Technical / Technical review - June 2020

The Ministry of Housing, Communities and Local Government (MHCLG) has published a second response to the Redmond Review on local authority audit. Although the Redmond review focused on local authority audit issues, some of its recommendations will impact on the NHS audit market. In this response, the MHCLG are recommending that the new Audit, Reporting and Governance Authority (ARGA) will take responsibility for the regulation of local audit, monitoring and review of local audit performance and development of the Code of audit practice. These responsibilities will cover both local authority and NHS audits. As ARGA has not yet formally been established the MHCLG will take the role of system leader in the meantime. The ministry will work with the Department of Health and Social Care, NHS England, NHS Improvement and the National Audit Office, as well as other stakeholders in local audit, while the arrangements for establishing ARGA, including this new role, are progressed by the Department for Business, Energy and Industrial Strategy (BEIS).

Guidance on the finance support and funding flows in the national hospital discharge fund has been issued by NHS England and NHS Improvement. The fund aims to help cover some of the cost of post-discharge care, including rehabilitation and reablement, during the first half of the financial year. The document notes the fund could be subject to updates, but in its current form people discharged between 1 April and 30 June will have up to six weeks of funded care, which falls to four weeks for those discharged between 1 July and 30 September. The fund is available to support the costs of new or additional needs and designated care settings for those who are Covid positive. It can only be used to fund care that is over and above activity normally commissioned by clinical commissioning groups and local authorities. Funding has been allocated to each integrated care system, but held centrally by NHS England and NHS Improvement, with CCGs reimbursed based on actual spend.

The HFMA has welcomed the principles set out in NHS England and NHS Improvement’s consultation on the proposed system oversight framework for 2021/22, but called for further detail to understand how the approach will work in practice. In particular, it wants to understand more about what is meant by operational and financial system performance, with a definition of 'what good performance looks like' being helpful. In its response to the oversight framework consultation, the association has also called for clarity on how place-based systems will be identified and on how ‘failure of an individual provider to collaborate in a system context’ will be defined. The HFMA has also responded to the consultation on the 2021/22 national tariff payment system and to the Health and Social Care Committee’s inquiry into the white paper on health and social care.

NHS England has issued guidance outlining all the system development and IT funds available to primary care from regions, systems and clinical commissioning groups. The funds include those for workforce growth and development, digital and access programmes, and practice and primary care network resilience and development. It said the funding would be important to help general practice now, as the emphasis shifts to recovery, and in the future.

A Mental health guidance and resources map brings together key national guidance and useful resources to support NHS finance professionals. The Covid-19 pandemic has put an increased focus on mental health services and there are significant amounts of guidance as the government prioritises investment in this area. Following a similar layout to the popular HFMA NHS efficiency map, the NHS corporate governance map and the Covid-19 guidance map, the new HFMA resource breaks guidance down into separate sections such as national strategic plans, tackling inequalities, payment systems and currencies, and funding for service developments and capital. The map will be kept up-to-date as a live reference document.