more

For information of community service providers 

NHS Providers - State of the provider sector

This report outlines the findings of NHS Providers' annual State of the provider sector survey, providing a snapshot of the issues facing hospital, mental health, ambulance and community services across England. Read more 

For information

Institute for Government - Public services performance tracker 2025: the NHS

This report looks at the productivity, staffing and performance of the NHS since Labour entered office in July 2024. Read more

For information

Re:State - Hospital of the future: ending the patient gridlock

This final report of the ‘Hospital of the Future’ programme seeks to open up the black box of hospitals to examine exactly what is preventing patients from moving in, out and through hospitals efficiently – otherwise known as patient flow.  It explores how hospitals can transition to a model where patients flow seamlessly through the system, at less cost to themselves, the system and the taxpayer. Read more

For information

The Health Foundation - From diagnosis to delivery: a framework for accelerating NHS productivity growth

This report explores current understanding of NHS system productivity and the reasons for the NHS’s recent stalling productivity. It sets out a four-driver framework which could guide future recommendations covering workforce, capital, technology and innovation, and transformation. Read more

For information

All-Party Parliamentary Group (APPG) – report on Emergency Care Corridor care

This report finds that almost one in five patients in emergency departments were being cared for in trolleys or chairs in corridors in England this summer, with so-called ‘corridor care’ leaving people feeling ‘forgotten and vulnerable’. The research, compiled by the Royal College of Emergency Medicine which acts as secretariat for the APPG, reveals what patients are experiencing when they seek urgent or emergency care in emergency departments, the harm they are exposed to, and what needs to be done to address this crisis. Read more

For information

Public Policy Projects - Designing the future health and care digital architecture

This report makes a series of recommendations to help modernise digital architecture, including the adoption of patient-centred reference architecture and a mandated core data model to eliminate the need for ‘one-off’ integrations. The report synthesises insights from the third roundtable in the Digital and Data Transformation series, which brought together leaders and experts from the NHS, integrated care systems, social care, local government, academia, and industry to address the critical challenges in modernising health and care services through digital and data transformation. Read more

For information

Healthcare Quality Improvement Partnership (HQIP) - Updated guide to managing ethical issues in quality improvement and clinical audit projects

HQIP have recently published an updated guide to managing ethical issues in quality improvement or clinical audit projects.  The guide is intended to help those responsible to review and develop arrangements for the effective ethics oversight of quality improvement and clinical audit activities.  The content in the guide is derived from an extensive search and analysis of published literature on ethics and quality improvement or clinical audit carried out by Healthcare Quality Quest.  The guide describes:

• What’s involved in ethics and how ethical principles may apply
• Why healthcare organisations should provide for ethical oversight
• The difficulty in distinguishing between a research and a QI or clinical audit project as the basis for ethical review.

In summary, the guide states that ethical principles applied to the concept of QI should require every project, clinical audit or service evaluation to meet the following criteria:

• Favourable benefit/risk balance
• Scientifically valid
• Equitable and reflecting priorities
• Value
• Awareness of conflict of obligation to patients.

It also contains a summary of the types of ethical actions for QI, clinical audit and service evaluation, as well as top tips for the successful management of ethical issues. Read more

For information of those involved in QI, clinical audit and clinical governance

NHS Employers – Staff Engagement and Flexible Working Case Studies

NHS Employers has published a case study describing how South Warwickshire University NHS FT continues to improve on its successful staff engagement work, which has resulted in some of the best NHS Staff Survey results for an organisation of its type. Read more

They have also issued a case study outlining the Bridgewater Community Healthcare NHS FT's “Making Flexible Work” campaign which aims to benefit both staff and patients. Read more

For information

UK Public Sector Internal Audit Standards Advisory Board (IASAB)

Updated Application Note on Global Internal Audit Standards in the UK Public Sector

The IASAB was established by the bodies responsible for setting Internal Audit Standards in the UK public sector.  It annually reviews its Application Note on using Global Internal Audit Standards in the UK Public Sector, and has issued an amended version.  The main change is addition of a new section 12 regarding the applicability of “Topical Requirements.”  Topical Requirements are a mandatory component of the IIA’s International Professional Practices Framework (IPPF), but do not automatically apply to internal audit in the UK public sector. Going forward each IIA Topical Requirement issued will be considered by IASAB, on behalf of the RIASS, for applicability to the UK public sector. Read more

For information

Chartered Institute of Public Finance and Accountancy (CIPFA) -
Understanding preventative investment: a practical approach to map and measure spend

This report and accompanying “how-to” guide explains how public sector organisations can define, map and measure preventative investment across their services.  Designed to be used alongside the plug-and-play tool, it shows how making prevention visible in financial terms supports evidence-based decision-making and the shift toward prevention. Read more

For information

CIFAS – Workplace Fraud Trends 2025

 CIFAS has published its latest Workplace Fraud Trends report – their research shows:

• Nearly a fifth (19%) of employees have admitted to secretly working for a competitor, with 24% saying it’s ‘justifiable’
• 1 in 8 (13%) of respondents admit to selling company login details
• Meanwhile, 19% have used fake job references
• 13% know someone who used company funds to place a bet
• 1 in 4 (24%) say expenses fraud is justifiable

These findings highlight a shift in workplace behaviours and the need for stronger fraud prevention, cultural accountability, and action. Read more

For information

HFMA - Artificial intelligence in the NHS

This briefing gives an introduction to artificial intelligence (AI), and suggests possible uses, benefits and risks. It describes operational factors for successful implementation, regulation and governance of AI in the NHS. Read more

For information

HFMA Briefing - Summary of medium-term planning guidance 2026/27 to 2028/29

NHS England published planning guidance over the course of October and November 2025. Integrated care boards (ICBs), and NHS trusts and foundation trusts (providers) must now work with this planning guidance to develop medium-term plans. This briefing pulls out key points from the planning guidance, as relevant to NHS finance staff. Read more

For information