Each year, the Audit Commission assesses how well NHS trusts and primary care trusts manage their resources and deliver value for money. For 2009/10, these assessments have been based on the Auditors' Local Evaluation (ALE) for NHS trusts and Use of Resources (UoR) for primary care trusts. NHS foundation trusts are assessed by Monitor.
We have published a national report outlining the scores and how they should be viewed in the context of the overall financial performance of the NHS in 2009/10.
The report shows sustained improvement nationally over five years. The great majority of NHS trusts and primary care trusts are managing their money well.
The report also summarises the audit of the 2009/10 accounts for strategic health authorities, NHS trusts and primary care trusts. Auditors found that:
- these NHS organisations returned a surplus of £1.5 billion;
- only 10 organisations out of 260 failed to achieve financial balance;
- no organisation had its accounts qualified on grounds of truth and fairness; and
- there was also no difference overall between draft and final accounts, which is a remarkable achievement.
This year, 2009/10, is the last in which auditors will undertake ALE and UoR assessments. Given the financial challenges the NHS will face in the next few years, we now intend to focus auditors' work until 2013 on the financial resilience of trusts, including their ability to achieve cost improvements.
Auditors make assessments in a number of themes using key lines of enquiry. There are five themes for ALE and three themes for UoR:
ALE
- financial reporting
- financial management
- financial standing
- internal control
- value for money
UoR
- managing finance
- governing the business
- managing resources
UoR differs significantly from ALE, although the process and scoring system are similar. The UoR assessment is more demanding than the ALE assessment. It is broader, with a greater focus on outcomes.
ALE and UoR list of scores
The full list of scores for both ALE and UoR can be downloaded from our website:
Case studies
A series of good practice case studies from previous years' assessments are also available to help NHS organisations continue to improve their financial management.