Guide for Audit and Risk Committees on Financial Reporting and Management during COVID-19

Guide for Audit and Risk Committees on Financial Reporting and Management during COVID-19
NAO 24 June 2020

• This guide aims to help audit and risk committee members discharge their responsibilities in several different areas, and to examine the impacts on their organisations of the COVID-19 outbreak, including on: annual reports; financial reporting; the control environment; and regularity of expenditure.

Health and wellbeing boards and integrated care systems

Health and wellbeing boards and integrated care systems
Kings Fund 13 November 2019

• This long read examines the part Health and Wellbeing Boards, and local government more broadly, have played in the emergence of ICSs so far and options for their future. 
• It examines the contribution of ICSs, to what extent the HWB features in the overall governance arrangements for ICSs and how it works in practice, and the future of HWBs in a world of ICSs.

Governance and accountability for integrated health and care

Governance and accountability for integrated health and care
NHS Clinical Commissioners 4 February 2019

• Increasingly local systems are coming together to deliver integrated approaches to health and social care. This briefing outlines some of the key governance and accountability challenges that these organisations may face when seeking to work more  collaboratively and potential solutions. 
• It also highlights some of the key enablers from those systems that have already progressed on this journey, such as Manchester, and what they need to go further.

Care closer to home through acute care vanguard

Foundations for Change: Foundation Healthcare Group end of programme report 
Dartford and Gravesham NHS Trust Guy’s and St Thomas’ NHS Foundation Trust, March 2018

• The Foundation Healthcare Group (FHG) is a partnership between Guy’s and St Thomas’ NHS FT (Guy’s and St Thomas’) and Dartford and Gravesham NHS Trust (Dartford and Gravesham) and is one of 13 acute care collaborations within NHS England’s New Care Models programme.
• The seven workstreams were:
• Vascular: To develop new models of care and support access to specialist opinion 
• Paediatrics: To develop new models of care in epilepsy, streamline flow through the hospital for paediatrics and standardise pathways 
• Cardiology: To reduce unwarranted variation, streamline pathways from primary to tertiary care and deliver more care locally 
• Information Technology: To digitally link Guy’s and St Thomas’ and Dartford and Gravesham 
• Location: To explore agile working Dartford 
• Health Partnerships: To streamline service delivery contract management 
• Governance: to develop a new governance model to formalise the collaboration

NHS in the spotlight - highlights week ending 29 March 2018

This week has seen the NHS in the spotlight recently with the publication of the Public Accounts Committee report on NHS sustainability and transformation, Prime Minister’s answers to the Liaison Committee,  Simons Stevens at  the Health Select Committee, and the NHS England Board meeting outlining the ongoing work to integrate NHS England and NHS Improvement.

Integration resource centre from Hempsons

Integration resource centre
Hempsons 2017

• Regular news  updates on new care models, integration, STPs and governance.

NHS governance - Introductory guide

Introductory guide - NHS governance
HFMA 23 April 2017

• An outline of what governance is and how it works in practice within an NHS organisation.
• Priced publication.

Six Steps to Managing Demand in Adult Social Care

Six Steps to Managing Demand in Adult Social Care - a performance management approach
Institute of Public Care (IPC) at Oxford Brookes University, March 2017

• Critical steps for managing demand in social care, as well as a range of strategic objectives and suggested performance indicators and targets.
• The steps are

1. Managing demand through the front door of the Council 
2. Managing demand from acute hospitals
3. Effective short-term interventions for people in the community 
4. Designing the care system for people with long term needs 
5. Developing a workforce to manage demand
6. Governance and management arrangements to sustain improvements

Exoskeleton - STPs and the Single Oversight Framework

Exoskeleton - STPs and the Single Oversight Framework
Mills & Reeve 6 March 2017

• It is suggested that there is a mechanism for making Sustainability and Transformation Plans (STPs) part of the governance structure of NHS trusts and foundation trusts through the Single Oversight Framework (SOF) which replaced the Risk Assessment Framework on 1 October 2016. It is argued that this may remove the requirement of new legislation to give the STPs a statutory framework.

Governance and accountability in new care models

Governance and accountability in new care models - presentations
Kings Fund 8 February 2017

• Presentations from a conference which looked at how governance and accountability will work in new care models and place-based systems of care.

Governing for transformation: STPs and governance

Governing for transformation: STPs and governance
Hempsons and NHS Providers November 2016

• This report sets the context for STPs, identifies the challenges for organisations, examines the role of the board and addresses the constraints of current legislation.
• It includes a template memorandum of understanding which STP partners may wish to adapt for use in their local area.

