Recommendations & Conclusions
24 items
2
Conclusion
Thirty-First Report - Department of Hea…
Accepted
The Department’s continued failure to deliver its accounts to an earlier timetable hampers effective and timely accountability of taxpayers’ money. Weaknesses in basic financial accounting at UKHSA, together with delays in the completion of local NHS audits, and a lack of resilience in the local audit market, meant the Department …
Government response. The government agrees and targets a return to pre-summer recess laying for its Annual Report and Accounts by the 2026-27 financial year, with a specific plan to lay the 2023-24 accounts by early December 2024. It is also actively engaging …
HM Treasury
3
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We are concerned that the Department has still not put in place adequate oversight to ensure strong financial management and reporting across its group which are fundamental to the effective delivery of its policy and operational work. The Department is responsible for ensuring there is an adequate and robust system …
Government response. The government agrees and states the recommendation is implemented, detailing that it is working closely with UKHSA and NAO, providing strong financial oversight including regular governance and assurance meetings. It also reports £75 million recovered from PPE fraud and anticipates …
HM Treasury
5
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We are disappointed that the Department lacks adequate controls over its inventory and, four years after the COVID-19 pandemic began, still does not have a plan for stockpiling for future pandemics. The Department does not know how much inventory it currently holds as it did not undertake inventory counting Department …
Government response. The government agrees and commits to implementing dynamic stockpiling for excess COVID-19 stock from autumn 2024 to reduce costs and improve value-for-money. It will also work with UKHSA to maintain existing medical countermeasure stockpiles and provide an update to the …
HM Treasury
1
Conclusion
Thirty-First Report - Department of Hea…
Accepted
On the basis of a report by the Comptroller and Auditor General (C&AG)2, we took evidence from the Department of Health and Social Care (the Department), the UK Health Security Agency (UKHSA) and NHS England on the Department’s Annual Report and Accounts for 2022–23.
Government response. The government has established a Finance and Control Improvement Programme and is actively working to produce auditable accounts for 2023-24 with NAO certification by November, targeting an unqualified opinion for the 2024-25 accounts. They have a comprehensive audit plan and …
HM Treasury
22
Recommendation
Thirty-First Report - Department of Hea…
Accepted
As part of our examination of the Department’s 2021–22 accounts, we recommended that UKHSA should urgently ensure that it had in place robust financial controls and processes and there was a clear plan to deliver unqualified accounts. Government agreed with our recommendation, and in its response told us the UKHSA …
Government response. The government agrees and is implementing a Finance and Control Improvement Programme, engaging PwC, and has an audit plan with the NAO, targeting an improved audit opinion for the 2023-24 accounts by January 2025.
HM Treasury
7
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked UKHSA whether it had sufficient organisational understanding and acceptance of the level of cultural change and process improvement required to fix these issues with its accounts. UKHSA responded that it understood and accepted this. It drew a distinction between the issues which had resulted in its 2022–23 accounts …
Government response. The government agrees with the committee's observation and commits to achieving an improved (though qualified) audit opinion for UKHSA's 2023-24 accounts by November. It details a comprehensive audit plan, external support from PWC, and an ongoing Finance and Control Improvement …
HM Treasury
8
Conclusion
Thirty-First Report - Department of Hea…
Accepted
The C&AG confirmed that UKHSA had introduced “quite a lot of important governance arrangements” following its 2021–22 accounts, and that it had made progress on being able to present a more manageable set of financial data for the NAO to audit. But he stressed that there was still a long …
Government response. The government agrees with the committee's observations and commits to achieving an improved (though qualified) audit opinion for UKHSA's 2023-24 accounts by November. It outlines a comprehensive audit plan, external support, and an ongoing Finance and Control Improvement Programme to …
HM Treasury
9
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked UKHSA what lessons could be learned from the setup of a complex new government body and the issues reported by the C&AG in 2021–22 and 2022–23.12 UKHSA responded that if setting up a similar new body it would go about it ”in exactly the same way” and that …
Government response. The government has accepted the implicit recommendation to improve UKHSA's financial controls, detailing an ongoing Finance and Control Improvement Programme. UKHSA aims for an improved 2023-24 audit opinion with certification in November and subsequent pre-summer recess laying without qualifications, supported …
HM Treasury
10
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked UKHSA how it was going to fix the issue with the covid vaccine demand model that was one of the causes of the C&AG disclaiming his opinions on its 2022–23 accounts. The Department confirmed it had made a mistake in failing to communicate the detail of the model …
Government response. The government agrees and is implementing a Finance and Control Improvement Programme, engaging PwC, and has an audit plan with the NAO, targeting an improved audit opinion for the 2023-24 accounts by January 2025.
