Recommendations & Conclusions
4 items
4
Recommendation
Thirty-First Report - Department of Hea…
Acknowledged
We are concerned that the Department is spending £2.6 billion on clinical negligence payments without an effective plan to minimise future costs of the scheme. Incidences of clinical negligence continue to result in significant cost to the taxpayer, particularly in maternity settings. The Department has made provisions in its accounts …
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We are concerned that the Department is spending £2.6 billion on clinical negligence payments without an effective plan to minimise future costs of the scheme. Incidences of clinical negligence continue to result in significant cost to the taxpayer, particularly in maternity settings. The Department has made provisions in its accounts worth over £21 billion to cover the potential costs of known clinical negligence events, one of the largest financial liabilities across government. The Department made cash payments relating to clinical negligence arising from maternity and neonatal services worth £1.1 billion in 2022–23, equivalent to an eye-watering one third of the NHS’ total maternity and neonatal services budget. Each claim is a tragedy for the people involved. Yet the Department does not know whether the number of clinical negligence claims across the NHS as a whole are increasing or decreasing. The NHS does not benchmark well on clinical negligence compared to many similar health systems, and the Department and the NHS recognise that huge improvements need to be made. Recommendation 4: The Department must reduce clinical harm. By summer 2024, the Department should set out the key reasons for patient harm and the actions it will take to address these, ensuring that its plans will reduce health disparities, ensure better patient outcomes, and reduce the costs for taxpayers.
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Government response AI summary
The government agrees with the recommendation and has identified various factors contributing to patient harm. It commits to prioritising continuous patient safety improvement and will write to the Committee later in 2024 to detail the specific actions it is taking with NHS England and partners …
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HM Treasury
6
Conclusion
Thirty-First Report - Department of Hea…
Acknowledged
NHS England again made payments to suspended GPs who were not eligible to receive them and has failed to adequately recover these overpayments. NHS England has made overpayments worth £1.3 million to suspended medical practitioners since 2017–18, just £33,000 of which it has recovered. For the second consecutive year the …
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NHS England again made payments to suspended GPs who were not eligible to receive them and has failed to adequately recover these overpayments. NHS England has made overpayments worth £1.3 million to suspended medical practitioners since 2017–18, just £33,000 of which it has recovered. For the second consecutive year the C&AG qualified his regularity opinion on NHS England’s accounts as a result of NHS England making these ineligible payments, which are contrary to statutory regulations. NHS England has failed to establish a system of control to ensure suspension payments were only paid to medical practitioners who met the qualifying criteria, and that these payments were stopped as soon as people were no longer eligible for them. Given the control failings that led to these overpayments were initially identified during the 2021–22 audit, this continued lack of appropriate safeguards over taxpayers’ money is unacceptable. NHS England has committed to reviewing all suspension payments and will be implementing a new national system to review and process suspension payments, replacing the existing regional system. Recommendation 6a): NHS England must ensure the planned changes to its control framework are implemented by summer 2024 to avoid further loss of money that should be used for patient care. b): NHS England must ensure that amounts that have been overpaid are in recovery by the summer of 2024. 8 Department of Health and Social Care2022–23 Annual Report and Accounts 1 Internal control failings and timely financial reporting
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Government response AI summary
The government agrees with the recommendation, stating that work is already underway to recover overpaid amounts from suspended GPs, and NHS England will oversee this progress. However, it does not detail specific planned changes to its control framework or explicitly confirm adherence to the summer …
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HM Treasury
20
Conclusion
Thirty-First Report - Department of Hea…
Acknowledged
The Department recognised that each incidence of clinical negligence is a tragedy for an individual and their families.31 They also come with a monetary cost to the taxpayer, in compensation payments for pain suffered and the impact on people’s everyday lives. The Department sets money aside in its accounts which …
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The Department recognised that each incidence of clinical negligence is a tragedy for an individual and their families.31 They also come with a monetary cost to the taxpayer, in compensation payments for pain suffered and the impact on people’s everyday lives. The Department sets money aside in its accounts which it can use to fund compensation payments in the event of clinical negligence. The Department recognises a financial liability for potential future payments of compensation. These are reported in the accounts of NHS Resolution and consolidated into the Departmental Group accounts.32 In 2022– 23, NHS Resolution paid £2.6 billion in cash to claimants.33 The cost of clinical negligence to the NHS in England relative to the population served is significantly higher than those of similar health and social care systems. The cost of clinical negligence in 2018–19 was higher than the combined cost of clinical negligence in the health and social care systems of Australia, Canada, New Zealand, and Sweden.34 The Department, alongside NHS England, recognised that getting patient safety right and reducing the number of incidents leading to clinical negligence claims, is a big objective. We asked the Department whether, in terms of the NHS as a whole, the number of litigation claims was going up or down. It did not know the answer to this question and committed to providing a response after the session.35
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Government response AI summary
The government agrees with the committee's observations on clinical negligence and patient safety. It commits to prioritising continuous improvement in patient safety and will write to the committee later in 2024 to detail actions being taken with partners to reduce harm and improve outcomes.
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HM Treasury
26
Conclusion
Thirty-First Report - Department of Hea…
Acknowledged
The Department also procured 20,900 individual ventilators at a cost of £569 million, held in stock as “an ICU reserve”. In February 2024 the Department decided to close the reserve and dispose of these ventilators. We asked the Department why these ventilators were being scrapped rather than being donated or …
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The Department also procured 20,900 individual ventilators at a cost of £569 million, held in stock as “an ICU reserve”. In February 2024 the Department decided to close the reserve and dispose of these ventilators. We asked the Department why these ventilators were being scrapped rather than being donated or sold. The Department set out that it had not yet determined how it will dispose of the stockpile, but a hierarchy will be used to ensure sale or donation before disassembly for recycling. The Department told us that it did not yet know how much of the £569 million spent it will recover. We asked the Department whether there was a pause on the NHS purchasing ventilators given the 20,000 currently held in warehouses and available for use by NHS. The Department and NHS England told us they were “not sighted on the specifics”, although they agreed it would be surprising if new ventilators were being purchased whilst this stockpile was available.46 The Department has since confirmed that no restrictions were placed on NHS organisations regarding the purchase of medical equipment, including ventilators similar to those held by the Department.47
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Government response AI summary
The Department has not yet determined how it will dispose of the stockpile of ventilators, but a hierarchy will be used to ensure sale or donation before disassembly for recycling.
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HM Treasury