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What Difference Does It Make?

Not a reference to The Smiths first top twenty single back in 1984 (yes I’m old enough to remember – I wish I still had all of that hair) – but a phrase that has enormous importance to everyone working in the National Health Service and particularly us at Audit Yorkshire.

I have sat in a lot of interviews over the years where we have asked nervous candidates why they want to come to work as an auditor or as a local counter fraud specialist in the NHS. I’ve heard many answers to that question (my favourite is probably still - ‘for the free healthcare benefits package’) – but one of the most common answers is ‘to make a difference.’

I imagine that this would be a common answer in interviews for most roles in the NHS.

I have to admit that this desire to ‘make a difference’ was one of the main drivers that encouraged me to move my career from accountancy in the commercial sector to audit in the NHS. It seemed to me that Audit work covered all of the key systems of control within NHS organisations – and that therefore there was a huge potential to make a difference – to spot opportunities, to make improvements, to recommend changes and to see the real benefits accruing from those actions we have recommended.

Recently I have been thinking more and more about how we make sure that real benefits do accrue from our recommendations. This is sometimes difficult as the auditor is able to shape the recommendation for action - but making the action happen and ensuring it is applied in the most effective way possible is dependent on the efforts of the managers and staff in the organisation assigned responsibility for taking the action. 

I was recently invited to give a presentation to the Clinical Audit team at Mid Yorkshire Hospitals NHS Trust on the subject of Effective Action Planning.  It was a really excellent session and we realised that we have a relatively common approach in terms of making sure that action plans are designed to be as effective as possible.  We identified a list of some of the key facets of Effective Action Planning:

We agreed that this final step is absolutely crucial in terms of getting best value from audit work undertaken and in terms of ‘making a difference.’ We discussed a list of some of the key facets of follow up:

Audit Yorkshire is currently reviewing its standard approach to recommendation follow up. The review to date has highlighted that Audit Yorkshire already adopts a really robust approach in line with the best practice outlined above.  It is really pleasing to see the impact of the recommendations we make – and the initial review work indicates that Audit Yorkshire can respond to The Smith’s question with the words ‘A really big difference!’

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