HM Treasury
11
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We questioned the Department on why it decided to transfer the CVU to UKHSA in October 2022, pushing additional responsibility on to a new and struggling organisation. The Department stated that, as an organisation of health protection experts who hold responsibility for established vaccination programmes, UKHSA was best placed to …
Government response. The government has accepted the implicit recommendation concerning UKHSA's financial controls, outlining the ongoing Finance and Control Improvement Programme, targets for an improved 2023-24 audit opinion with November certification, and engagement of PWC for external support.
HM Treasury
12
Recommendation
Thirty-First Report - Department of Hea…
Accepted
As part of our inquiry in the Department’s 2021–22 Annual Report and Accounts, we found that the Department had prepared its accounts in exceptional circumstances for the previous two years but noted that it was imperative that it got back on track with the delivery of its accounts ahead of …
Government response. The government has accepted and is implementing a multi-year plan to publish its Annual Report and Accounts by at least one month earlier each year, targeting a return to pre-summer recess laying by Summer 2027. For 2023-24, certification is planned …
HM Treasury
14
Conclusion
Thirty-First Report - Department of Hea…
Accepted
The delays to the accounts were the combined result of issues with the accounts of a key arm’s-length body (UKHSA) and delays in completion of local NHS audits. The accounts for UKHSA, NHS England and the Consolidated NHS Provider Accounts all need to be complete before the Department’s group accounts …
Government response. The government has accepted the implicit recommendation and implemented a multi-year plan to publish its Annual Report and Accounts by at least one month earlier each year, targeting a pre-summer recess laying by Summer 2027. For 2023-24, certification is planned …
HM Treasury
15
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked the Department about its plans to certify its accounts earlier in future. The Department advised us that producing its accounts is a difficult task and the expenditure included represents approximately 8% of the UK economy. It told us that every year it faced a new challenge that was …
Government response. The government has accepted the implicit recommendation to accelerate account certification, stating its multi-year plan to publish Annual Report and Accounts earlier, targeting a pre-summer recess laying by Summer 2027, and aiming for 2023-24 certification in November 2024.
HM Treasury
16
Conclusion
Thirty-First Report - Department of Hea…
Accepted
The C&AG disclaiming his audit opinion is very rare. The fact that this has happened two years in a row for UKHSA gives us great cause for concern. While UKHSA has its own Chief Finance Officer, the Department has taken steps for its Director General Finance to undertake a formal …
Government response. The government states the recommendation is implemented, highlighting its robust financial management framework and ongoing close work with UKHSA and the NAO through governance meetings and an audit plan to address disclaimed opinions.
HM Treasury
17
Conclusion
Thirty-First Report - Department of Hea…
Accepted
A large proportion of the Departmental Group expenditure flows through from NHS commissioning bodies into NHS England and NHS providers into the Consolidated Provider Accounts, both of which are prepared by NHS England. Given their impact on the timeliness of the Department’s accounts, we asked the Department and NHS England …
Government response. The government has accepted the implicit recommendation to improve the timeliness of audits for NHS bodies, outlining its multi-year plan to accelerate the publication of its Annual Report and Accounts and its engagement with stakeholders to address local audit capacity …
HM Treasury
18
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We observed that the Department appeared to be “slightly skating over the problem” in saying that it did not have the levers needed to address the local audit issues affecting its accounts. Whilst we accepted that the Department did not have responsibility for issues with the audit of local government, …
Government response. The government has accepted the implicit recommendation to address local audit capacity issues affecting NHS accounts, outlining its multi-year plan to accelerate Annual Report and Accounts publication and its engagement with stakeholders to address these challenges.
