I am delighted to welcome you to our ninth edition of TIAN News as we all digest the result of the recent election, and look ahead to what the new government may mean for the NHS and other public services.  In addition to details of recent and upcoming events, this edition includes another wide range of articles covering some really important risk and governance issues, including:

• Some great work by Audit Yorkshire around maximising assurance from Electronic Patient Records, and how one client is minimising its temporary staff costs.
• How 360 Assurance are helping to support their clients with system-wide assurance.
• Briefings produced by MIAA designed to support Audit Committees to understand changes in the new HFMA Audit Committee Handbook, and to share learning around Cost Improvement Planning.

Louise Cobain, MIAA Executive Director of Assurance and TIAN Vice Chair

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Headlines:

Getting the most out of Electronic Patient Records

A well-designed Electronic Patient Record (EPR) should open up a world of possibilities for undertaking internal audit reviews rich with previously uncaptured detail and enabling thousands of patients’ stories to be reflected. By basing an audit around an EPR, what may once have been limited to small sample testing can now, in theory at least, be 100% of cohort testing telling us how patients experience the systems we review. We can use the data to identify patients whose journey did not follow the expected patterns and pathways and undertake specific analysis of what happened, and what was done about it.

System-wide reviews – learning from 2023/24 work

As the internal audit provider for all NHS organisations within a number of Integrated Care Systems, 360 Assurance has, for the last few years, capitalised on this position to the benefit of our clients by delivering some System-wide pieces of work. However, undertaking work across multiple partners in a System is not without its challenges, and there are a number of things to consider.

Summary guide to changes in the NHS Audit Committee Handbook

At the end of March the HFMA issued a significantly revised new version of the NHS Audit Committee Handbook. This replaces the previous version issued in 2018, and has been substantially restructured and rewritten. It is important that all NHS audit committee members, and staff that regularly attend and support audit committees, are aware of the Audit Committee Handbook, and the changes from previous versions. To assist in this MIAA have produced an ‘Insight’ briefing which summarises the major changes between the new Handbook and previous versions and reiterates some of the key elements.

How can AI affect fraud in the NHS?

We’re regularly hearing in the news about how Artificial Intelligence (AI) will impact and shape our work and home lives. However, we have looked on how it may impact on fraud in the NHS.

Cost Improvement Programmes - How do processes compare?

MIAA recently issued an ‘Insight’ briefing in May summarising the anonymised results of a survey of NHS Foundation Trust/Trust Board members and other relevant personnel, across MIAA’s client base, to collate views on the CIP processes within their organisations.

Reducing the Cost of Agency staff – An Innovative Approach at one NHS Organisation

Media headlines like the ones above are relatively common.  The reality is that all NHS organisations work hard to secure the most appropriate staffing at the most reasonable cost. Audit Yorkshire recently audited the ‘Use of Agency Staff’ at an NHS organisation. During that review we noted an innovative approach which has significantly reduced their cost of agency staff (nursing).

Events Round Up

TIAN members organise and facilitate a number of Groups and Forums across the country to support and develop NHS governance.  e.g. Regional Audit Committee Chair meetings.  A wide range of other education, training and networking events are also run, with many of these sessions now held virtually and being accessible to all TIAN member’s NHS clients.

Upcoming Events

• September 12, 2024 - NHS Impact - Embedding Continuous Improvement into Health and Care - By creating the right conditions for continuous improvement and high performance, systems and organisations can respond to today’s challenges, deliver better care for patients and give better outcomes for communities
• September 17, 2024 - Financial Planning at System Level.  This half-day virtual event will focus on topics related to financial planning at a system level.  The session is aimed at Board members, and particularly those who sit on Finance Committees.
• December 10, 2024 - Governance and Risk Management (Audit Committee). This half-day virtual event will focus on topics related to governance, risk management and audit.  The event is aimed at Board members (particularly those who sit on Audit Committees)

Details of planned and past events organised by Audit Yorkshire and 360 Assurance are available at and This includes slides from the recent session on June 13, 2024 relating to “Hearing the Staff Voice”.

MIAA is a member of the NW Collaborative. You can view and book 24/25 Collaborative NW masterclasses here.

Watch Back:

Collaborative NW masterclasses here and watch back recordings of previous NW Collaborative masterclasses or read about all the previous sessions by visiting the North West Collaborative YouTube channel. This includes a recording of their latest webinar on 3rd of July 2024 which covered “AI and the Public Sector”. This webinar covered what AI and generative AI are, policy and practical considerations, and how it might be used to support public services.

And Finally….. HFMA Awards!

Recognising their longstanding and dedicated contributions to the HFMA, both at branch level and on the national Governance & Audit Committee, Mike Townsend and Louise Cobain each recently received a “Key Contributor” award from the association.  The awards were presented by the HFMA president, Claire Wilson, at their annual Key Supporters dinner on 11th July - which was held this year in the very impressive surroundings of the Members Dining Room of the House of Commons!

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