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The discussion took place at a meeting of the committee on 23 July, the minutes of which were seen by the Medical Independent through Freedom of Information legislation.
The committee advised consultancy firm Mazars, which the NTPF had newly-appointed as internal auditors, that “the treatment of patients and the management and control regime around the commissioning process is a key risk for the organisation”, according to the minutes.
It was agreed that a draft “risk appetite document” would be circulated to outline a policy “appropriate” to the NTPF in the area.
“It was acknowledged that the complete elimination of risk was impossible,” according to the minutes. “It was noted that internal audit can only advise in this area and cannot be part of any decision-making process.”
The meeting decided that the risk register needed to identify different types of risk, such as strategic, financial and operational.
In addition, data risk, data integrity and IT systems security should be considered as part of the internal audit programme, the meeting heard.
“Other areas for consideration in the programme are procurement and compliance with public sector procurement rules, a clinical process review as part of commissioning and a review of internal financial controls to provide the board with comfort that they are working and effective,” outlined the minutes.
It was agreed that Mazars would discuss a work programme for the coming 12 months with NTPF executive management, prioritising the high-risk areas, including reputational risk.
At a previous meeting of the committee, in May, a discussion took place on quality assurance and patient safety in relation to the commissioning process.
“It was noted that all hospitals must be accredited by Joint Commission International (JCI), which is an internationally-recognised accreditation system for hospitals and all consultants carrying out NTPF work must be included in the relevant section of the specialist register.”
The meeting heard that all relevant hospitals have been visited by the NTPF’s medical adviser Prof Frank Keane, who has reported on his findings.