As Geoff says save that in a highly specialised area the IAO may be even less likely than the DPO to have the resource to sign off SARs personally.
In a large hospital forever the IAO for patient records will probably be at director level and will hardly ever see a SAR. He / she is however responsible for setting the process, delegating decision making to specialist staff, and ensuring resources provided are adequate to meet timescales. In practice he/she will also manage the risk, subject to oversight by SIRO - and now with DPO keeping a watchful eye over all and reporting to the board / Cex if they fudge it.
... and all subject to monitoring and auditing.
And going back to the OP and the relationship with auditors, that is down to conversation and agreement. DPO has a formal responsibility, but how hands on that is is pretty much open. Much may be effectively delegated e.g. to existing internal and external auditors, to the IG team (e.g office / ward spot-checks), to the IT team (e.g. monitoring system security). The DPO needs to consider the whole program of monitoring much of which will pre-date GDPR by years.
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