Analysis of 2016/17 internal audit high priority management actions in the NHS

The NHS continues to operate within a significantly challenging environment, and whilst the scale and depth of those challenges are well documented, pressure on the NHS is arguably greater than it has ever been. While NHS funding is rising in real terms, it is at a slower pace compared with historical trends, meaning that financial pressures remain and trusts continue to encounter deficits. Allied to this, reductions in funding in other governmental departments, notably local government and social care services, has further increased the pressure on the NHS to pick up the slack. Increases in service demand mean that trusts are operating at capacity levels and treating more people; this is putting pressure on waiting times and staff, which is compounded by growing patient expectations.

Against this backdrop, we have undertaken an analysis of all high priority management actions agreed with our internal audit NHS clients in 2016/17. This paper highlights what we, and our NHS clients, consider to be the most important matters to be addressed from the outcomes of our internal audit reviews and allows NHS organisations to gain an insight into those key themes arising. 

We agreed 436 high priority management actions across 86 healthcare clients. Those healthcare clients where we agreed high priority management actions are:

NHS high priority management actions

As part of our approach to categorising internal audit findings, we agree low, medium and high priority management actions with clients. A high priority management action is agreed where there is a serious internal control or risk management issue and where immediate management attention is necessary.

In analysing the outcomes, we have categorised agreed management actions into key themes and, for those more prevalent categories, provided further analysis through the use of sub-themes. We now analyse those agreed management actions across NHS providers, CCGs, CSUs and CICs – download the full report.