Key NHS Publications - November 2024
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) - Review into the operational effectiveness of the Care Quality Commission (CQC): full report
In May 2024, Dr Penny Dash was asked by the DHSC to conduct a review into the operational effectiveness of the CQC. An interim report, providing a high-level summary of her emerging findings, was published in July 2024. The full report has found significant failings in the internal workings of the CQC, which have led to a substantial loss of credibility within the health and social care sectors, a deterioration in the ability of the CQC to identify poor performance and support a drive to improve quality, and a direct impact on the capacity and capability of the sectors to deliver much-needed improvements in care. The report outlines the necessary changes to improve the CQC. Read more
For information
Department of Health and Social Care - Change NHS: help build a health service fit for the future
Members of the public, health and care staff and organisations are being asked to help shape the government's plan to reform the NHS. The responses to this consultation will help to shape the government’s 10-year health plan, which will be published in spring 2025. It will be underlined by three big shifts in health care: hospital to community, analogue to digital, and sickness to prevention. Read more
For information and engagement by individuals, organisations and integrated care systems
Care Quality Commission - The state of health care and adult social care in England 2023/24
This annual assessment of the state of health and social care in England looks at the quality of care over the past year. It draws on inspection activity, findings from the CQC’s national NHS patient survey programme and statutory reports, bespoke research into people’s experiences, insights from key stakeholders, and evidence collected by the regulator throughout the year about the quality and safety of services in all areas of health and care. Read more
For information
NHS England - Primary care patient safety strategy
This strategy outlines the primary care implementation of the NHS Patient Safety Strategy, and is for all areas of primary care, though with some improvements implemented first in general practice to enable the successes and learning to be used in the rollout to community pharmacy, optometry and dental services.
For information of those involved in primary care
NHS England – ICB Freedom To Speak Up (FTSU) Arrangements
A letter sent by NHSE to ICB chairs and chief executives sets out the expectations of their FTSU arrangements, including the adoption of the national FTSU policy and ensuring primary care workers have access to a FTSU Guardian. The letter asks ICBs to:
- ensure that primary care workers are aware of and have access to speaking up routes
- raise the profile of FTSU in primary care across every system
- ensure an executive lead is appointed to oversee this work.
NHSE Regions will be checking on progress as part of 2024/25 arrangements, and NHSE expect that by 2026, ensuring access to FTSU guardians in primary care will form a new part of the delegation arrangements. Read more
Further resources including guidance, tools and case studies are available here.
For information and guidance of ICB Audit Committees
NHS England - Sexual Misconduct Policy
Following the launch of the NHS sexual safety charter last year, NHSE have launched a new internal Sexual Misconduct Policy. The policy aims to ensure any member of NHSE staff who has experienced inappropriate and/or harmful sexual behaviours at work is supported. They have also launched the first-ever public sector national guidance to all NHS systems on tackling and responding to sexual misconduct at work. This includes a National Policy Framework on sexual misconduct and Assurance Framework to support local NHS organisations implement the sexual safety charter and ensure steps are taken to prevent sexual harassment at work. As part of this package, staff across the NHS are encouraged to complete the new e-learning module on understanding sexual misconduct in the workplace.
For information and implementation across all NHS systems
NHS England – Delivering productivity through the NHS estate NHSE has issued a report looking at estate costs and productivity performance in 2022/23
NHSE has issued a report looking at estate costs and productivity performance in 2022/23 when compared with those recorded in the 2016 report by Lord Carter. The report found that over the past nine years, the cost of occupancy across NHS secondary care has fallen from £12.2bn in 2014/15 to £11.9bn in 2022/23 while the number of patients using these facilities increased by 13.8 million. The non-clinical occupied floor area has dropped from 44% to 33% of the total estate, below Lord Carter’s 35% target, while the under-utilised occupied floor area has dropped to 1.9% from 4.4% in 2014/15. Read more
For information
Institute of Internal Auditors – Risk in Focus 2025
Risk in Focus is an annual thought leadership research project analysing the top risks faced by organisations in all sectors across Europe currently in its 9th year of publication. It is a tool for internal auditors and audit committees and an indicator of what Chief Audit Executives (CAEs) and others perceive as their organisations’ risk priorities for 2025 and beyond. Key Findings this year include:
- Digital disruption, new technology and artificial intelligence (AI) was the survey’s fastest riser – going from 6th place in 2024, to 4th place in 2025 and expected to rise to 2nd position by 2028.
- 83% of respondents indicated that cybersecurity and data security was a top 5 risk and the top risk yet again in this year's survey.
- Human capital, diversity, talent management and retention held its 2nd place ranking with 52% of CAEs placing it as a top 5 risk. Read more
For information
King’s Fund - Tackling health inequalities: seven priorities for the NHS
A King’s Fund report advocates that the government must put a greater focus on prevention - with funding for both capital and revenue spending. The report sets out seven priorities to ensure the new 10-year NHS health plan addresses health inequalities and tackles the worst health outcomes. The think tank considers the case for addressing health inequalities is ‘clear and overwhelming’, with little progress having been made in recent years. Prevention is seen as key to addressing health inequalities, with the failure to invest in prevention to date having hit the poorest communities hardest. Read more
For information
NHS Employers - Recruiting people who have experienced homelessness toolkit
This new recruitment toolkit includes guidance and strategies for organisations to diversify their workforce by recruiting staff who have experienced homelessness and to support them to stay in and thrive in their role.
For information
NHS Employers - Home and agile/hybrid working guidance
This guidance aims to support employers with assessing whether a role could be suitable for home or agile/hybrid working. It also includes guidance on tax implications/considerations and potential contractual implications. Read more
For information
NHS Resolution - Workplace violence prevention and reduction
This report highlights how workplace violence can be prevented and reduced by ensuring high-quality, accurate risk assessments are undertaken that acknowledge and mitigate the risks of escalating violence.
