Recommendations & Conclusions
6 items
2
Recommendation
Thirty-Fifth Report - Introducing Integ…
Accepted
We remain very concerned about the critical shortages across the NHS workforce and the Department’s repeated delays in publishing a strategy to address them. Workforce shortages are widespread across the NHS, and particularly acute in some specialisms, for example midwifery. This can result in unsafe care for patients. This is …
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We remain very concerned about the critical shortages across the NHS workforce and the Department’s repeated delays in publishing a strategy to address them. Workforce shortages are widespread across the NHS, and particularly acute in some specialisms, for example midwifery. This can result in unsafe care for patients. This is a long-standing issue which pre-dates the pandemic and which has continued to worsen: NHS vacancy rates increased from 8.3% in December 2021 to 9.7% by June 2022. The NHS Long Term Plan committed to producing a Workforce Implementation plan by late 2019, and in September 2020 the Department told us that it expected to publish it following the 2020 Spending Review. It still has not done so. The Department’s ongoing failure to publish the workforce plan is extremely disappointing. It is unclear how ICSs are supposed to plan for workforce shortages when the Department has not published a national plan, or the analysis underpinning it. We are encouraged that, not long after our evidence session, the Department committed to publishing a full NHS workforce plan during 2023, and we hope it is finally able to meet its own deadline. 6 Introducing Integrated Care Systems Recommendation: The Department should make good on its commitment to publish a comprehensive NHS workforce plan and the forecasts underpinning it in
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Government response AI summary
The government agrees with the recommendation and will publish a long-term workforce plan for the NHS in 2023.
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HM Treasury
6
Recommendation
Thirty-Fifth Report - Introducing Integ…
Accepted
NHS funded dental care is in crisis in some parts of the country, and NHS England’s failure to ensure people can access routine dental care is leading to more acute dental health problems. NHS England, rather than ICSs, remains responsible for most NHS dentistry but in some parts of the …
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NHS funded dental care is in crisis in some parts of the country, and NHS England’s failure to ensure people can access routine dental care is leading to more acute dental health problems. NHS England, rather than ICSs, remains responsible for most NHS dentistry but in some parts of the country it is impossible to find a dentist offering NHS treatment. At our evidence session in November NHS England could not tell us how much longer it expected these gaps in the provision of an essential service to remain. It told us about several changes it has recently made, including increasing payments for complex work, allowing dental health technicians to accept NHS patients for treatment, and increasing the activity cap for high performing practices. Following the session NHS England wrote to us to set out more details on these plans. We welcome NHS England’s assurance that it sees restoring dental services as a critical priority. However even in December 2019, before the pandemic, more than 40% of children and half of adults in England had not received any NHS dental care at all in the previous two years. We were disappointed that NHS England is still unable to say by when it expects the changes it is making to result in more dentists offering NHS treatment. 8 Introducing Integrated Care Systems Recommendation: Alongside the Treasury Minute response to this Report, NHS England should write to us and set out: • The funding intended for NHS dentistry in 2022/23 and 2023/24 and what coverage this provides, in terms of the proportion of adults and children who could access these services, and what services the funding will and will not cover. • Its understanding of the proportion of adults and children using non-NHS dentistry, and the proportion of people who do not access any dentistry services at all. • By when it expects to be able to consistently provide the target level of coverage, and • What patients should do if they require dental care and are unable to find a dentist o
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Government response AI summary
The government agrees with the committee’s recommendation and sets out the funding intended for NHS dentistry in 2022/23 and 2023/24. The government outlines several measures taken to secure recovery of dental access, improve accessibility and indicates people can attend any dentist accepting NHS patients and …
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HM Treasury
1
Conclusion
Thirty-Fifth Report - Introducing Integ…
Accepted
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department) and NHS England about the introduction of Integrated Care Systems (ICSs) in England.1
Government response AI summary
The government agrees with the Committee’s recommendation and states Integrated Care Systems will provide tangible benefits for local population, including the delivery of commitments that are set out in the government’s mandate to the NHS England and accompanying documents.
