Select Committee · Public Accounts Committee

DHSC Annual Reports and Accounts 2020-21

Status: Closed Opened: 1 Feb 2022 Closed: 2 Sep 2022 20 recommendations 13 conclusions 1 report

The NAO has published its report on DHSC’s accounts for the year 2020-21, with its official audit opinion “ qualified” on a series of grounds related to the Department’s spending : - there was insufficient evidence to support the year-end inventory and accruals balances - £1.3 billion of the Department’s COVID-19 spending was spent either … Show more

Clear

Reports

1 report
Title HC No. Published Items Response
Sixth Report - Department of Health and Social Care 2020–21… HC 253 10 Jun 2022 33 Responded

Recommendations & Conclusions

23 items
3 Recommendation Sixth Report - Department of Health and… Accepted

There is no clear plan for how big the PPE stockpile needs to be and...

There is no clear plan for how big the PPE stockpile needs to be and how the Department will build greater resilience into the NHS supply chain so that it can respond at pace to future urgent needs. Having an appropriate PPE stockpile and a resilient NHS supply chain is … Read more

Government response AI summary
The department is undertaking a fundamental review of the clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease.
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HM Treasury
4 Recommendation Sixth Report - Department of Health and… Accepted

The Department has regularly failed to follow public spending rules and across the Departmental Group...

The Department has regularly failed to follow public spending rules and across the Departmental Group there is a track record of failing to comply with the requirements of Managing Public Money. The Department is required to obtain approval from the Treasury before committing to expenditure where such authority is needed. … Read more

Government response AI summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs) and will provide a further update to the Committee by October 2022.
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HM Treasury
5 Recommendation Sixth Report - Department of Health and… Accepted

The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how...

The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how it identifies and manages declarations of interests. A considerable amount of taxpayers’ money was spent on products from new suppliers, including those with no previous experience of supplying certain Department of Health and Social Care … Read more

Government response AI summary
The department has implemented the agreed revised process for identifying and disclosing interests and related parties, incorporating all lessons learned from the 2020-21 process and recommendations from the National Audit Office (NAO) and will continue to include a full list of interests in each and …
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HM Treasury
6 Recommendation Sixth Report - Department of Health and… Accepted

There have been inappropriate unauthorised payoffs made to staff by health bodies, and the planned...

There have been inappropriate unauthorised payoffs made to staff by health bodies, and the planned large-scale NHS restructuring increases the risk of this happening again. Special severance payments when staff leave public service employment should be exceptional and they require Treasury approval because they are often ‘novel, contentious and repercussive’. … Read more

Government response AI summary
The department has processes in place for monitoring and controlling the approval of exit payments; ALBs are required to comply with schedules of delegation issued by the department, including approvals required in respect of special severance and redundancy payments and NHS England conduct a due …
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HM Treasury
7 Recommendation Sixth Report - Department of Health and… Accepted

With 23 days to go until the financial year end the UK Health Security Agency...

With 23 days to go until the financial year end the UK Health Security Agency did not have an agreed budget for the new financial year. The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as a new executive agency to be the UK leader for … Read more

Government response AI summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
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HM Treasury
9 Recommendation Sixth Report - Department of Health and… Accepted

We asked the Department what plans it had for disposal of the £4 billion of...

We asked the Department what plans it had for disposal of the £4 billion of PPE that it has identified cannot be used in the NHS. The Department told us that it had approached 75 different countries to see if they could use any of the unusable PPE. This has … Read more

Government response AI summary
The Department of Health and Social Care (DHSC) is focusing efforts on accelerating the disposal programme, appointing two Lead Waste Providers (LWPs), Suez and Veolia, to assess the options for disposal, and will write to the Committee over the Summer to set out the detail …
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HM Treasury
10 Recommendation Sixth Report - Department of Health and… Accepted

Prior to the COVID-19 pandemic, the Department held a stockpile of PPE to respond to...

Prior to the COVID-19 pandemic, the Department held a stockpile of PPE to respond to what it considered was a reasonable worst-case scenario of an outbreak of pandemic influenza.19 It was identified in the early stages of its COVID-19 pandemic response that the stockpile it held was inadequate to respond … Read more

Government response AI summary
The department is undertaking a fundamental review of the clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease.
Read full response →
HM Treasury
12 Recommendation Sixth Report - Department of Health and… Accepted

We asked the Department about its commercial capability.

We asked the Department about its commercial capability. It confirmed that this was on its “worry list” prior to the arrival of the COVID-19 pandemic and continues to be a challenge.24 The Department stated that it has an ongoing programme of contract training with some 972 learners across health (DHSC, … Read more

Government response AI summary
The department has undertaken a commercial reset with new structures implemented on 1 April 2022, aligned to the Government Commercial Function (GCF) standards, and is implementing a range of priority commercial capability activity for 2022-23, including a bespoke procurement capability programme.
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HM Treasury
13 Conclusion Sixth Report - Department of Health and… Accepted

We asked the Department for an update on the current position of contracts it had...

