National Audit Office Research Articles

Challenges and development pathways for the expert examination of grants

Introduction. Organisational and methodological aspects of the examination of applications submitted for grants provided by Russian scientific foundations. Purpose. To determine the role of artificial intelligence in the system for the selection of grant applications. To study methods of project analysis currently used by experts and to develop an innovative algorithm for the verification of applications. Methods. The study used data from the Ministry of Finance of the Russian Federation, the National Audit Office, information provided by Russian scientific foundations (Russian Foundation for Basic Research and Russian Science Foundation), and other data related to the regulation of grant funding. The methods of the investigation included analysis, observation, generalisation, comparison, grouping, etc. Results. A critical analysis of the multicomponent structure of the application procedure was carried out. Methods for the expert support of projects were identified. A conceptual model of a hybrid method for assessing grant applications was developed. The completeness and versatility requirements to the inspected projects were determined. Conclusions. The hypothesis was confirmed that it is necessary to apply an innovative approach to expert examinations, which ensures the effectiveness of controlling applications at various stages of their life cycle.

VfM audit and the UK public sector: A critical review of the VfM reports

AbstractThe study investigates why the value for money (VfM) audit, in its current form, fails to capture the actual state of affairs in the UK public organizations. To address this, we utilize a VfM assessment matrix and key public sector performance indicators to critically evaluate the VfM reports published by two main public bodies in the United Kingdom, that is, the National Health Services and the police authorities, alongside the reports published by the National Audit Office and Her Majesty's Inspectorate of Constabulary and Fire & Rescue Services. Our results reveal that the VfM reports do not clearly show how the 3Es (i.e., economy, efficiency, and effectiveness) associated with the VfM assessment are attained. There are also limited suggestions on the public bodies’ service output or social outcomes and how performance targets are fulfilled. We deduce that the VfM audit's failure to capture these elements significantly curtails the benefits of the VfM exercise to public bodies. We argue for complementing the current VfM assessment with a review of the performance of these bodies based on the services they offer as well as their strategic objectives.

1012 ASSESSING THE CLINICAL EFFECTIVENESS OF EMERGENCY HEALTH CARE PLANS (EHCPS); A RETROSPECTIVE REVIEW

Abstract Introduction Almost 30% of hospital patients are in their last year of life; mortality is five times higher one year post-hospital admission for patients aged 85+ (Clark D, Armstrong M. Palliative Medicine, 2014, 28, 474–479). Studies have shown 40–50% of those who die in hospital could have died in the community (End of Life Care, National Audit Office, 2008). As a geriatric department, we wanted to adopt existing good practice to ensure we were recognising individuals in their last 12 months of life and enabling them to die where they chose. Method Using the Gold Standards Framework (Clifford C, Thomas K, Armstrong-Wilson J. End of Life, 2016, 6) in 2019 DrZin introduced a standardised document for EHCPs. We reviewed 123 EHCPs implemented March 2019—August 2021, focusing on the number of attendances to A&E in the year prior to implementation, the number of avoidable admissions to hospital following completion of an EHCP, and place of death. Results Of 123 patients, the mean number of A&E attendances in the year before EHCP implementation was 2.52 per patient; post implementation it was 0.18. There were 22 A&E attendances after implementation (17.8%); all resulted in an admission. Of those, 12 (54.5%) were deemed avoidable. There were 100 deaths (81.3%) within 12 months of implementation; 5% died in hospital. Conclusion 95% of patients with an EHCP died in their preferred setting. Having an EHCP reduced patients’ attendance to A&E. However, work is required to reduce avoidable attendances, through education for GPs and community carers. Although every EHCP was sent to the patient’s GP and residence, several attendances contained no reference to the patient having an EHCP. Therefore, the next step of our project will be creating an alert for patients with an EHCP on their electronic record and re-reviewing hospital admissions rates.

Developing the 2020-2030 mental health strategy for Malta: Addressing the needs of a small island state undergoing rapid socioeconomic transition

Malta has embarked on a renewed national endeavour to reform the mental health sector, prioritising mental health in the context of the national health strategy post 2020. Past attempts at reforming this sector were stifled due to insufficient and unsustained political commitment, leaving it direly under-resourced. An interplay of factors over recent years has rekindled political and public interest in mental health. These include: the establishment of a mental health commissioner; indictment from a National Audit Office report; and coordinated public pressure from local media, non-governmental organisations and professionals. Government responded by publishing a mental health strategy to address both long-standing and new challenges arising from rapid socioeconomic changes which have put further strain on an already overstretched system, demanding urgent action. The concept of strengthening resilience is put forward as a central tenet in the strategy and a combination of initiatives were proposed for the prevention of mental illness, investment in physical and human resources and the creation of a new service framework. Successful implementation of this strategy is dependent on continued political commitment, visible leadership, ongoing investment commitment, and meaningful engagement by key stakeholders. Ongoing stakeholder advocacy appears to be crucial to ensure that mental health continues to be considered as a national priority.

