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Presentation by Ernst and Young, from the 3rd October 2013 Audit Committee Chair Forum, on the key challenges facing the NHS and how audit committees can help to address these.


  • 1. Health challenges external audit perspective South Central Audit Committee Chairs Meeting 3 October 2013

2. Agenda Current issues and challenges Sector developments and the wider economy Developments in regulation Accounting and governance External audit challenges Implications for audit committees Questions and discussion 09 October 2013 [Presentation title]Page 1 3. Current issues and challenges Sector developments and the wider economy Spending review 2015-16 Health and social care performance A&E funding 2012/13 FT performance Sir Bruce Keogh and Cavendish reviews Improving care for vulnerable older people 09 October 2013 [Presentation title]Page 2 4. Current issues and challenges Developments in regulation NHS England and Monitor working together Consultation on the mandate to NHS England CQC thematic review of mental health care and new inspection plans 09 October 2013 [Presentation title]Page 3 5. Current issues and challenges Accounting and governance Auditing the accounts 2012-13 Data assurance framework: Mental health National Fraud initiative 09 October 2013 [Presentation title]Page 4 6. External audit challenges - a reminder of what we do Mandated Code of Audit Opinion Value for Money conclusion Regularity opinion Remuneration report Annual report Consolidation schedules Specific reporting powers Section 19 referrals Public interest reports Introduction to External AuditPage 5 Additional Services Yes, but have to consider Independence Fee 7. External audit challenges - key risks 2013/14 and beyond Increasing financial pressures Joint working Relationship between CCGs and CSUs Continued uncertainty from change CCG opening balance sheet More financial statements to produce and audit 09 October 2013 [Presentation title]Page 6 8. Implications for audit committees Assurance framework Internal reporting Joint working Influence and control Management information and external assurance s Continued scrutiny and accountability 09 October 2013 [Presentation title]Page 7 9. Implications for audit committees How should you go about meeting your responsibilities? Use audit (internal and external) and counter fraud Meet with the auditors Consider clinical governance Obtain management assurances Consider third party assurances shared services and partnership working Strong admin support and preparation clear reports in advance 09 October 2013 [Presentation title]Page 8 10. Other services available EY can help organisations manage change in many ways Act as critical friend Provide performance and improvement consultancy services Carry out benchmarking exercises Advise on out sourcing of services or new ways of service delivery Advise on risk management Advise on IT risk and assurance Provide Tax, pensions, IA services and accountancy services BUT Must comply with ethical standards and report any conflicts of interests between our audit and advisory work Introduction to External AuditPage 9 11. Discussion and questions The only stupid question is the one left unasked Introduction to External AuditPage 10 12. Thank you