We asked the Department for an update on the current position of contracts it had entered into in response to the COVID-19 pandemic. The Department has now identified 17 Q 43 18 Q 79 19 Q 88; DHSC 2020–21 ARA, page 123 20 C&AG’s Report, The supply of personal protective … Read more

Government response AI summary
The government agrees with the implied recommendation to address problematic contracts. It has established a Dissolution Team to work through contracts in dispute and commits to providing regular quarterly updates to the Committee on progress, including amounts reclaimed and commercially sensitive information, with a target …
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HM Treasury
14 Conclusion Sixth Report - Department of Health and… Accepted

The Department has also identified a contract for 3.5 billion gloves where there are allegations...

The Department has also identified a contract for 3.5 billion gloves where there are allegations of modern slavery. When we questioned the Department about this matter, it was unable to confirm the value of the contract. However, it believed that should evidence become available that supports the modern slavery allegations, … Read more

Government response AI summary
The government agrees with the implied recommendation to address the contract with modern slavery allegations. It has established a Dissolution Team to resolve contracts in dispute and will provide quarterly updates to the Committee, with a target implementation date of August 2023.
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HM Treasury
15 Conclusion Sixth Report - Department of Health and… Accepted

The Department told us that the stockpile it held at the beginning of the pandemic...

The Department told us that the stockpile it held at the beginning of the pandemic was exceptionally useful and that there would have been PPE shortages without it. This stockpile was established in 2009, after the swine flu outbreak.28 We questioned the Department on its plans for holding a PPE … Read more

Government response AI summary
The department is undertaking a fundamental review of clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease and is working with the UK Health Security Agency (UKHSA) and NHS Supply Chain on the product …
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HM Treasury
16 Conclusion Sixth Report - Department of Health and… Accepted

We asked the Department why it had started disposing of PPE before it had made...

We asked the Department why it had started disposing of PPE before it had made a decision on the size of the stockpile to hold for future emergencies. It told us that it will not need or be able to use all of the PPE it currently holds. As an … Read more

Government response AI summary
The Department of Health and Social Care is focusing efforts on accelerating the disposal programme of personal protective equipment (PPE) and will write to the Committee over the Summer to set out the detail in full, providing regular updates on the volume of PPE that …
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HM Treasury
18 Recommendation Sixth Report - Department of Health and… Accepted

When granting additional funding to assist with the Department’s COVID-19 pandemic response activity, HM Treasury...

When granting additional funding to assist with the Department’s COVID-19 pandemic response activity, HM Treasury set conditions to ensure appropriate use of the money, that the Department was required to follow. These were in areas such as: advance payments to secure personal protective equipment; advance funding for community pharmacies; enhanced … Read more

Government response AI summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs) and will provide a further update to the Committee by October 2022.
Read full response →
HM Treasury
19 Recommendation Sixth Report - Department of Health and… Accepted

The Department told us that in order to get money to where it thought it...

The Department told us that in order to get money to where it thought it was needed during the COVID-19 pandemic it deliberately loosened controls and thereby took on a lot of additional risk spending money without prior approval.35 It acknowledged that its controls and processes were inadequate for the … Read more

Government response AI summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs), including updated financial delegations, a training programme for senior civil servants, and re-developed internal business case guidance, and will provide …
Read full response →
HM Treasury
20 Recommendation Sixth Report - Department of Health and… Accepted

The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not...

The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not best support the current operating environment” and that “necessary adjustments are required to the framework of risk control and governance arrangements for them to be considered effective in what is a new operating environment”. The … Read more

Government response AI summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs), including updated financial delegations, a training programme for senior civil servants, and re-developed internal business case guidance, and will provide …
Read full response →
HM Treasury
21 Conclusion Sixth Report - Department of Health and… Accepted

There has been considerable public and political interest in the Department’s COVID-19 pandemic procurement including...

There has been considerable public and political interest in the Department’s COVID-19 pandemic procurement including how significant amounts of taxpayers’ money had been spent- especially where products had been sourced from new suppliers including from companies with no previous experience in these types of products. Such procurement- undertaken at pace- … Read more

Government response AI summary
The government agrees with the implied recommendation for improved commercial governance and transparency. It has undertaken a commercial reset with new structures implemented on April 1, 2022, to strengthen accountability, governance, and commercial awareness across the department, and is implementing a bespoke procurement capability programme …
Read full response →
HM Treasury
22 Recommendation Sixth Report - Department of Health and… Accepted

We asked the Department how with such a large number of potential and potentially significant...