For information
Nuffield Trust - The state of social care in England, and the case for a comprehensive social care strategy
This briefing describes the key findings from Nuffield Trust research and analysis on social care over several years. It outlines the definition and context of social care, the current range of dire problems, and makes recommendations to address these, building a thriving future for the sector as a vital public service. It suggests urgent, immediate actions as well as the shape of successful reform in the long term, and looks at how adult social care can work better with the NHS. Read more
For information
Localis - Heart of the matter: getting to grips with whole place transformation
The aim of this report is to debate what needs to happen, at a local level, to improve public services and revive local economies. It draws on research and conversations with local leadership from across England in an attempt to present some of the key elements of a reform agenda aimed at whole place transformation. Read more
For information
Local Government Association - Championing inclusion health: local government’s key role
Local government plays a vital role in championing inclusion health for the country's most vulnerable communities. This report, and the case studies within it, offer insight into the optimal ways of working with inclusion health groups - while also shining a light on the scale of work required to improve health care for a diverse range of people across England. Read more
For information
NHS Confederation - Paving a new pathway to prevention: leveraging increased returns on our collective investment
This report (produced together with Carnall Farrar) suggests that better targeting of existing money spent on prevention could deliver an extra £11 billion annual return on investment (ROI) and hold the key to the government achieving its goal of increasing the impact of prevention. The analysis also found that if the upper quartile ROI was achieved across all interventions, then the financial impact could be up to £22B per year – an increase from the £11B per year estimate that comes from the £5B per year of current spending. Read more
For information
NHS Confederation - Working better together in neighbourhoods
This report sets out the evidence for neighbourhood and community-based efforts to improve health and wellbeing. It finds a spectrum of different types of interventions, from those developed within and by statutory bodies, to those that have arisen entirely within communities themselves, often in a conscious response to gaps within, or perceived failings of, the local services upon which all communities rely. This report shows what can be learnt from these experiences to build a better set of co-ordinated, neighbourhood-based responses to improving health and care, working together. Read more
For information
NHS Confederation - Unlocking prevention in ICSs
This report establishes: what prevention means to people working within integrated care systems (ICSs); the barriers, enablers and opportunities for prevention within systems; best practice on overcoming those barriers; and the support needed at the national level to progress the prevention agenda through ICSs.
Read more
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The Confederation has also published an accompanying guide to balancing short- and longer-term impact regarding prevention initiatives. The guide explores practical considerations for leaders looking to move forward decisively with the delivery of their strategic prevention agenda by demonstrating impact in the short term. It includes emerging thinking and prompt questions to support leaders in system-level discussions, together with case studies of how system partners are driving forward progress in practice. Read more
For information
Nuffield Trust - NHS hospital care: who is waiting and what are they waiting for?
This analysis from Nuffield Trust and the Health Foundation reveals there are large differences between how long different groups of patients are waiting for NHS care in England. In particular, it shows that people from the most deprived areas are much more likely to say they are waiting for planned care, young people of Black ethnicity experience longer waits in A&E, and those waiting for gynaecological care face a hugely increased waiting list. Read more
For information
NHS Providers - Counting the cost: understanding your ethnicity pay gap
This guide has been co-produced with leading health care law firm Hempsons, to support trust board members to understand their organisation's ethnicity pay gap. Read more
For information of NHS Trust Board members
Information Commissioners Office (ICO) - New Freedom of Information (FOI) resources
The ICO has launched two new resources to help public authorities handling information requests under the FOI Act:
- a checklist for undertaking internal searches, designed to help organisations to conduct FOI searches and find the correct information first time; and
- examples of how Section 14 (vexatious requests) can be applied in practice.
They have also updated their website to highlight FOI decisions and learnings from decision notices and outcome of FOI tribunals.
For information
HFMA - A guide to business cases for digital projects
As a key part of good governance, a robust, well-evidenced business case demonstrates the potential of a new idea to deliver real value across the whole health and care system, giving a digital tech innovation the best chance of being adopted. This briefing looks at the structure of a good business case for digital investment projects in the NHS. Read more
For information, and implementation as appropriate, by all NHS bodies investing in digital programmes
NHSE - Implementing and evaluating AI in health and care
NHSE have released a new report capturing key insights and lessons learned from the rollout and evaluation of artificial intelligence (AI) in the NHS. The report provides valuable guidance for implementing and evaluating AI in health and care, as well as national teams working to support innovation. Read more
For information
NHS Confederation - AI in health care: navigating the noise
This guide aims to support health care leaders to make sense of artificial intelligence and explore what is currently possible. It includes a jargon buster and various case studies on how AI is currently being used in some NHS trusts. Read more
For information
Royal Society for Public Health - Public health 2040: how technology and AI is reshaping the wider public health workforce
New technology and artificial intelligence (AI) has already had a profound impact on the UK, and offers new opportunities to improve the delivery of public health. However, these developments also pose potential threats to the wider public health workforce, who are key to ensuring a healthy population. They are uniquely placed to help manage these changes to the public’s health and will be essential in navigating and utilising new technological developments. Read more
For information
Ada Lovelace Institute - Predicting: the future of health? Assessing the potential, risks and appropriate role of AI-powered genomic health prediction in the UK health system
This report is the second of two reports published as part of a two-year ‘futures’ research project conducted by the Ada Lovelace Institute in partnership with the Nuffield Council on Bioethics. The project seeks to anticipate, assess and navigate the potential impacts of the convergence of AI and genomics over the coming 5–10 years. This report sets out the potential effects on the UK health care system. 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.
