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 - Independent investigation of the National Health Service in England

In July 2024, the Secretary of State for Health and Social Care commissioned Lord Darzi to conduct an immediate and independent investigation of the NHS. Lord Darzi’s report provides an understanding of the current performance of the NHS across England and the challenges facing the health care system. Lord Darzi has considered the available data and intelligence to assess: patient access to health care; the quality of health care being provided; and the overall performance of the health system.

The NHS Confederation has issued a summary and analysis briefing of Lord Darzi's report, called “The Darzi investigation: what you need to know”. 

For information

 

NHS England – Updated Guidance on managing conflicts of interest 

Guidance on managing conflicts of interest has been updated to take account of changes introduced by the Health and Care Act 2022, specifically relating to the establishment of integrated care boards and the introduction of the Provider Selection Regime. It sets out consistent principles to support good judgement about how interests should be approached and managed, and provides advice about what to do in common situations.

For information of NHS Audit Committees

 

NHS England - NHS IMPACT Improvement guides

NHSE have published 4 improvement guides which bring together the best clinical and operational practice. A supporting letter introduces new improvement features within the Model Health System, provides additional information on learning and improvement networks and sets out next steps. The Improvement guides relate to:

• outpatient services
• theatres, surgery and perioperative care
• medical consultant job planning
• urgent and emergency care

For information, and implementation as appropriate, by all NHS bodies within local improvement programmes

 

NHS England - Community diagnostic centres: guidance for planning, design and implementation

The national Community Diagnostic Centre (CDC) Programme is now in its third year and has approved 170 CDC sites across England. This guidance sets out next steps and best practice for systems on developing CDCs, including sections on commissioning, governance, engagement, regulatory and accreditation requirements, digital connectivity, workforce and pathway development.

For information

 

NHS England - New virtual wards operational framework

Our operational framework supports standardisation across the country by highlighting the core components, requirements and benefits of delivering virtual wards at scale for our patients. It is in line with the objectives of the UEC recovery plan year 2. We’ll hold a webinar to answer your questions and details will be shared shortly.

For information

 

NHS England - New Single Point of Access guidance to support winter resilience

The Single Point of Access (SPoA) guidance supports you with winter resilience, operational planning and UEC recovery priorities. It sets out the foundations that all systems need to have in place for winter 2024/25, and best practice case studies and learning.

For information

NHS England - All deaths in England now reviewed independently

From Monday 9 September the Death Certification Reforms, including the statutory medical examiner system, are in effect. This marks the first major change to death certification in decades, ensuring all deaths in England and Wales are now independently reviewed by either a coroner or an NHS medical examiner. Contact details are available for medical examiner offices in England and you can read the recently published National Medical Examiner’s report for 2023.

For information

 

Care Quality Commission - National review of maternity services in England 2022 to 2024

This report presents the findings from a recent national maternity inspection programme. It highlights common issues impacting on the quality and safety of NHS hospital maternity services across the country.

For information of NHS bodies involved in the delivery or commissioning of Maternity Services

 

Office for Budget Responsibility (OBR) - Fiscal risks and sustainability: September 2024

Based on current policy and the latest demographic projections, public debt is projected to almost triple from just under 100% of GDP to more than 270% of GDP over the next 50 years. The estimated damage to the economy and public finances from a changing climate could add between 20% and 30% of GDP to these pressures on debt, while improving the health of the population could reduce them by more than 40% of GDP by the mid-2070s. Chapter 3 of the report updates the assumptions driving the OBR's long-term projections of health spending and looks at the economic and fiscal consequences of alternative health scenarios.

For information

 

Nursing and Midwifery Council - Whistleblowing disclosures report 2024: health and social care professional regulators

This annual joint whistleblowing disclosures report is part of a collaborative initiative with eight other regulators. This aims to highlight how, together as partners, they are addressing serious concerns raised by health and care professionals in the UK.

For information of NHS Audit & Risk Committees and Freedom to Speak up leads

 

Marie Curie - Time to care: findings from a national survey of experiences at the end of life

This report sets out the findings from a national post-bereavement survey, the QUALYCARE survey, conducted in 2023 across England and Wales. The aim was to describe the outcomes, experiences, and use of care services by people affected by dying, death and bereavement in England and Wales. The report reveals that 1 in 3 people were severely or overwhelmingly affected by pain in the last week of life, with bereaved people reporting how difficult it was to get joined-up support from health and care professionals at home.

For information

 

Centre for Mental Health - Just living and coping: the cost-of-living crisis and the nation’s mental health

The cost-of-living crisis has had a profound impact on people with mental health problems, with many struggling to get by day-to-day at the expense of their health. This report draws together research commissioned by Mind to explore the impact of the cost-of-living crisis. The Centre’s researchers heard from 500 people across England and Wales, many of whom already had mental health problems. The research found that 84% of people said the crisis had made their mental health worse, with the biggest impacts among those living in the deepest poverty. The report makes recommendations for the NHS and central government.

For information

 

NHS Confederation - Achieving the 18-week standard for elective care

This analysis (produced together with the consultancy Carnall Farrar) reveals why extra appointments alone will not meet the Labour government's waiting-time pledge to ensure that 92% of patients wait no longer than 18 weeks from referral to treatment.

