Recommendations & Conclusions
19 items
2
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services and do not give a clear overarching narrative on social …
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The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services and do not give a clear overarching narrative on social care. The Department’s accounts contain very little information in key areas of interest to us, and to Parliament. This includes a lack of financial data on the prevention of ill health in the first place, which has the biggest long–term impact on health outcomes, and on technological advances, which are needed to improve future productivity for the NHS. While the Performance Report section of the Department’s Annual Report and Accounts contains some high level information on these areas, there is a lack of detailed financial data to set out how money has been spent in these areas. The Department’s accounts also do not provide information in enough detail to allow Parliament or the public to establish whether legal costs relating to exit packages and employment tribunals represent a good use of public funds, or provide the best outcomes. The Department is unable to tell us how much is spent on palliative and end–of–life care, nor what outcomes were delivered through this spending. recommendation a. In line with its Treasury Minute response, the Department should write to the Committee to set out its plans to improve the transparency and usability of its Annual Report and Accounts in the following areas: social care; productivity; prevention; digital and artificial intelligence; palliative and end–of–life care; severance and clinical negligence payments; and any new and emerging areas of Parliamentary and public interest. b. All future annual reports and accounts should be very clear about what productivity and efficiency gains have been made during the year and how. Also, a prediction for future years should be included.
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Government response AI summary
The government agrees and commits to improving the transparency and usability of its Annual Report and Accounts (ARA) by covering the specified areas, including social care, productivity, and prevention, in its 2024-25 ARA. The department will provide an update to the Committee on this progress …
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HM Treasury
3
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
There is little to show for the £400 million spent so far on the development of Harlow Health Security Campus, with no decision yet on the future of the site. This is an example of a poorly overseen project to replace the UK’s critical public health infrastructure. UKHSA’s high containment …
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There is little to show for the £400 million spent so far on the development of Harlow Health Security Campus, with no decision yet on the future of the site. This is an example of a poorly overseen project to replace the UK’s critical public health infrastructure. UKHSA’s high containment laboratories are central to protecting the population against potentially highly infectious diseases. The current facilities at Porton Down and Colindale are nearing the end of their life. The programme to build new facilities at Harlow has been underway for over a decade, and the cost of the current plan has risen from the initial estimate of £530 million to an eye–watering projected £3.2 billion. UKHSA has developed an 5 alternative proposal involving modernising the existing facilities at Porton Down and Colindale. The decision between these two options is complex. The final decision is currently being made by Ministers and is expected in the second part of the spending review. But this is still some 3 years after the programme was suspended. As well as having cost implications, these delays could risk leaving the nation without adequate protection against emerging new diseases. UKHSA estimates its current facilities could continue to operate for 15 years, and in 2024 the NAO reported that the earliest date for having a fully operational new or upgraded site is 2036, 11 years from now. Time is running out for UKHSA to decide on the best course of action in order to avoid exposing the public to any unnecessary risk. recommendation a. In line with the recommendations this Committee made in May 2024, UKHSA should urgently outline how it will ensure that the UK continues to have the infrastructure it needs to protect public health, and confirm its plans for its high containment laboratories, including setting out full costs and timeline for completion. In light of spending review, and given UKHSA’s poor record of delivering new facilities, it should set out as soon as possible, exa
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Government response AI summary
The government states the recommendation is implemented, explaining that the department already possesses well-established governance structures to oversee investment decisions and delivery of major health infrastructure projects. These existing structures include cost and value-for-money tests and are subject to regular review.
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HM Treasury
4
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
It is unacceptable that the Department is yet to develop a plan to deal with the cost of clinical negligence claims, and so much taxpayers’ money is being spent on legal fees. The Department has set aside an astounding £58.2 billion to cover the potential costs of clinical negligence events …
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It is unacceptable that the Department is yet to develop a plan to deal with the cost of clinical negligence claims, and so much taxpayers’ money is being spent on legal fees. The Department has set aside an astounding £58.2 billion to cover the potential costs of clinical negligence events occurring prior to 1 April 2024, the second largest liability across government. Some £9.3 billion of that £58.2 billion relates to events occurring in 2023–24, when it also paid out £2.8 billion on clinical negligence claims. Behind these jaw–dropping amounts lie many tragic incidents of patient harm. The Department has only recently written to us in response to the previous Committee’s recommendation which was to set out, by summer 2024, the key reasons for patient harm and the actions it will take to address these. In addition, the Department says that an astronomical 19% of the money awarded to claimants goes to their lawyers, on top of the fees payable for the Department’s defence team. We are disappointed that huge improvements still need to be made to better protect both patients and public money. 6 recommendation Within the next 6 months, the Department should set out a plan with clear actions to: • Reduce tragic incidences of patient harm to as low a level as possible; and • Manage the costs of clinical negligence more effectively, including introducing a mechanism to reduce legal fees. • Improve patient safety across the NHS and in particular in maternity services.
