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.

 

Department of Health and Social Care (DHSC) - Advanced Foundation Trust Programme: policy framework

NHS England has published its policy framework underpinning the advanced foundation trust programme, alongside a guide for applicants offering information for trusts that are seeking to apply. The policy framework sets out the overarching policy intent and principles of the programme. Meanwhile, the guide for applicants sets out the eligibility criteria to apply to become an advanced foundation trust; the assessment criteria to be met to be approved as an advanced foundation trust; the assessment process, including the responsibilities of both applicants and NHS England; and the possible outcomes of the application and what they mean for the applicant. Read more

 

For information

 

DHSC - Lord Mann review of antisemitism and other forms of racism in the NHS and healthcare regulatory system

Lord John Mann, the government independent advisor on antisemitism, was commissioned by the Secretary of State of Health & Social Care and the Prime Minister to lead a review into how the NHS and its regulatory system recognises, reports, and tackles antisemitism and other forms of racism, following multiple cases of intolerable antisemitism. The report sets out a comprehensive set of recommendations to strengthen accountability, improve reporting and investigation processes, and embed an anti-racist culture across the health system to ensure that patients and staff are better protected from discrimination and abuse. Read more

For information

 

DHSC - group accounting manual 2026 to 2027

This manual includes mandatory accounting guidance for DHSC group bodies completing statutory annual reports and accounts. These group bodies include integrated care boards, NHS trusts, NHS foundation trusts and arm’s length bodies. Read more

For information

 

NHS England – NHS Operating Framework 2025/26 Q4 segmentation results, and 2026/27 NHS Oversight Framework

NHSE has published the 2025/26 Q4 segmentation results and public performance dashboard, including NHS league tables for acute, mental health, community and ambulance trusts. A detailed version is available to NHS staff via the Model Health System. Read more

The 2026/27 NHS Oversight Framework has also been published, setting out how NHS England will oversee and assess NHS trusts, foundation trusts and ICBs, and support improvement. Read more

For information

 

NHSE - Board and executive assurance: cyber security risk

The head of cyber security at NHS and the DHSC has written to all NHS trusts and integrated care boards to ask for assurances that cyber security risks are being managed effectively. The letter from Tom Wechsler asked health leaders to show that they have 'clear, sustained programmes for improvement' regarding cyber security, and recommends that each NHS organisation should formally appoint a member of the executive team responsible for cyber security to assist the board of directors in meeting their accountabilities. This staff member should ensure that the right cyber security measures are in place, that risks are checked and managed, and that improvements are carried out across the organisation. The letter also recommends that organisations ‘gain assurance of their emergency preparedness'. Read more

For information and action as necessary

 

DHSC - Findings, conclusions and essential actions from the Independent Review of Maternity Services at Nottingham University Hospitals NHS Trust

This independent review of maternity services at the Nottingham University Hospitals NHS Trust (led by Donna Ockenden) considered the quality of care relating to newborn, infant and maternal harm at the trust. This report covers the findings, conclusions and essential actions of this independent review of maternity services. Based on a review of over 2,500 family cases that formed part of this investigation, the final report outlines: local actions for learning that staff at the trust must do; system-wide learnings; and immediate and essential actions to improve maternity and neonatal care. 
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For information and consideration by all providers of maternity services

 

Cabinet Office - Insourcing and the Public Interest Test: Guidance Note

The government has issued guidance on insourcing for contracting authorities, as well as details of a public interest test, which it says should enable contracting authorities to critically review the delivery of a service overall, and support them in making evidence-based sourcing decisions. The test should also inform elements of a contracting authority’s commercial strategy and help identify opportunities to deliver value for money, the government said. The test does not apply to contracts for regulated health procurement exempted under Regulation 43 of the Procurement Regulations 2024 Act. 
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For information and application on any relevant transactions

 

House of Commons Library - Health Bill 2026-27

This briefing sets out the aims of the Bill and what it would do, and summarises stakeholder commentary on reforms to the NHS that the Bill would make. 
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For information

