Audit and Expenditure Management in Healthcare Organizations

The content is about the importance of audit and expenditure management in healthcare organizations and effective strategies to improve the quality of care services.

Health care Coursework

Table of Contents
QUESTION 1...................................................................................................................................3
QUESTION 2...................................................................................................................................4
QUESTION 3...................................................................................................................................5
QUESTION 4...................................................................................................................................6
QUESTION 5...................................................................................................................................7
REFERENCES................................................................................................................................9

QUESTION 1
Kings college hospital managed by NHS foundation trust is a leading teaching hospital
known for handling patients with major trauma injuries in Lambeth, Southwark, Lewisham and
Bromley districts (The King's Story, (2020)). It is renowned worldwide for its commendable
work in liver diseases and transplantation, haemato-oncology, neurosciences and foetal
medicine, stroke and blood cancers (Sneep, et. al. (2020)).
It was established in 1840's and since then it has been setting milestones starting from
performing the first bone marrow transplantation of UK to setting up world's first voluntary
blood donor service (King’s Green Plan, (2022)). Its future prospects include mould breaking
research and clinical trials to help achieve a Greener NHS that is sustainable healthcare for all
(Hammami, et. al. (2018)). Kings hospital with a total of 1300 around beds, a staff of more than
7000 and a patient count of at least 400 per day, it made a revenue of about 1 billion in the year
2020-2021 (Shah, et. al. (2020)).
The organogram of the hospital includes three structural units-
 Key members: Board of directors, council of governors, and members.
 Care Groups: Whole trust care groups, kings college hospital care group, PRUH and
South care groups (Russell, et.al. (2021)).
 Corporate teams: Business Intelligence, Transformation and site estates and facilities,
capital estates and facilities, corporate medical, corporate nursing, data, technology and
Information, finance, strategy and commercial services and workforce development
(Rela, et. al. (1998)).
The financial flow in NHS initiate from the collection of funds by the government from the
citizens in the form of taxes and national insurance which goes into the Treasury (Corporate
Structure at King’s, (2022)). Then a budget is prepared for each government sector and the
budget decided for Department of Health and Social Care is then split into revenue required for
spending on buildings and equipment, staff salaries and medicines and rest of the funds are
transferred to the NHS (Childers et. al., (2018)). NHS then utilizes the funds for providing the
services it has planned and then passes on the rest of the funds to the Clinical Commissioning
Groups and providers of services (Holland, & Wiseman, (2018). Other than the NHS source, the
Kings Hospital generate its income through charities as well. Data of year 2021 states the total

income of the hospital from charity to be around 3,701,014 (KING'S COLLEGE HOSPITAL
CHARITY, (2021)).
QUESTION 2
National Health Services have a department of Mental Health Services provide better and
effective health care services (Bachmann, et.al, (2019)). This can allowed to provide a better
delivery of health care services and psychological therapy (Harper, et.al. (2013)). This enable
individual to improve their mental health condition. Here, psychological therapist provides
treatment condition like social anxiety, depression, generalized anxiety, other phobia's, panic,
stress disorder, obsessive compulsive disorder (Jati et. al., (2020)).
Skills mix refers to the combination of different category of worker which can employed
within healthcare provision for the patient . It also include macro level planning for local service
delivery ( Dunn, (2012)). It can influence skill mix initiative along with existing professional
roles that need for supporting government and professional associate and along with healthcare
system. Skill mix includes the combination of improved quality of care, job satisfaction and
quality of life.
There are some of the contextual factor which can influence skill mix implementation
that may include need of healthcare system, existing professional roles, supporting government
and relevant professional association. They should be different from country to country (eJohn,
(2021)). This is the one in which need of healthcare system which can have effective role and
can impact the skill mix. There is another sensitivity to existing professional roles that can also
affects skill mix. There is need for different staff which have different shift where they can use
their skills to provide better healthcare service delivery (Antonini, Teo, & Chaudhuri, (2020)).
This may include balancing their skills per safety which can be effective and can allowed to
deliver quality of care services within different shift with utilizing their skills. There are some
speciality of staff in the mix that can enable them to deliver quality of care services and provide
better health improvement to patient (Wiguna et. al., (2019)).
There is also impact of experience which can allow healthcare professional to use their
experience in delivering health care services. This can also improve quality of services that can
have positive impact on patient health outcome (Khawaja, et.al.(2019)). Through experience
healthcare professional are able to deliver better and effective healthcare services to people for
their better and improved health. This can also lead to provide effective healthcare services that

are associated with delivery of quality care services and use their skill to improve patient health
(Webster, Weinman,.& Rubin, (2018)).
Every healthcare premises have their numbers of qualified nurses that can provide better health
care assistant to their other staff member (Karsan, et.al. 2018)). This can be effective and can
provide better health care services to large number of population. Australian nurses association
website can help to share the information about register number of that are qualified nurse within
healthcare that can provide assistant for better delivery of services for patient health (Bushell,,
Thomas, & Combes, (2020)).
QUESTION 3
Staff expenditure refers to the expenses which can include the engagement of staff and
include their salaries and wishes (Soomro et. al., (2018)). This my also include their commission,
bonuses, sick pay, expenses, holiday pay, maternity pay, income tax contribution to occupational
or personal person, income national insurance contribution and many more (Geary et. al.,
(2019)). This is the one in which healthcare organization expenses on their staff member to
enable them and retain them at their healthcare premises to deliver quality of care services for
improved health. This can help a to deliver quality care services (Innayatulloh et. al., (2019)).
Audit refers to official inspection along with verification of credibility of the financial
report. This is the one in which it can be conducted for the business management for internal
control process like government (Tursunbayeva, (2019)). This can be effective and can help
organization to form a view about information which should be presented in financial report.
This can also reflect the financial position of the healthcare organization at given date
(Shanasirova, (2018)).
E-rostering system refers to the system which can help to automate process of
maintaining and creating work schedule (Peimbert-García et. al., (2019)). This is the one which
can be effective and can allow to increase productivity within the organization. Within healthcare
system e-rostering can be helpful to make the organizational schedule for healthcare
professional. This can enable them to perform their role at provided work schedule. This can be
helpful to allocate resources more effectively. E-rostering system can be effective and can allow
the management to track their employee performance (Johnson et. al., (2018)). This can be
effective and can enable to identify specific employee performance in different shigt. This may
include number of staff per shift where productivity should get record with another shift that

