Developments: External Audit Fee Levels in NHS Trusts

Abstract

This article discusses the external auditing regime of NHS trusts and analyses the fees charged by their auditors. It adapts approaches developed in the private sector to investigate audit fees paid by NHS trusts and finds that, while similar factors are associated with the audit fees of trusts, there is no evidence of a ‘Big 6’ premium and trust audit fees are significantly lower than those of similar private sector organizations. Explanations for this are sought in the different natures of public and private sector audits, which indicate that differences in fees might be anticipated in the public sector, especially with the presence of a quasi-regulator in the form of the Audit Commission.