For information

 

NHS Confederation - Improving our nation’s health: a whole-of-government approach to tackling the causes of long-term sickness and economic inactivity

A ‘whole-of-government approach’ is needed to tackle causes of ill health and reduce NHS demand, according to a new report from the NHS Confederation and the Boston Consulting Group. The analysis stated that reintegrating between half and three-quarters of people who have dropped out of the workforce for reasons of ill health since 2020 could deliver an economic boost of between £109bn and £177bn to the UK’s GDP and unlock between £35bn and £57bn in fiscal revenue by 2029. The report called for the new government to break down the departmental silos that have held back the collaboration needed to tackle this issue.

For information

 

NHS Confederation - AI in healthcare: navigating the noise

The NHS Confederation has released a comprehensive guide to AI to support healthcare leaders. Aimed at board members and wider teams, the guide explains the language surrounding AI and offers examples of how organisations and systems are using it. It also includes case studies on how AI can help with did-not-attends and cancellations, transforming wound care, improving patient triage and establishing a better cataract care pathway.

For information

 

NHS Confederation - The state of integrated care systems 2023/24: tackling today while building for tomorrow

A new survey of integrated care system (ICS) leaders has found that while 9 in 10 are committed to shifting more care out of hospitals, there are widespread concerns that a lack of long-term investment and planning is holding them back.

For information and guidance - of ICS/ICBs in particular 

 

Kings Fund - People power: lessons from the health care response to the Grenfell fire

This King's Fund report examines the health and care response to the Grenfell Tower disaster, how survivors, bereaved families and wider communities stepped in to make their voices heard, and the lessons health and care services across the country can learn.

For information of all NHS Board members

 

NHS Employers - International recruitment toolkit updates

NHS Employers has updated the international recruitment toolkit to reflect recent changes in the international recruitment space. It includes links to the latest tools and resources, including a webinar recording with North West London ICB on recruiting refugees.

For information

 

NHS Providers - Priorities for the NHS workforce: the NHS trust perspective

This briefing provides an overview of the following areas of NHS workforce policy: building an NHS fit for the future, pay, and culture and staff wellbeing.

For information

 

The Health Foundation - Is the use of privately funded health care on the rise?

This analysis explores trends in attitudes, activity and spending on privately funded health care. Where possible, it draws on data covering the whole of the UK, but some data sources exclude Northern Ireland or only cover England. While there may be some distinctive regional trends at play, The Health Foundation believes the findings generally hold true for the UK overall.

For information

 

The Health Foundation - Personalised prevention in England: bridging the gap between policy rhetoric and practical reality

Personalised prevention describes a range of individualised approaches to preventing poor health based on genetic or clinical data and has been politically heralded as a way of reducing strain on the NHS. The opportunities to improve health through personalised prevention are based on underlying assumptions that are not yet matched by today’s clinical, technical and data capability on the ground, and risk widening inequalities. This report concludes that more is needed to build the evidence base and guide future investment in these capabilities.

For information

 

Health Services Safety Investigations Body (HSSIB) - Workforce and patient safety: temporary staff – integration into health care providers

The NHS regularly uses temporary staff to fill gaps in its workforce. This investigation report reveals there is widespread discrimination against temporary staff in the NHS, and this creates a culture of fear that stops them speaking up about patient safety.

For information

 

Policy Exchange - Just about managing: the role of effective management and leadership in improving NHS performance and productivity

This report – based upon more than forty interviews and the findings of FOI requests to every trust and integrated care board in England – considers the role that management and leadership can play in enhancing NHS performance and productivity. It argues that a greater focus on the competencies, permissions and placement of management is required, noting that a weak and anecdotal evidence base has often defined the public debate. The report sets out sixteen recommendations to improve NHS management, including a reduction to vertical, tiers of NHS management, including the abolishment of NHS England and (re)merging its functions with Department of Health and Social Care (but for a delivery function to exist in the form of an NHS management board).

For information

 

Reform - Prescription for prevention: a new model of primary care

This paper sets out a new vision for primary care. Rather than simply calling for workforce growth or bigger GP appointment targets, it sets out a variety of interventions on estates, workforce composition, technology, regulation, and funding models. These are oriented around three core principles: to intervene earlier, respond faster, and avoid decline – all supported by a new technology and funding infrastructure (which are covered in two supplementary papers).

For information

 

IMPOWER - 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 the country in an attempt to present some of the key elements of a reform agenda aimed at whole place transformation.

For information – of ICB/ICPs in particular

 

SC Magazine UK - Learning lessons from the June cyber-attack which impacted multiple NHS Trusts

Earlier this summer, the NHS experienced a crisis that has been marked as a significant moment in its history.  On June 3rd, leading pathology testing organisation Synnovis fell victim to a devastating cyber-attack that resulted in major impacts affecting seven hospitals managed by two NHS trusts. The attackers gained access to 300 million patient records, including sensitive blood test results for HIV and cancer. Leveraging this to issue a £40 million ransom demand, the attack disrupted 3,000 outpatient appointments at King’s College and Guy’s and St Thomas’ hospital trusts in the two weeks following. Learn more.

For information - of SIROs and Audit & Risk Committee members in particular

 

Centre for Thriving Places - Thriving Places Index

The 2024 Thriving Places Index (TPI) provides an up-to-date picture of how well different areas are doing in creating the conditions for everyone to thrive. It brings together the very best existing data and evidence to help you understand and map the pathways to developing a thriving place where you are.

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.