Select Committee · Public Accounts Committee

NHS financial sustainability

Status: Closed Opened: 31 Oct 2024 Closed: 16 May 2025 3 recommendations 23 conclusions 1 report

The scale of the challenge facing the NHS is unprecedented. Local NHS systems in England ended 2023/24 with a collective deficit of £1.4bn. NHS England (NHSE) received more than £4.5bn in extra funding in 2023/24, and reduced planned spending against its central budget by £1.7bn – but these actions did not prevent NHS systems’ deficits …

Clear

Reports

1 report
Title HC No. Published Items Response
5th Report - NHS financial sustainability HC 350 29 Jan 2025 26 Responded

Recommendations & Conclusions

5 items
10 Conclusion 5th Report - NHS financial sustainabili… Acknowledged

NHS systems recorded doubled deficit despite significant additional government funding in 2023-24.

NHSE received significant extra funding from the government during the course of 2023–24. This included £2.8 billion to support new pay deals for staff, and £1.7 billion to mitigate the impact of industrial action. Despite this extra money, NHS systems still finished the year with an aggregated £1.4 billion deficit, …

Government response. NHS England and DHSC continue to work together to enable planning guidance to be published well in advance of the start of the financial year, and ideally before Christmas.
HM Treasury
12 Conclusion 5th Report - NHS financial sustainabili… Acknowledged

DHSC consistently diverted NHS capital funds to revenue, despite new fiscal rules.

Demand for capital in the NHS continues to outstrip supply and the UK lags behind other OECD countries in terms of capital investment in its health system. DHSC has maintained its recent track record of not fully investing the capital funds HMT allocates it and instead reallocating large amounts for …

Government response. The government stated that the fiscal rules set out by the Chancellor at the Autumn Budget 2024 mean that no further capital-to-revenue transfers will be used, and the department welcomes this decision. In 2025-26, a budget of £13.6 billion for …
HM Treasury
13 Conclusion 5th Report - NHS financial sustainabili… Acknowledged

DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.

DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would be hard to do and should take place only over …

Government response. The government states that the financial position of NHS providers is significantly improved and that the 10 Year Health Plan will consider how to build a prevention-focused health system, shift the balance of care to community settings, and maximize the …
HM Treasury
14 Conclusion 5th Report - NHS financial sustainabili… Acknowledged

NHS productivity remains below pre-pandemic levels; future targets are significantly ambitious and challenging.

According to official ONS measures, long-term productivity gains in the NHS averaged 0.6% a year over the period 1996–97 to 2018–19. But productivity subsequently fell, both before and during the pandemic, and has yet to recover fully. In March 2024, the government announced that the NHS would receive £3.4 billion …

Government response. The NHS is working hard to recover lost productivity caused by the Covid-19 pandemic, NHS productivity continues to recover and to support this NHSE are focused on increasing clinical and operational productivity, improving staff retention, technology-enabled transformation, moving care to …
HM Treasury
16 Conclusion 5th Report - NHS financial sustainabili… Acknowledged

NHSE confident in technology for productivity gains, but current metrics inadequately measure improvements.

We challenged NHSE on what it would do differently to achieve the ambitious annual productivity improvements it has committed to. NHSE told us annual productivity improvements were currently running at about 1.8% and it was confident that the annual gains that it has committed to of 2.0% could be achieved …

Government response. The NHS is working hard to recover lost productivity caused by the Covid-19 pandemic, NHS productivity continues to recover and to support this NHSE are focused on increasing clinical and operational productivity, improving staff retention, technology-enabled transformation, moving care to …
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
25 Nov 2024 Amanda Pritchard · NHS England, Andy Brittain · Department of Health and Social Care (DHSC), Antonia Williams · HM Treasury, Julian Kelly · NHS England, Sir Chris Wormald KCB · Cabinet Office View ↗

Correspondence

6 letters
DateDirectionTitle
10 Sep 2025 To cttee Letter from the Permanent Secretary of the Department of Health and Social Care…
4 Sep 2025 From cttee Letter to the Permanent Secretary of the Department for Health and Social Care …
7 Apr 2025 To cttee Letter from the Interim Permanent Secretary of the Department of Health and Soc…
27 Mar 2025 To cttee Letter from the Interim Permanent Secretary of the Department of Health and Soc…
10 Mar 2025 To cttee Letter from the Chief Financial Officer and Deputy Chief Executive at NHS Engla…
4 Feb 2025 To cttee Letter from the Interim Permanent Secretary of the Department of Health and Soc…