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. 

Road to recovery: the government's 2025 mandate to NHS England

The government’s mandate to NHS England sets out the objectives it should seek to achieve. This mandate will apply from 30 January 2025, until it is replaced. The objectives cover reforms to: cut waiting times; improve primary care access; improve urgent and emergency care; the operating model; and drive efficiency and productivity.

For information

Department of Health and Social Care - Better Care Fund policy framework 2025 to 2026

For 2025 to 2026, the objectives of the Better Care Fund (BCF) reflect the government’s commitment to reform via a shift from sickness to prevention and from hospital to home. This policy framework is intended for use by those responsible for delivering the BCF at a local level, such as integrated care boards, local authorities, and health and wellbeing boards.

For information and implementation

NHS England - Revenue finance and contracting guidance for 2025/26

This guidance sets out the revenue finance and contracting frameworks for 2025/26 (1 April 2025 to 31 March 2026) and should be read in conjunction with the 2025/26 priorities and operational planning guidance and the capital guidance for 2025/26.

For information and implementation

NHS England - Neighbourhood health guidelines 2025/26

This document sets out guidelines to help integrated care boards (ICBs), local authorities, and health and care providers continue to progress neighbourhood health in 2025/26 in advance of the publication of the 10 Year Health Plan. Neighbourhood health aims to create healthier communities, helping people of all ages live healthy, active and independent lives for as long as possible while improving their experience of health and social care, and increasing their agency in managing their own care.

The NHS Confederation has provided a helpful briefing and analysis of these guidelines which aims to summarise “what you need to know”.

For information and implementation

NHS England - Green plan guidance

In 2020, the NHS became the first healthcare system globally to commit to reaching net zero carbon emissions, in response to the health risks posed by climate change. This updated guidance is to help NHS organisations develop robust plans to support world-leading patient care, save money and minimise waste – continuing the NHS’s journey to achieving net zero. Refreshed green plans should be approved by the organisation’s board or governing body, published in an accessible location on the organisation’s website, and shared with NHS England by 31 July 2025.

For information and implementation

NHS England - National elective access policy

This policy will support implementation of the updated Recording and reporting guidance. It covers the core principles that all providers and systems should include in their local elective access policies, to support consistent application of waiting times rules and guidance. Local policies should reflect local pathways and implementation plans. E-learning training materials are available to support the consistent use of referral to treatment rules.

For information and implementation

Care Quality Commission - Addressing health inequalities through engagement with people and communities: a self-assessment and improvement framework for integrated care systems

The CQC, in partnership with National Voices and the Point of Care Foundation, has developed this self-assessment and improvement framework. It is a voluntary resource to support integrated care systems in reducing health inequalities by improving how they engage with people and communities.

For information and consideration

Health Services Safety Investigations Body (HSSIB) - Safety management: accountability across organisational boundaries

This report is intended for health care organisations, policy-makers and the public to help improve patient safety in relation to the management of patient safety risks across organisational boundaries. This has been explored through an understanding of the pathways of care for patients whose care involves engaging with providers in primary, secondary and community care and with integrated care systems. It makes reference to processes which exist within the health and care system relating to the management of safety.

For information

King’s Fund, National Voices and Healthwatch England - Lost in the system: the need for better admin

Poor administrative practices in the NHS are leaving patients in a state of uncertainty and risking their health, according to a report from The King’s Fund, National Voices and Healthwatch England. The report says almost two-thirds of patients and carers have experienced at least one admin problem over the past year, such as lost test results, difficulties in changing or cancelling appointments, or receiving incorrect information. One-fifth of people who had used the NHS in the past 12 months said they had received an appointment invitation after the date of the appointment. The report calls for NHS bodies to put admin higher on their agenda.

For information

Chartered Institute of Public Finance and Accountancy (CIPFA) - The role of the chief financial officer (CFO) in the NHS

This report aims to provide a definitive statement on the role of the CFO in NHS organisations. The report explores the nature of the work of the CFO in NHS organisations at national, regional and local level across the UK. It considers the competencies required and key themes, such as the opportunities and challenges they face, the nuances of operating within a political environment, and the importance of accountability, stewardship and sound ethical values.