have number of work. This should be also recorded by the e-rostering that provide proper record
of employee about their presence, absence and their sickness. It can also help to skill mix where
staff member are involved and should be presented within the health care system (Song et. al.,
(2018)).
E-rostering can be helpful and reduce the manager stress where they should not take
stress about a managing shifting for each and every staff member specifically through the help of
e-rostering. It can enable to shift the employee with different shift that can create a better help to
the manager and help in reducing the stress for making work schedule for every staff member
(Duffell et. al., (2018)). This staff member can also select the shift and input holiday which can
be effective and can enable manager to just provide the approval and e-rostering can make it
automatically (Johnson et. al., (2018)).
E-rostering can also effectively manage the record of every employee along with their
working performance or working schedule (Hasanpoor et. al., (2021)). It can also provide a
smooth process in salary payment according to their presents and attendance (van der Goot et.
al., (2021)). It can also provide smooth process in pay role system where it reduce the
manipulation and does not have risk of fraud. It also provide better management to maintain the
system without any human error (Fosso Wamba et. al., (2021)).
QUESTION 4
Mental health care organization, need to audit non staff expenditure which can include
extra social security payment, lost income and lost taxes (Chen et. al., (2018)). This is the
effective expenditure that can also be known as non staff expenditure on the healthcare premises
(Laokri et. al., (2018)). This is the one which can include a personal income through labour
market earning and resources that can include different payment rather than staff member
(Schwendicke et. al., (2020)).
There are some of the none staff expenditure which may include needle, syringes,
chemicals, equipment, electrical, electricity, gas, repairs, waters and their maintenance and
management (Voskanyan et. al., (2020)). These are some of the non staff expenditure which are
highly effective and can lead to impact on delivery of health care services. This is the
expenditure which should be calculated. Non staff expenditure should be audit in the monthly
basis within the health care setting (Zhao et. al., (2018)).

Inventory should also be included and the none staff expenditure where it include
different equipment. Record keeping can also be expensive and should taken in consideration
where it also include none staff expenditure (Tangcharoensathien et. al., (2018)). First in first out
and first expired first out can also be taken in consideration which have some non staff
expenditure along with borrowing book that can be effective for the health care professional to
deliver quality care services (Mash et. al., (2018)).
Cost effective strategy may also include controlling order, controlling waste and
equipment durability rather than affordability. They are some of the cost effective strategy that
can allow to create high effectiveness on audit of a condition. This can be effective strategy that
can help to implement and maintain best practices and health care premises (Al-Sartawi et. al.,
2018)).
Controlling order which are also present in a stock can help to reduce the none staff
expenditure (Chisholm et. al., (2018)). Controlling waste can also increase the optimum
utilization of resources that can reduce the non staff expenditure. Through controlling order can
help to reduce the extra expanses which is an effective strategy to reduce non staff expenditure
(Wirtz et. al., (2018)).
Durability of equipment can also be effective and can help to reduce the cost effectiveness within
the health care premises. Durable equipment can be effective and can reduce the non staff
expenditure (World Health Organization. (2019)). There is no need to expense on the equipment
every year (Greenaway et. al., (2018)). This can be effective and through low maintenance and
repairing can help to utilize the equipment for longer and can help to reduce the risk of
affordability of equipment with needed high expenses (Saville et. al., (2019)).
QUESTION 5
Management audit refers to analysis and assessment of competencies which can include
capability of company management to carry out corporate objectives (Versino et. al., (2019)). It
can be effective and can help to audit the individual executive performance which include a staff
expenditure and non stop expenditures (Gearhart, (2019)). Here, budgeting can be effective and
can help to include the expenditure for the staff and non staff expenditure include proper cost
that can ensure to run the business more effectively (Parast et. al., (2019)). Here, principle of
budgeting includes the quality and specialization which include traditional budgetary and
provide role of lapse, inclusiveness accuracy and transpiration along with accountability for the

business (Stafseth et. al., (2018)). Here, management skill can be effective and can help to
manage the expenditure and provide through keeping in patience through applying the
mentorship skills (Gainforth et. al., (2021)). This can be effective and can include good
communication that can help to reduce the cost effectiveness and help in decision making
through using the decision making skills for proper budgeting in healthcare organization
(Abraham et. al., (2019)). There is need to ensure about the leadership style which include
autocratic, democratic and lesses-flair that can be effective and can help to perform more
effective role to run the management more (Liebler et. al., (2020)). Lewis change model include
freezing, change and refreezing which include process to entire creating of perception (Kamble
et. al., (2018)). It include resist the change and forces to place accepting the change and
supporting it more effectively (Paneru, (2018)).
From above discussion, it can be conclude that there is high expenditure and need to
ensure about the audit of the healthcare premises that can help to perform and make budget for
the healthcare premises to run the organization more effectively (Harrison et. al., (2021)). This
may include skill mix and some constructual factor that can influence healthcare service delivery
(Devebakan et. al., (2018)). This can also include impact of experience and health care premises
(Shingler-Nace et. al., (2019)). This can also include staff expenditure and staff expenditure that
can help to maintain the expenditure and budget of the organization (White et. al., (2021)).

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