Towards an Integrated Mobile Technology on Animal Disease Surveillance Framework in Tanzania: A Systematic Review

Tanzanian Government, through its national audit office in March 2020, reported the prevalence decline of two animal diseases, namely; Foot and Mouth Disease (FMD) and Contagious Bovine Pleuropneumonia (CBPP). Similarly, an increase in three animal diseases, which are African Swine Fever (ASV), Contagious Caprine Pleuropneumonia (CCPP), and Lumpy Skin Disease (LSD). The national audit office mentioned inadequate animal disease surveillance system in the country was among the challenges that hinder diseases control. Therefore, this study reviews the existing animal diseases surveillance systems global and suggests measures to enhance animal diseases surveillance systems in Tanzania. This review focuses on the possibility of sharing surveillance data among livestock stakeholders (including livestock keepers) in Tanzania, considering available resources such as animal diseases existing prediction models and mobile-based surveillance systems. Also, the availability of mobile technologies such as Short Message Service (SMS), Unstructured Supplementary Service Data (USSD) and automatic voice calls (Robocalls). Reviews synthesize the previous studies to explore strengths, opportunities, weaknesses and challenges for better future interventions through proper and timely information sharing. This study selected 46 records from the 147 identified for review. The selected records include 24 from bibliographic databases, 14 from full-text journals and other non-bibliographic databases, and 8 from the open search on websites

The Cybernetics of political communications and social transformation in Colombia: the case of the National Audit Office (1995-1998).

This contribution offers the author’s personal experience with a project that took place 25 years ago in Latin America. This was about Second Order Auditing in Colombia during the second part of the 1990s. This project was carried out at the Country’s National Auditing Office (CGR), and was an application of the Viable System Model (VSM) and the Viplan Methodology to a National Context. It was an innovative project at the CGR, focused on Second Order Auditing, to improve communications within the fabric of the Colombian government. Its emphasis was building responsible trust between public enterprises, ministries and political agencies. Its emphasis was building communications between ministries and public entities, with the aim of increasing their effectiveness. At its core were methodological and epistemological developments. Key questions it attempted to answer were how to model the complexity of the enterprises and how to transform the auditors’ views of their relations with people in public entities, from one focused on requesting information, to one focused on communications. Structural changes were proposed for the National Audit Office and state enterprises, and hundreds of auditors were trained, through epistemological methodological workshops, in second order auditing and the reports of their auditing were debated extensively in government and beyond. This paper finishes with a short discussion of these transformations in the light of organisational cybernetics and in particular of the Viable System Model.

The Decay of University Education in Sri Lanka: A Rejoinder to the Performance Audit Report of the National Audit Office on Arts Education

The Decay of University Education in Sri Lanka: A Rejoinder to the Performance Audit Report of the National Audit Office on Arts Education

Performance auditing and neoliberal governmentality: future research directions

PurposeThis paper aims to interpret the role and professional issues of public sector performance auditing (PA) as a mechanism of neoliberal governmentality in the New Public Management (NPM) era by drawing on a Foucauldian conceptual lens to chart directions for future research.Design/methodology/approachThe study uses the Foucauldian concepts of visibility and identity to interpret PA against the background of neoliberal imperatives of public sector management.FindingsAs the growing emphasis on PA in recent decades can be understood as driven by the concurrent development of neoliberal and NPM rationalities, the relatively underexploited concepts of visibility and identity allow further inquiry into important PA issues. This paper identifies avenues for future research under the following three themes: the issue of visibility in neoliberal governmentality and potential for auditors-general to expand the domain of influence of National Audit Offices through the PA role; the potential for PA as a unified distinct specialisation; and the neoliberal idea of professional identity as the individual expert and its interplay with the potential emergence of PA as a distinct function within the accounting profession.Research limitations/implicationsThis conceptual paper is anticipated to stimulate future PA research. Key areas in this respect include the position and authority afforded to PA and the possibility of transformation in auditors’ conception of their professional worldview.Originality/valueThis paper charts direction for future research by interpreting PA using Foucauldian concepts of visibility and identity that remain to be exploited in PA research.

Predicting Food Safety Compliance for Informed Food Outlet Inspections: A Machine Learning Approach.