We asked the Department how with such a large number of potential and potentially significant conflicts of interest, within staff, non-executive directors or Ministers at the Department, they make sure that conflicts are identified and dealt with properly. The Department told us that this is particularly challenging for them, because … Read more

Government response AI summary
The department will maintain and improve accountability by embedding their revised processes so that these are undertaken on a timely basis each and every year and normalise the transparency of the results by inclusion of the full list of interests identified in every Annual Report …
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HM Treasury
23 Recommendation Sixth Report - Department of Health and… Accepted

The Department set out in its Governance Statement that during the audit of the Department’s...

The Department set out in its Governance Statement that during the audit of the Department’s accounts, it became apparent the Department’s process for collating and assessing potential related parties and related party transactions did not provide the necessary completeness assurance over the interests held by senior individuals. Consequently, the Department … Read more

Government response AI summary
The government agrees to maintain and improve accountability by embedding their revised processes for identifying and disclosing interests and related parties and will continue to include a full list of interests in each annual report and accounts.
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HM Treasury
24 Recommendation Sixth Report - Department of Health and… Accepted

The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an...

The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an Integrated Care Board (ICB), responsible for the commissioning of healthcare services and an Integrated Care Partnership (ICP), an alliance of organisations and representatives to improve care, health and wellbeing, jointly convened by local authorities and … Read more

Government response AI summary
The department will monitor and control the approval of all redundancy payments made by entities within the Departmental Group to ensure such payments are properly authorized in advance and are not irregular by using updated ALB delegations, the Exit and High Risk Sub Group (EHRSG), …
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HM Treasury
26 Recommendation Sixth Report - Department of Health and… Accepted

Three Clinical Commissioning Groups (CCGs) paid special severance payments without obtaining the required approvals.47 The...

Three Clinical Commissioning Groups (CCGs) paid special severance payments without obtaining the required approvals.47 The C&AG qualified his regularity audit opinion on the NHS England 2020–21 Annual Report and Accounts in respect of one of these, a special severance payment made by Berkshire West CCG to its former Accountable Officer.48 … Read more

Government response AI summary
The department has processes in place for monitoring and controlling the approval of exit payments.
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HM Treasury
27 Recommendation Sixth Report - Department of Health and… Accepted

We questioned the Department on what forward thinking it is doing to prevent unauthorised payments...

We questioned the Department on what forward thinking it is doing to prevent unauthorised payments being made to individuals leaving the NHS as a result of the planned re-organisation. The Department acknowledged there is a chance that the re-organisation of the NHS will result in special severance payments being made. … Read more

Government response AI summary
The department will monitor and control the approval of all redundancy payments made by entities within the Departmental Group to ensure such payments are properly authorized in advance and are not irregular by using updated ALB delegations, the Exit and High Risk Sub Group (EHRSG), …
Read full response →
HM Treasury
28 Recommendation Sixth Report - Department of Health and… Accepted

The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as a...

The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as a new executive agency to be the UK leader for health protection responsible for ensuring the nation can respond quickly and at greater scale to deal with pandemics and future threats. Public Health England’s (PHE’s) health … Read more

Government response AI summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
Read full response →
HM Treasury
30 Conclusion Sixth Report - Department of Health and… Accepted

Given the uncertainty and plan to reduce test and trace activity we asked the Department...

Given the uncertainty and plan to reduce test and trace activity we asked the Department whether UKHSA would have enough funding to operate going forward. The Department replied that this was under discussion.58 We asked the Department when we took evidence on 7 March 2022 when the UKHSA 2022–23 financial … Read more

Government response AI summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
Read full response →
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
7 Mar 2022 Andy Brittain · Department of Health and Social Care (DHSC), Jonathan Marron · Department for Health and Social Care, Shona Dunn · Home Office, Sir Chris Wormald · Department of Health and Social Care View ↗

Who gave evidence

4 witnesses
WitnessOrganisationSessions
Andy Brittain · DHSC Director General, Finance Department of Health and Social Care (DHSC) 1
Jonathan Marron · Director General for Primary Care and Prevention Department for Health and Social Care 1
Shona Dunn · Second Permanent Secretary Home Office 1
Sir Chris Wormald · Permanent Secretary Department of Health and Social Care 1

Correspondence

3 letters
DateDirectionTitle
24 May 2022 Correspondence from Sir Chris Wormald, Permanent Secretary, Department of Healt…
21 Apr 2022 Correspondence from Sir Chris Wormald, Permanent Secretary, Department of Healt…
28 Mar 2022 Correspondence from Sir Chris Wormald, Permanent Secretary, Department of Healt…