 

Kings Fund - NHS Modernisation Bill (Health Bill): House of Commons Second Reading

As the NHS Modernisation Bill reaches Parliament, The King’s Fund has been analysing what the proposed reforms could mean in practice. This briefing explores the Bill’s ambitions, and the risks, for how the NHS is led, managed and held to account. 
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The Kings Fund have also published an ‘explainer’ examining what the Health Bill 2026 could mean for the NHS, patients and the wider health and care system, and setting out what they believe should happen next. Read more
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For information

 

Public Policy Projects - Delivering the National Cancer Plan

This report looks at the challenges of delivering cancer care reform. It highlights the gap between ambitious policy goals and frontline realities, addressing systemic needs in areas such as workforce capacity, sustainable funding, and IT infrastructure. It makes suggestions to help health systems navigate these challenges and deliver sustainable care. Read more
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For information

 

Royal College of Emergency Medicine - The state of emergency medicine in England

This report examines the scale of overcrowding in emergency departments and the impact this is having on patient safety and staff. Drawing on national data, research and frontline evidence from clinicians, it highlights how long waits, high bed occupancy and a lack of patient flow continue to lead to overcrowded emergency departments. Long waits are closely linked to an increased chance of death within the following 30 days. The analysis estimates that there were 15,860 excess deaths associated with long waiting times in English emergency departments in 2025. While the number of deaths is slightly lower than 2024 (16,644), further analysis reveals that the estimated mortality figure increased almost tenfold when compared to 2015 (1,657). 
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For information

 

Health Foundation - Immigration and the NHS: the evidence

The NHS is often part of debates about immigration and its impact in the UK. This briefing reviews existing research and analyses publicly available data to assess the relationship between immigration and the NHS. Overall, evidence suggests immigration makes a positive contribution. The average person who migrates to the UK is more likely to work in the NHS, less likely to use health services and contributes significantly to NHS funding. NHS pressures are largely down to funding constraints, workforce shortages and changing health needs. 
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For information

 

Health Services Safety Investigations Body - Electronic prescribing and medicines administration: procurement and safety learning in acute hospitals

This report warns that inconsistent design, procurement and regulation of electronic prescribing and medicines administration (ePMA) systems across NHS trusts pose risks to patient safety and may increase medication-related harm. While digital technologies offer clear benefits, the current framework does not adequately support safe, large-scale adoption. The findings highlight the need for more consistent standards and stronger oversight as digital transformation accelerates. 
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For information of Acute Hospitals

 

Policy Exchange - NHS, heal thyself! The avoidable cost and impact of sickness absence in the NHS

This report finds that sickness absence in the NHS has reached unsustainable levels at rates nearly three times higher than the private sector. Based on Freedom of Information requests to NHS Trusts and Integrated Care Boards, analysis of NHS workforce data, and interviews with occupational health and HR professionals, the report concludes that sickness management in the NHS is financially unsustainable, operationally damaging and ultimately unfair to both patients and staff. It calls for a modernisation and overhaul of the way the NHS manages sickness absence and makes a number of recommendations. 
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For information

 

Children's Commissioner for England - Children’s and young people’s mental health services: 2024-25

This year’s annual report finds demand for children’s mental health services continues to soar, outstripping system capacity and investment, with referrals almost doubling since 2018-19. The analysis shows that demand is driven in part by increasing referrals of children for suspected autism and neurodevelopmental conditions, and that these children were most likely to face some of the longest waits for help. Read more
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For information

 

Mental Health Foundation - The state of mental health inequality in the UK

This report says that mental health in the UK has worsened over the past 15 years, but this picture is not shared evenly across society. This report presents analyses of mental health trends across England, Scotland, Wales and Northern Ireland from 2009 to 2024, using data from “Understanding Society: the UK Household Longitudinal Study.” Read more
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For information

 

Health Foundation - Young people with mental health conditions are now more likely to be NEET