Consumer food environments have transformed dramatically in the last decade. Food outlet prevalence has increased, and people are eating food outside the home more than ever before. Despite these developments, national spending on food control has reduced. The National Audit Office report that only 14% of local authorities are up to date with food business inspections, exposing consumers to unknown levels of risk. Given the scarcity of local authority resources, this paper presents a data-driven approach to predict compliance for newly opened businesses and those awaiting repeat inspections. This work capitalizes on the theory that food outlet compliance is a function of its geographic context, namely the characteristics of the neighborhood within which it sits. We explore the utility of three machine learning approaches to predict non-compliant food outlets in England and Wales using openly accessible socio-demographic, business type, and urbanness features at the output area level. We find that the synthetic minority oversampling technique alongside a random forest algorithm with a 1:1 sampling strategy provides the best predictive power. Our final model retrieves and identifies 84% of total non-compliant outlets in a test set of 92,595 (sensitivity = 0.843, specificity = 0.745, precision = 0.274). The originality of this work lies in its unique and methodological approach which combines the use of machine learning with fine-grained neighborhood data to make robust predictions of compliance.

409 The impact of inadequate pain control following chest trauma on hospital acquired pneumonia rate and hospital admission length

Abstract Introduction Patients with blunt chest wall injuries often have severe associated injuries and even isolated chest injuries may have a high mortality and morbidity. The National Audit Office (2010) report estimated that there are 20,000 cases of major trauma per year in England; 5,400 people die of their injuries with many others sustaining permanent disability. Aim To assess compliance with trust guidelines for chest trauma pathway and the impact of poorly controlled pain on hospital acquired pneumonia (HAP) rate and hospital admission length Method A retrospective audit of all chest trauma between October 2019 to February 2020. Data obtained from electronic patient records and admission notes. Patients notes and imaging records are used to analyse adequate pain control based on local chest trauma pathways. Results 28 patients identified (M:F 15:13) aged 47-94 yrs old (average age 73) who suffered from chest trauma in a district general hospital in England. Chest trauma was associated with high levels of morbidity (32%) and mortality (7%). 39% of patients were found to have inadequate pain control based on the local chest trauma pathway. 33% of chest trauma patients developed a HAP and 44% of pts with inadequate pain control developed a HAP. The admission length of patients with HAP secondary to chest trauma was on average three times longer relative to uncomplicated patients (15 days vs 5 days). Conclusions Chest trauma patients often receive inadequate pain control and delayed specialist team input. This results in an increase in the frequency of HAPs and admission length.

New development: Whither the strategic direction of public audit in an era of the ‘new normal’?

IMPACT Given ongoing questions about the role and performance of auditing, the challenges faced by public sector auditors are how to not only maintain the confidence of governments/parliaments and the general public but also to show the usefulness and relevance of audit processes, findings and recommendations in an environment that is significantly adjusting and evolving to a ‘new normal’. This article is a timely examination of public audit strategies from national audit offices, assessing whether they are likely to deliver the objectives of the new normal, for example with the increased focus on digital transformation, work methods, communication and collaboration. It also contributes to the now long-standing practice of shared learning by public audit offices around the world. The article includes national audit offices’ reactions to the changes needed post Covid-19.

Democracy, accountability and audit: the creation of the UK NAO as a defence of liberty

PurposeThe study focusses on explaining why advocates for reform to state audit in the United Kingdom (UK) in the early 1980s, focussed on improving the links between the new National Audit Office (NAO) and Parliament, rather than on traditional notions of audit independence. The study shows how this focus on the auditor's link to Parliament depends on a particular concept of liberty and relates this to the wider literature on the place of audit in democratic society.Design/methodology/approachUnderstanding the issue of independence of audit in protecting the liberties and rights of citizens needs addressed. In this article, the authors investigate the creation of audit independence in the UK in the National Audit Act (1983). To do so, the authors employ a neo-Roman concept of liberty to historical archives ranging from the late 1960s to 1983.FindingsThe study shows that advocates for audit reform in the UK from the 1960s to the 1980s were arguing for an extension to Parliament's power to hold the executive to account and that their focus was influential on the way that the new NAO was established. Using a neo-Roman concept of liberty, the authors show that they believed Parliamentary surveillance of the executive was necessary to secure liberty within the UK.Research limitations/implicationsThe neo-Roman republican concept of liberty extends previous studies in considering the importance of audit for public accountability, the preservation of liberty and democracy.Practical implicationsPublic sector audit can be a fundamentally democratic activity. Auditors should be alert to the constitutional importance of their work and see parliamentary accountability as a key objective.Originality/valueThe neo-Roman concept of liberty extends previous studies in considering the importance of audit for public accountability, preservation of liberty and democracy.

