Statutory guidance

Monitor's risk assessment framework

Monitor's approach to making sure NHS foundation trusts are well run and can continue to provide good quality services for patients.

Documents

Risk assessment framework (updated August 2015)

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Governance over audit, assurance and accountability: guidance for foundation trusts

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Detail

The framework describes how Monitor oversees NHS foundation trusts’ compliance with the governance and continuity of services requirements of their provider licence.

Listen to our podcast: Introducing Monitor’s risk assessment framework

Updates to the risk assessment framework (August 2015)

The risk assessment framework has been updated in response to the consultation in June 2015. These changes are in addition to those made in March 2015 and include:

  • monitoring in year financial performance (income and expenditure margin) and the accuracy of planning
  • combining a foundation trust’s rating on these 2 measures with the existing elements of the CoS risk rating to produce a new single financial sustainability risk rating
  • including a value for money governance measure within the existing governance rating
  • the requirement for all foundation trusts to submit monthly financial information as highlighted in the recent FT bulletin.

The changes we have made will enable us to act sooner where there are concerns about a foundation trust’s financial sustainability and/or efficiency. However they will not lead to an automatic licence breach. They allow us to consider whether a potential investigation is necessary.

We have also made changes to the accounting officer memorandum to strengthen the requirement to consider value for money.

Updates to the risk assessment framework (March 2015)

The risk assessment framework has been updated in response to the consultation in late 2014, these updates include:

  • introducing the new access measures for mental health as governance proxies
  • specific requirements for providers of high security psychiatric services
  • adding an additional trigger for investigating financial risk at trusts
  • general updates to bring it up to date with recent policy changes

Governance over audit, assurance and accountability: guidance for foundation trusts

This document accompanies the risk assessment framework and gives guidance for NHS foundation trusts on governance over audit and assurance. It replaces some of the provisions previously included in Monitor’s audit code for NHS foundation trusts.

Update to appendix C

After a period of public consultation, Monitor updated appendix C of the risk assessment framework, which relates to NHS foundation trust transactions.