HM Treasury
21
Conclusion
Thirty-First Report - Department of Hea…
Accepted
NHS Resolution’s 2022–23 accounts include a liability of £69.3 billion to cover the potential costs of clinical negligence. Of this, £45 billion, some 65% of the £69.3 billion total, related to maternity and neonatal liabilities. The Department told us that this was not unusual across international comparators and reflected the …
Government response. The government agrees with the committee's findings and commits to prioritizing patient safety, writing to the new Committee by the end of 2024 to outline specific actions taken with NHS England and partners to reduce patient harm.
HM Treasury
23
Conclusion
Thirty-First Report - Department of Hea…
Accepted
When we examined the Department’s 2021–22 Annual Report and Accounts, we found that it had written off £14.9 billion of public money as a result of overpaying and over ordering significant volumes of Personal Protective Equipment (PPE), COVID-19 medicines and vaccines. We noted that the Department was paying large amounts …
Government response. The government agrees with the committee's findings, noting past reviews and a future PPE strategy, and commits to ceasing storage costs for excess PPE by January 2025, providing an update by the end of January 2025.
HM Treasury
24
Conclusion
Thirty-First Report - Department of Hea…
Accepted
In 2023, we found that the Department did not have adequate controls over its PPE inventory and was unable to perform proper stocktakes to confirm what it held and the condition of these items. The Department did not perform full and complete stock counts on the PPE inventory it held …
Government response. The government agrees with the committee's findings, has replenished pandemic preparedness PPE stockpiles using excess stock, and will begin dynamic stockpiling from autumn 2024, committing to update the committee by the end of 2024.
HM Treasury
25
Conclusion
Thirty-First Report - Department of Hea…
Accepted
In 2023, the Department estimated that it would cost £319 million to store and dispose of unusable or unneeded PPE. The Department told us that it had accelerated its disposal programme, to save £130 million in storage costs that it would otherwise incur. We asked the Department what consideration had …
Government response. The government has accepted the implicit recommendation, confirming that storage costs for excess PPE will cease by January 2025. It also committed to continue examining lessons learned from the pandemic, including engagement with the Covid-19 inquiry, with an update to …
HM Treasury
27
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We recommended in our reports on the Department’s 2020–21 and 2021–22 Annual Reports and Accounts that the Department should develop a clear plan for a stockpile for a future pandemic. In response to our report on the 2021–22 Annual Report and Accounts, in September 2023 the Department told us that …
Government response. The government agrees with the committee's findings, has replenished pandemic preparedness PPE stockpiles using excess stock, and will begin dynamic stockpiling from autumn 2024, committing to update the committee by the end of 2024.
HM Treasury
28
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked the Department how many contracts relating to COVID-19 procurement were still in dispute. The Department stated that 45 contracts were in dispute at 31 March 2023, and that the number at the time of the evidence session was below 20. Most of the contracts under review are not …
Government response. The government agrees, providing updated estimates of COVID-19 PPE fraud at £324 million, with £75 million recovered and £163 million prevented, and anticipates settlement of all matters by Autumn 2025 with a target implementation date for the recommendation of December …
HM Treasury
29
Conclusion
Thirty-First Report - Department of Hea…
Accepted
NHS England can make payments to medical practitioners who have been suspended, in accordance with the relevant statutory regulations and conditions. The C&AG qualified his opinion on NHS England’s accounts for the second time, as a result of it making ineligible suspension payments to medical practitioners. NHS England made payments …
Government response. The government has accepted the implicit recommendation, implementing a new national process with additional checks for suspended practitioner payments from April 2024 and requesting a review of eligibility determinations. For overpayments, work is underway to recover amounts where there is …
HM Treasury
30
Conclusion
Thirty-First Report - Department of Hea…
Accepted
We asked NHS England why it did not have adequate controls in place to prevent ineligible payments of this nature and what controls it was putting in place to ensure that this does not happen again. NHS England confirmed that following two cases that were identified in late 2022 as …
Government response. The government has accepted the implicit recommendation to improve controls for suspended practitioner payments, confirming a new national process with additional verification and central oversight was implemented from April 2024, and a submission made to DHSC to review and simplify …
HM Treasury