Iran's criminal policy towards money laundering in the country’s banking system

Using the documentary research methodology, the aim of the article was to study Iran's criminal policy towards money laundering in its banking system. A number of measures have been taken in the Iranian legal system to combat money-laundering, the most important of which is the adoption of the anti-money-laundering law in 2007 and its executive regulations in 2009. With the enactment of this law, the crime of money laundering officially entered the Iranian legal system with its own special and independent title. By way of conclusion, it is evident that various governmental and judicial institutions have made the fight against money-laundering one of their main objectives and tasks. Meanwhile, the role of the National Audit Office has also been prominent, and it has made numerous efforts, both nationally and internationally, to identify cases of money laundering, eliminate money laundering and ultimately combat it effectively and efficiently.

Armed Forces and Veteran Housing Policies: The United Kingdom 2021 Vision

Accessing suitable accommodation post transition into civilian life from the military is one of the key markers for future success and wellbeing. For many this process can and does start during their military career. Some veterans struggle to find appropriate housing, often complicated by other difficulties associated with employment, physical and mental injuries, or difficulties with relationships. Over the past two years the position of veterans, veterans’ families, and service people in transition in the United Kingdom (UK) has gained increased national and international visibility through the establishment of the Office for Veterans’ Affairs. The Ministry of Defence’s 2018 Strategy for Our Veterans’ report contains a key theme that veterans in the UK should have a secure place to live either through buying, renting or social housing. However, the National Audit Office (NAO) recently reported that the Ministry of Defence (MOD) is not meeting its commitment to provide high-quality, subsidised accommodation to all service personnel. Satisfaction with single living accommodation has declined in recent years and can impact on the retention of military personnel, risking the MOD’s ability to deliver defence capabilities. This review looks at the policy changes made in the past two years to support quality UK service accommodation, aid, sustain successful post-military transitions, and ensure veterans do not want for adequate housing.

Exploring the Audit Supervision of China’s Medical Insurance Fund Based on the 2019 Medical Insurance Fund Audit Data

This study is mainly based on the auditing of medical insurance funds in the audit work report of the National Audit Office’s 2019 central and provincial and municipal budget implementation and other fiscal revenues and expenditures to conduct audit supervision of China’s medical insurance funds, based on the risk-oriented violation of regulations. Identify and evaluate the risks of each stage of the medical insurance fund from the perspective of risk of breaches, thus draw audit points, summarize the path of the medical insurance fund audit supervision so that that audit resources can be concentrated in important stages and key areas. Audit costs can be reduced, and build the regulatory system of the medical insurance fund audit will be constructed accordingly.

Accounting and accountability practices in times of crisis: a Foucauldian perspective on the UK government's response to COVID-19 for England

PurposeThis paper considers the accounting and accountability practices of the UK government’s response to COVID-19 for England, focussing on the first wave of the pandemic in 2020.Design/methodology/approachBased on a close reading of the news media and official reports from government departments, Parliament select committees and the National Audit Office, among others, this paper frames the UK government's uses of accounting and accountability in its response to COVID-19. This is by using the categories of “apparatuses of security”, Foucault's schematic of government for economising on the uses of state power.FindingsThe paper shows that an important role for accounting is in the process of enabling the government to gauge the extent of the crisis and produce calculations to underpin its response, what Foucault called “normalisation”. This role was unlike statistics and economics. The government relied most on monthly statistical reporting and budgeting flexibilities. By contrast, the multi-year Spending Review and financial reporting were not timely enough. That said, financial reporting fed into financial sustainability projections and enabled audit that could provide potential accountability regarding regularity, probity, value for money and fairness. The authors’ findings suggest that, conceptually, accountability should be added to the object–subject element of Foucault's apparatuses of security because of its significance for governments' ability to pursue crisis objectives that require popular assent.Practical implicationsIn view of the ongoing uncertainty, with the crisis extending over longer budget and financial reporting periods, a Spending Review is becoming ever more necessary for better planning, without limiting, however, the budget flexibilities that have proven so useful for rapid government responses. Moreover, the government should continue its accounting reforms post COVID-19 so that improved accountability and audit can contribute to enhanced future financial resilience.Originality/valueThis is the first paper to apply Foucault's notion of apparatuses of security to an analysis of government accounting and accountability practices.