This analysis examines the relationship between the number of young people who are not in education, employment or training (NEET) and the prevalence of mental health conditions. As Alan Milburn's review of Young People and Work publishes interim findings, the analysis highlights the significant role mental health is playing in the rising number of young people who are NEET. Read more
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For information

 

Re:State - Building the preventative state

This report finds that preventive approaches can be highly effective, but to work at the scale needed the State needs to transform its approach, and build the capabilities it needs to underpin the shift to prevention. The report shares insights from a series of roundtables and a workshop on how to achieve the shift to prevention in different parts of the public sector, and ideas about how Whitehall can move from isolated to systemic approaches to prevention. Read more
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For information

 

CIFAS – Fraud Behaviours Survey 2025

CIFAS have published their latest ‘Fraud Behaviours Survey’ results – and the report reveals a worrying shift in public attitudes.  The research finds that half of UK adults (50%) now believe it is ‘reasonable’ to commit first‑party fraud – up 2% on the previous survey.

Key findings from the latest report include:

• 1 in 13 adults (8%) admit to committing first‑party fraud
• Retail non‑delivery, Single Person Discount and mobile phone insurance fraud are the most common first-party crimes
• Young adults are driving the trend, with 1 in 3 people aged 25–34 saying they have been involved in first‑party fraud

The research also highlights growing confusion over what is — and isn’t — illegal, particularly around behaviours such as money muling and falsifying information on financial applications. Read more
Read more
  

For information

 

HFMA – Governance Award 2025 Case Studies

The HFMA Awards celebrate excellence and innovation across the NHS finance function. The governance award, one of 13 categories, recognises individuals, teams or organisations working collaboratively to strengthen assurance, risk management and governance, enabling improved delivery of organisational objectives.  The award promotes a strong, integrated and effective approach to governance. It is open to initiatives of any scale that demonstrate meaningful improvement in governance arrangements and outcomes, with judges considering: evidence of the impact on outcomes, services and decision-making; the application of best practice; the use of technology and innovation; and the wider impact across organisations and systems.

This paper highlights key themes emerging from this year’s submissions, alongside learning from previous years, and showcases examples of governance innovation across NHS organisations. Many of the core learning points remain consistent over time, particularly the importance of collaboration, organisational culture and the effective use of data and technology. 

Across the 2025 submissions, organisations reported tangible improvements in how governance operates in practice. These include clearer accountability, stronger and more transparent assurance and more timely and consistent decision-making. Collectively, these initiatives show how governance can be made more practical, proportionate and effective in supporting organisational and system priorities. 
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For information

 

HFMA - Financial reporting watching brief 2025/26 and beyond

2025/26 is a relatively quiet year for financial reporting changes. This briefing identifies the changes to accounting standards as well as public sector reporting requirements.

The June 2026 version of the brief highlights updates to public sector specific guidance audit. 
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For information

 

HFMA - Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD)

Demand for attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) services is rising rapidly, with commissioners seeing continued growth in referrals, provider activity and service complexity. The ICB Finance Group’s survey highlights common challenges across systems, including variation in pricing, limited data visibility, uneven controls and resource-intensive assurance processes.

This briefing presents survey findings on ADHD/ASD commissioning, spend and oversight. It is intended to support discussion on improving consistency, transparency and value for money. 
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For information

 

HFMA - A framework for the ethical and effective decommissioning and disinvestment of clinical services

The Health Economics Unit (HEU) has developed “A framework for the ethical and effective decommissioning and disinvestment in clinical services”, in partnership with the HFMA.  The framework is designed to support health and care leaders to systematically evaluate, prioritise and implement decommissioning and disinvestment decisions, particularly in systems facing significant financial deficit.

In producing the framework, the HEU explored the following questions:

• Reasoning: How are services or providers identified for decommissioning, consolidation or other significant change?
• Process: What constitutes best practice in decommissioning, consolidation, service redesign and the reallocation of funds?
• Challenges: What gaps and limitations have been identified that affect or constrain the decommissioning process and associated decision-making.

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 members and NHS managers. It is not exhaustive and TIAN cannot be held responsible for any omission.