As hospitals become foundation trusts and move into the area of profit and loss, the Audit Commission is threatened with a loss of business. Hospitals may prefer auditors well versed in the commercial accounting world to those concerned about whether public money is spent economically, efficiently, and effectively in the areas of local government, housing, health, criminal justice and fire and rescue services. The Commission is responding to the challenge by changing and adapting and ensuring that auditors have commercial expertise, experience and knowledge.So far 31 trusts have gained Foundation Trust status and a further 32 trusts are eligible to apply for the next phase of authorisations due from 1 April 2006. The trusts are tailored to the needs of local populations and run by local managers, staff and members of the public. The Health and Social Care Act 2003 establishes NHS foundation trusts as independent public benefit corporations modelled on co-operative and mutual traditions. The first foundation trusts were authorised by Monitor, the regulator, from 1 April 2004.
The Audit Commission is currently the leading supplier of external audit services to foundation trusts and it has been appointed as external auditors to over half of the existing trusts. The Commission is currently going through a process described as ‘enriching’ its auditors with commercial experience and knowledge.
A more commercial approach is also noticeable in the Commission’s marketing. It has launched a new publication Financial Health News, its first news magazine dedicated to its work with the health sector. Its aim will be to inform NHS stakeholders about the Commission’s role in health with regular updates on planning for national studies and reports and new developments within its regulatory role. The first issue has been delivered by email and hard-copy to more than 5,000 health trust non-executive directors and finance directors.