Internal Audit (IA) is a key source of independent internal assurance to Boards and Chief Executives (as Accountable Officers) of individual NHS bodies. A strong, independent internal audit function is also important in Accountable Officers, through their Annual Governance Statements, assuring the Chief Executive, NHS Wales of his ability to place reliance on the information provided by individual NHS bodies.
External assurance providers, including the Wales Audit Office (WAO) and Healthcare Inspectorate Wales (HIW) may also seek to rely upon the work carried out by Internal Audit in planning their own work. Indeed HIW and WAO are already doing so, in line with the requirements of the Concordat between bodies inspecting, auditing and regulating health care in Wales. This relationship between internal audit and external regulators has potential to develop further with the increasing professional conduct and independence of the Internal Audit function.
Aligned with the 2009/10 healthcare structural reforms Welsh Government set out a framework for the effective provision of Internal Audit within the new NHS in Wales. These arrangements have matured and developed further with the introduction of a new model of audit service provision through the NHS Wales Shared Services Partnership (NWSSP) from 2011/12.
NWSSP Audit & Assurance Services now provides professional quality audit and assurance services to all NHS organisations in Wales. The function is headed by a Director of Audit & Assurance with a named Head of Internal Audit assigned to each local organisation. This model enables bodies to enjoy a service responsive to local organisation needs and priorities whilst conforming to mandatory standards and industry best practice in terms of operating frameworks, policies and protocols. Further information about the NWSSP Audit & Assurance Services is available at the useful links section on this page.
The overall framework within which Internal Audit provides a flow of assurance to the Accountable Officer and the Board has also been developed and strengthened. Key amongst these changes is the introduction of the Public Sector Internal Audit Standards (PSIAS). The standards apply to all public bodies with effect from 1 April 2013 and replace the Internal Audit Standard for the NHS in Wales published in 2009.
The new Standards, are based on the mandatory elements of the Institute of Internal Auditors (IIA) International Professional Practices Framework (IPPF), and are intended to promote further improvement in the professionalism, quality, consistency and effectiveness of internal audit across the entire public sector. They have been revised to take account of comments received during an open consultation process and reaffirm the importance of robust, independent and objective internal audit arrangements to provide the Accountable Officer with the key assurances they need to support them both in managing the organisation and in producing the Annual Governance Statement. The PSIAS are available in the resources section on this page.
Other documents and guidance have likewise been updated since the 2009 framework to maintain their currency and ensure best practice in the provision of Internal Audit in NHS Wales. These new documents, which are available as Key Documents on this page, include:
NHS Boards and Trusts will need to ensure their Internal Audit provision through the NHS Wales Shared Services Partnership operates in accordance the updated framework and requirements set out in Standing Orders. In particular, Boards will need to:
Board Secretaries will facilitate these requirements through the planning of Board business.
The work of internal audit is overseen by an Audit Committee set up by the Board to consider audit matters, and this committee is responsible for advising the Board on the effectiveness of the internal audit function. The work of the Audit Committee should itself follow the guidance set out in the NHS Audit Committee Handbook which can be seen via this page.