Key NHS Publications - December 2023

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: Charity regulators - update for NHS charities

This briefing is intended to update members on recent guidance from the three charity regulators and other relevant bodies that is likely to have an impact on the financial management and governance of NHS charities. It is based on the information that is available from their websites and provides appropriate links to that guidance. 

The briefing covers recent updates in relation to the Charities SORP and the various codes of governance for charities. It also covers recent updates in relation to changes to legislation and guidance from the:

• Charity Commission for England and Wales
• Office of the Scottish Charity Regulator (OSCR)
• Charity Commission for Northern Ireland
• Fundraising Regulator and Scottish Fundraising Adjudication Panel.

It can be found here.

For Information

Enhancing doctors’ working lives – 2023 annual report

This NHSE report details new and developing initiatives which support the delivery of more integrated and person-centered care and highlights those developed to reduce the impact the pandemic has had on training progression and wellbeing. 

It can be found here.

For Information

Addressing the significant financial challenges created by industrial action in 2023/24, and immediate actions to take

The NHSE issued a letter on 8 November providing clarity on the funding and actions the NHS has been asked to take to manage the financial and performance pressures created by industrial action following discussions with Government.

It can be found here.

For Information

NHS non-executive director remuneration and morale

NHS Providers were invited by NHS England (NHSE) to share evidence, feedback and insight we have from our members in relation to:

• Members’ approaches to NED and chair remuneration since 2019 (when the remuneration alignment framework first applied)
• NED and chair morale and motivation (and by extension the potential impact on recruitment and retention of high calibre individuals to these roles)

The anonymised evidence submitted draws on NHS Providers survey responses and discussions with leaders from member trusts and foundation trusts. It is intended to support NHSE’s work on NED and chair remuneration.

The briefing can be found here.

For Consideration within health systems and providers

The Health Foundation briefing: Improvement as mainstream business

Improvement approaches, which provide a systematic means of bringing about measurable improvements in the quality and outcomes of care for patients as well as care productivity, have been in common use in some health care settings for more than 20 years, often producing impressive results where they are deployed well.

Yet approaches to improvement are far from being embedded into the core strategy and operations of every health care organisation or system-wide partnership of organisations. This briefing examines why this is still the case, argues that embedding improvement approaches across all health care settings is now vital, and describes what needs to happen to shift improvement from the margins to the mainstream of health care.

Improvement approaches are not just a mechanism for improving care processes and pathways and tackling variation. They are indispensable when it comes to tackling the biggest delivery and transformation challenges that health care faces, such as the need to make greater use of technology and tackle waiting times and winter pressures. They provide a systematic, collaborative and inclusive approach capable of delivering sustained improvement at scale.

To help organisation, system and national leaders navigate the complex landscape of improvement activity, this briefing describes four key current ‘improvement modes’. It also sets out the evidence for why the NHS and other care sectors cannot do without improvement approaches, and summarises the steps needed to overcome the barriers to their routine large-scale deployment across all health care settings.

The briefing can be found here.

For Information

NHS Confederation report: Improving health and care at scale: learning from the experience of systems

NHS England has outlined plans to develop an improvement approach - NHS IMPACT - to support continuous improvement. There are also ambitions for integrated care systems (ICSs) to become ‘self-improving systems’.

This report, written and researched by Sir Chris Ham and jointly commissioned by the NHS Confederation, the Health Foundation and the Q community, reviews the experience of a number of ICSs identified as being at the forefront of this work, focusing on the approaches they have taken and the results achieved.

System leaders have been resourceful in ‘going with the grain’ of existing improvement methods, creating improvement and learning communities of experienced staff, and sharing expertise with organisations and services that may lack capabilities. System leaders are ‘learning by doing’ as they seek to bring about improvement through influence and persuasion and build shared commitment to change.

There are concerns that the legacy of top-down performance management in the NHS might create barriers to realising the ambitions behind NHS IMPACT. System leaders argue that the work of NHS IMPACT should focus on a small number of national programmes and leave scope for systems to work on local priorities.

The NHS Confederation suggest that The National Improvement Board should use the findings of this report when shaping its strategy and should ensure that expertise in ICSs and other partners is used.

It can be read here.

For Information

Reforming adult social care in England

This NAO report looks at how DHSC is responding to the challenges facing adult social care in England, and its progress with delivering the reforms set out in the 2021 white paper. This report examines:

• Key pressures and challenges in adult social care in England
• DHSC’s response to increasing pressures in adult social care during 2022
• How DHSC is delivering reform and progress against its commitments

The report can be found here.

For Information

Investing to save: the capital requirement for a more sustainable NHS in England

Capital is the number one issue NHS leaders believe is holding back their progress according to this NHS Confederation report. To better understand this, they asked ICS leaders how much they need to meet the NHS Long Term Workforce Plan’s ambitious productivity targets.

NHS leaders are calling on all political parties to commit to a £6.4 billion annual capital funding increase for the NHS at next year’s three-year Spending Review. As we enter a general election year, there has never been a more urgent time to set out an ambitious plan to put the NHS on a path to financial sustainability. NHS leaders are committed to working closely with the new government to ensure this money is used as swiftly and effectively as possible.

This report can be found here.

For Information