Recommendation 17

A large proportion of the Departmental Group expenditure flows through from NHS commissioning bodies into NHS England and NHS providers into the Consolidated Provider Accounts, both of which are prepared by NHS England. Given their impact on the timeliness of the Department’s accounts, we asked the Department and NHS England what they were doing to ensure a more timely audit of NHS commissioners and NHS providers. The Department explained that the issues faced last year were in part because more audits needed to be completed owing to the in-year establishment of Integrated Care Boards (ICBs), combined with particular issues with a small number of firms within the local audit market. It explained that it was working with NHS England to address these issues, including engaging the market to try to build capacity within local audit.25 We therefore asked what steps the Department was taking to ensure that there were sufficient numbers of local auditors and sufficient people in the firms to be able to undertake local audits. The Department told us that it “does not have all the levers under its control on the local audit” but that it was working to ensure that local audit issues “as they refer to the Department and the NHS” were managed and mitigated.26 The Department recognised that the audit of local NHS bodies was a serious issue, but explained that most of the frontline work would be done by NHS England. It told us that this would require “considerable effort” by NHS England and that the Department’s role would be to “do the supporting, national stuff we can do over the top of this”.27