Whole Life Program Success, Leadership Competencies and Motivation for Learning – UK Defence Case

The value of learning from program management has not received full recognition in the workplace. The purpose of our study was to investigate whole life program management success and its link to leadership competency units to define meaning of true program success and motivation for learning. An inductive interpretive approach using open-dialogue interview technique was applied. Seventeen Defence leaders responsible for the acquisition and support of UK major defence programs in excess £50 Billion published in the UK National Audit Office (NAO) Major Project Report 2015 participated in this study. A case study of the UK Defence programs provides insights into what success is in a Defence context. The study suggests that whole life program management success, measured against capability outcome as against performance, cost and time (PCT), can be achieved through competent leadership. This can be a motivation for learning from the program success. The findings showed that success extended beyond baseline deliveries, and it is insufficient to measure success with PCT parameters. Our study defines what success is and propose its achievement has a direct correlation to program leadership competency and its non-achievement be understood by organisations for survival in a complex highly structured environment.

64 The Impact of Inadequate Pain Control Following Chest Trauma on The Incidence of Hospital Acquired Pneumonia and Hospital Admission Length

Abstract Introduction The National Audit Office (2010) report estimated there was 20,000 cases of major trauma per year in England; of which 5,400 died and many others sustaining permanent disability. Blunt chest wall injuries are associated with high levels of morbidity and mortality, and we aimed to investigate the impact of poor pain control in patient outcomes. Method Compliance with trust guidelines was assessed via a retrospective audit of all chest trauma patients between October 2019-20. Results 28 chest trauma patients identified (M:F 15:13) with ages ranging from 47-94 yrs old (average age 73). Chest trauma was associated with high levels of morbidity (32%) and mortality (7%). 39% patients were found to have inadequate pain control. Only 17% patients eligible for regional anaesthetic blocks were performed within 24hrs. 33% patients developed hospital acquired pneumonias (HAP), of which 44% had received inadequate pain control. Average admission length of patients with a HAP was 15 days compared to 5 days without. 85% patients experienced either delayed or no assessment by specialist teams (i.e., physiotherapy, pain team). Conclusions Chest trauma patients often receive inadequate pain control and delayed specialist team input resulting in increased frequency of HAPs, admission length and morbidity/mortality.

Strategic management accounting in the public sector context: the case of the Swedish Transport Administration

PurposeThe objective of this paper is to generate further knowledge about strategic management accounting (SMA) in the public sector context. The authors attempt to do this through a study of SMA work in a public sector agency (PSA), the Swedish Transport Administration (STA). The paper elaborates on the formation of the agency's strategies and the challenges the agency's SMA work had to deal with, and focuses its analysis on the interplay between SMA and the characteristics of the public sector as well as how it is constitutive of strategy.Design/methodology/approachThe empirical material was gathered between 2013 and 2015 and consists of documents that include the STA's appropriation, mandate, strategic and operational plans, and balanced scorecard, as well as interviews with 35 civil servants at various levels of the STA.FindingsThe study finds that, depending on the performances of PSAs in their specific environment and the influences from the environment's constituents, SMA may function as an instrument that makes or breaks strategies. The characteristics of the public sector context may therefore affect SMA, and by extension, strategy, in several ways. First, the present case shows that the inherent reduction that the focus of SMA techniques entails, and their inability to deal with the complexity of a PSA's context, places them at constant risk of becoming strategically irrelevant in the eyes of knowledgeable local managers in a PSA. Second, interventions from the government may override a PSA's SMA and in effect make a PSA's strategic focus ambiguous. Third, outside monitoring performed by such actors as the National Audit Office and the mass media may influence a PSA's SMA work both directly and indirectly when the agency and the government are responsive to the agenda set by such scrutiny.Originality/valueThe paper broadens the scope of earlier SMA research in the public sector by including the specific characteristics of the public sector in the analysis and how accounting techniques may come to compete for strategic placement as they are propelled from within and from without the organization.

Determinants of cost deviations and overruns in UK transport projects

Cost deviations have long been a relevant research topic within the field of public works and infrastructure. Attempts to evaluate the frequency of cost deviations and overruns (CDOs), and the magnitude of these deviations, have been reported in the literature. Using data published by the UK National Audit Office in the period 1985–2018, a unique overview of 175 UK transport projects is provided in this paper. The aim of this work was to evaluate CDOs in the UK and to identify the main determinants, with a focus on exogenous determinants (context-related), which have been neglected in the existing literature. The results confirm that transport projects show a tendency towards overruns, although there are significant differences between road projects (with an average deviation of 18%) and other types of transport projects (with an average deviation of 60%). The results show that an increase in government efficiency levels leads to a decrease in cost overruns. The findings support an existing theory that there is evidence of the existence of political determinants in cost overruns, but also that economic dynamics play a role in explaining cost overruns. Whether the political bias is psychologically or strategically driven is yet to be demonstrated.