Governance of new care models: approaches being taken in the vanguards

Governance of new care models: approaches being taken in the vanguards
Kings Fund

• Analysis of new governance and organisational approaches being taken by six of the vanguard sites: Salford Integrated Care Organisation, Northumberland Accountable Care Organisation, South Somerset Symphony Project,  Sandwell & West Birmingham Modality Partnership, Dudley MCP.
• Areas covered by the approaches
• Approaches to contracting for the new services
• Partnerships and organisational forms among providers 
• Governance, decision-making and management of providers’ systems 
• Roles of commissioners in the new system 
• Approaches to measuring and incentivising performance 

Alliance contracting, prime contracting and outcome based contracting. A literature review

Alliance contracting, prime contracting and outcome based contracting: What can the NHS learn from elsewhere? A literature review
PRUComm 25 October 2016

• A summary of the findings of a literature review of the available evidence concerning the characteristics of these new models of contracting, such as alliance contracting, prime provider contracting and outcome based contracting, and their implementation in other sectors. 
• The report outlines the characteristics of each model, discusses contract negotiation and specification using the models and potential governance issues in relation to their implementation in the NHS.

Is Bigger Better? Lessons for large scale general practice

Is Bigger Better? Lessons for large scale general practice
Nuffield Trust 19 July 2016

• According to  research drawn from a 15-month study of large-scale general practice organisations in England, three quarters of English practices have now joined large-scale GP organisations, formed to help cope with rising pressure and policies demanding longer hours and new services. This report discusses the factors influencing collaboration in general practice.
•  While these organisations can help to sustain general practice in the face of intense financial pressure and shortages of doctors and nurses, they have so far made limited progress in expanding into new services, and taking on a strategic role in redesigning care.
• Key findings are as follows:
• This agenda is well underway across the country, with almost three-quarters of general practices already in some form of collaboration with others, almost half of which formed during 2014/15. The major reasons for forming were to ‘achieve efficiencies’ and ‘offer extended services in primary care’. 
• Larger scale has the potential to sustain general practice through operational efficiency and standardised processes, maximising income, strengthening the workforce and deploying technology. 
• However, scaling up will take a lot of hard work and cannot just be left to a few heroic leaders. All GPs will need to play a part in making these new organisations successful.
• The evidence that these organisations can improve quality is mixed. Patients had differing views about the benefits of large-scale organisations. Some appreciated increased access, while others were concerned about losing the close relationship with their trusted GP.
• The case study organisations had established high-quality specialist services in the community which were popular with patients, but were delivered at relatively small scale. Trust and close engagement between practitioners and commissioners were very important for successful implementation. CCGs had to manage the tension between supporting large-scale organisations to develop while also managing conflicts of interest.
• The report offers a series of practical insights and lessons for general practitioners as well as important lessons for policy-makers, national leaders and commissioners.

Draft guidance on good governance in a local health economy

Draft guidance on good governance in a local health economy
NHS Improvement 23 May 2016

• This guidance sets out what NHS Improvement expect as a matter of good governance from providers when working in a Local Health Economy (LHE).
• Many providers are likely to be part of more than one unit of planning or working, depending on their purpose. For example, the appropriate unit for specialised services collaborations might look different to Sustainability and Transformation Plan footprints or a devolved area. 
• The guidance also defines what is meant by a LHE and when NHS Improvement might consider taking action against a provider.

Shared principles for redesigning local health and care landscape

Shared principles for redesigning the local health and care landscape
LGA, ADASS, SOLACE, CfPS, ADPH, 14 October 2015

• This document lays out five key principles to provide all local system leaders with shared principles which will ensure that service redesign meets a number of fundamental requirements and provide assurance that proposals are focused on improving services and health and wellbeing outcomes. 
• It also emphasises the need to co-create and co-design new services in partnership with local service users and the community
• The principles are:
• Do the proposals promote a person centred approach?
• To what extent are they rooted in local accountability?
• Are they evidence-based? 
• Do they support a community budgeting, place-based approach?
• Will they make a difference?

Glossary for NHS and local authority finance and governance

Glossary for NHS and local authority finance and governance
HFMA, 13 October 2015

• The briefing outlines the role of relevant national and local NHS and government bodies and goes on to provide a glossary of terms used frequently in relation to finance and governance in the NHS and local government. 
• You must enter personal details to download this document

Legacy records management

Legacy records management: Department of Health Records Office
Department of health 22 July 2015

• An explanation of the services of the Department of Health Records Office (DRO), including a form for registering organisational contact details.

Future of governance and accountability in the NHS

Reconsidering accountability in an age of integrated care
Ben Jupp, Nuffield Trust 15 July 2015

• An examination of the future of governance and accountability in the NHS and social care amid the rise of new provider models, in the context of the growing focus on integration and deep cuts in council funding.

Healthwatch governance

Local Healthwatch Governance: a self-assessment toolkit for local Healthwatch and local Healthwatch Commissioners
LGA 7 July 2015

• This toolkit sets out some key governance questions for local Healthwatch and local commissioners to think about in development discussions and in renegotiating contracts.