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HM Treasury
9
Conclusion
Thirty-Fifth Report - Introducing Integ…
Accepted
The threadbare provision of NHS funded dental care is a further example of a failure to provide preventative or protective routine care leading to more acute health problems.24 NHS England, rather than ICSs, remains responsible for most of NHS dentistry provision in England.25 In some parts of the country it …
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The threadbare provision of NHS funded dental care is a further example of a failure to provide preventative or protective routine care leading to more acute health problems.24 NHS England, rather than ICSs, remains responsible for most of NHS dentistry provision in England.25 In some parts of the country it is impossible to register with a dentist offering NHS treatment and there is huge concern about lack of access. We raised concerns about children’s dental health seriously deteriorating to the extent that they required hospital treatment.26 NHS England told us it has begun implementing the first steps in a wider programme of dental reform that it announced in July 2022; that these represented the first major change to the profession in fifteen years; and that the changes had been widely welcomed. These reforms included changing the national dental contract to recognise and provide greater payment for more complex work; allowing dental therapists to accept NHS patients for treatment to free up dentists to do more urgent or complex work; and increasing the amount of activity high-performing practices could undertake by 10%.27 NHS England is also, as part of its work with Health Education England on the NHS workforce plan, looking at ways to improve the pipeline into NHS dentistry, to make it a more attractive place for new dentists to come to do work and to stay.28
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Government response AI summary
The government agrees with the committee's concerns and states that securing recovery of dental access is a key NHS priority, outlining existing measures such as funding allocations and reforms to the national dental contract.
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HM Treasury
10
Conclusion
Thirty-Fifth Report - Introducing Integ…
Accepted
However, NHS England was unable to tell us how many more dentists it expected these reforms to produce, or by when they would appear. It told us that a sustainable solution required further engagement with the dental profession on the longer-term elements such as workforce and contract reform.29 NHS England …
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However, NHS England was unable to tell us how many more dentists it expected these reforms to produce, or by when they would appear. It told us that a sustainable solution required further engagement with the dental profession on the longer-term elements such as workforce and contract reform.29 NHS England wrote to us following our evidence session to provide more details. It assured us that it sees restoring NHS dentistry services as a critical priority. However, it also confirmed that even before the pandemic when dentists were delivering “around 90%” of contracted care, that equated to only around 50% of adults and 58% of children receiving any NHS dental care at all over the two-year period to December 2019.30 23 Qq 25–26 24 Q 12 25 C&AG’s Report, para 2.14 26 Q 12 27 Q 12 28 Q 15 29 Qq 16–17 30 Letter dated 26 November 2022 from Amanda Pritchard at NHS England to the Committee 12 Introducing Integrated Care Systems 2 Effective and sustainable ICSs Funding and accountability arrangements between the NHS and Local government
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Government response AI summary
The government agrees with the committee's concerns and states that securing recovery of dental access is a key NHS priority, outlining existing measures such as funding allocations and reforms to the national dental contract.
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HM Treasury
16
Recommendation
Thirty-Fifth Report - Introducing Integ…
Accepted
We have been raising concerns about the lack of long-term planning for the NHS workforce since well before the COVID-19 pandemic52. We have noted that among comparable OECD countries the UK has relatively low numbers of nurses and doctors per 1,000 population.53 The Department has repeatedly failed to make good …
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We have been raising concerns about the lack of long-term planning for the NHS workforce since well before the COVID-19 pandemic52. We have noted that among comparable OECD countries the UK has relatively low numbers of nurses and doctors per 1,000 population.53 The Department has repeatedly failed to make good on its commitments to produce a plan to address this issue, and now many areas of the NHS workforce appear to be in crisis.54 This places significant constraints on ICSs’ ability to deliver their aims and objectives.55 These shortages appear to be particularly acute in some specialisms, such as midwifery, and we highlighted how this increases risks around unsafe care and patient safety.56 Workforce pressures in the NHS predate the COVID-19 pandemic, and have continued to worsen: NHS England told us there had been increased numbers of staff leaving the NHS “since the pandemic ended”.57 The NAO’s report highlights how the total NHS vacancy rate increased from 8.3% in December 2021 to 9.7% by June 2022, the latest date for which data is available, and NHS England told us that NHS vacancies were currently well in excess of 100,000 posts.58
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Government response AI summary
The government commits to publishing a long-term workforce plan for the NHS in 2023.
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HM Treasury