For information

NHS Providers - 2025/2026 priorities and operational planning guidance

This briefing highlights the key points from NHS England's recent 2025/26 priorities and operational planning guidance, and includes NHS Providers’ view. It also summarises updates to the financial framework, including the revenue finance and contracting guidance for 2025/26, capital guidance for 2025/26 and NHS Payment Scheme 2025/26.

The NHS Confederation has also issued a briefing providing a summary and analysis of NHS England’s 2025/26 priorities and operational planning guidance. It analyses the priority areas and suggests ways of measuring whether they are successful.

In addition, the HFMA has issued a briefing which pulls out key points from the planning guidance, as relevant to NHS finance staff.

For information

NHS Providers - Governance survey 2024

This report details the findings of the NHS Providers’ 2024 governance survey, exploring the views and experiences of chairs, company secretaries and governance leads in NHS trusts and foundation trusts.

For information

NHS Employers - Get your board onboard to improve staff experience

This guide has been developed in collaboration with NHS staff experience and health and wellbeing leads, as well as NHS People Promise managers. Its purpose is to empower those responsible for elements of the staff experience agenda to engage senior leaders and board members in promoting a positive and supportive staff experience.

For information

NHS Confederation - Capital efficiency: how to reform health care capital spending

This report finds that the NHS is being held back from most effectively spending the investment it has been given to repair its estates, purchase vital equipment and build new facilities due to the 'bureaucratic hurdles' that are slow, unclear and duplicative. The report sets out how the capital regime can be improved to deliver on the government’s missions for health and economic growth.

For information

Socitm - Public sector digital trends: beyond borders

This report covers the leading technological and digital trends influencing local public services innovation, change, and reform in the face of a "perfect storm" of social, economic, and environmental demands.

For information  

Information Commissioners Office - Employment records guidance

The ICO has published their latest guidance to help organisations understand best practice for storing employee records.

For information

HFMA - Guide to NHS finance

The HFMA’s introductory guide to NHS finance is a comprehensive guide of how the NHS finance regime works, as well as the wider landscape in which it operates. It is designed to give readers a solid grounding in – and practical understanding of – all key aspects of NHS finance and will provide contextual background that helps explain how the NHS has developed over the years.

The guide is a vital resource for anyone who wants to understand NHS finance and get the maximum value from NHS resources. It will be of interest to finance staff at all levels, non-executive directors, clinicians, budget holders and general managers.

For information

HFMA - Common themes from the investigation and intervention regime reports

Investigation and intervention (I&I) reports led to significant improvements in the financial run rates of eight of the 10 systems engaged and some improvement in one of the other two. This briefing paper summarises common themes. These include a lack of triangulation (of finance with workforce and activity), a lack of system working and transformation, poor post implementation review, and controls that included workarounds or overrides

For information

HFMA - Market forces factor (MFF): The impact of changes to NHS funding flows

This briefing provides an overview of the calculation and use of the MFF, along with the reported challenges to the MFF and the potential impact of changes.  The briefing is designed to be a helpful introduction or a refresher to the topic for the NHS finance community or others with an interest in this area.

For information

HFMA - The NHS external audit market: Key findings from the 2024 survey and roundtables

In July 2024, in response to growing concerns about difficulties NHS bodies are facing to appoint and retain auditors, the Financial Reporting Council (FRC) launched a comprehensive market study into the audit market for NHS providers and integrated care boards (ICBs). The HFMA worked with the FRC to engage with finance directors and non-executive directors through a survey and two roundtables in October 2024. This briefing summarises the findings from the survey and roundtables. 

Overall, the audit market would mostly benefit from more choice and competition. There is a lack of choice in the NHS audit market, supported by the survey findings that 47% of respondents only received one bid and 7% received no bids at all in response to recent procurement exercises. A total of 70% of respondents had concerns about their next audit tender, with a further 17% having serious concerns.

For information

CIFAS - Fraud Behaviours Survey

The latest research by CIFAS shows that almost half (48%) of adults believe it is ‘reasonable’ to commit first-party fraud. The 2024 survey results make clear that first-party fraud, when someone knowingly misrepresents their identity or provides false information for financial or material gain, is on the rise.

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.