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Government response AI summary
The government agrees and outlines several specific actions to reduce patient harm and manage clinical negligence costs, including implementing NHS England's 3-year maternity plan. It has announced a national, independent investigation into maternity and neonatal care, expected to report by December 2025, and will establish …
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HM Treasury
5
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
We are disappointed by the Department’s continued failure to return to publishing its accounts before the summer Parliamentary recess. Timely production of accounts is essential to understanding public finances and supporting accountability and Parliament expects Departments’ accounts to be published before the summer recess each year. Yet the Department has …
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We are disappointed by the Department’s continued failure to return to publishing its accounts before the summer Parliamentary recess. Timely production of accounts is essential to understanding public finances and supporting accountability and Parliament expects Departments’ accounts to be published before the summer recess each year. Yet the Department has failed to deliver its accounts on time for each of the last five years, which hampers effective and timely accountability of taxpayers’ money. The Department is making some progress and published its 2023–24 accounts on 17 December 2024, nearly six weeks earlier than its 2022–23 accounts. But this is still five months later than the timescale needed to meet the expected pre–summer recess delivery. Weaknesses in basic financial accounting at UKHSA, together with delays in the completion of local NHS audits have continued to cause the accounts to be late. The absorption of NHS England into the department will need to be carefully planned in the accounts production and auditing process, otherwise timelines could slip backwards. recommendation By the start of September 2025, the Department must write to us with a realistic and credible plan to produce audited accounts before the summer Parliamentary recess. This must include how it will: • Effectively support and hold group bodies to account to ensure they produce accounts of appropriate quality on a timely basis; and • Work with stakeholders across the local audit system to build capacity, resilience and ensure deadlines are met in particular given organisational changes.
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Government response AI summary
The government agrees and is working on a multi-year plan to publish audited accounts before the summer recess, acknowledging challenges due to private sector audit firm capacity. It commits to writing to the Committee in September 2025 with further details on this plan, associated risks, …
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HM Treasury
6
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
NHS England does not have a coherent plan to better protect taxpayers’ money and prevent future unapproved exit packages. There remain far too many special severance payments where approval has only been sought after the payment has been made. Five such unapproved payments 7 totalling £180,868 were made by NHS …
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NHS England does not have a coherent plan to better protect taxpayers’ money and prevent future unapproved exit packages. There remain far too many special severance payments where approval has only been sought after the payment has been made. Five such unapproved payments 7 totalling £180,868 were made by NHS trusts in 2023–24. Without approval, this expenditure has not been spent in line with Parliament’s expectations. NHS England’s plan to stop such payments occurring in future has been to remind providers of the rules in place. However, it has acknowledged that solely reminding providers is not enough to guarantee future unapproved payments will not happen. NHS England is also unable to identify any meaningful consequences for trusts that would act as a deterrent. recommendation As part of its Treasury Minute response, NHS England should set out how it will ensure that all exit packages receive the appropriate approvals in advance of payment being made, including details of consequences for non–compliance with the rules. Given the proposed scale of redundancies it should set out how its new approvals mechanism can be enforced to prevent even more unauthorised severance payments. This should include how it will ensure that this corporate knowledge and any lessons learned are not lost when it is abolished and its functions are taken on by the Department. 8 1 The operation of the Department and its reporting Introduction
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Government response AI summary
The government commits to publishing new comprehensive guidance on all types of exit packages and communicating it via regional teams and the NHS England website, aiming for impact from 2025-26. It also outlines existing lesson-learning for non-compliance.
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HM Treasury
1
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
On the basis of a report by the Comptroller and Auditor General (C&AG), 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 2023–24.2
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On the basis of a report by the Comptroller and Auditor General (C&AG), 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 2023–24.2
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Government response AI summary
The government broadly aligns with the committee's general observation, describing ongoing initiatives to improve patient care through partnership working and system efficiency, and referring to upcoming plans in a 10 Year Health Plan.
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HM Treasury
10
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
It had previously been announced that NHS England’s Chief Executive, Chief Financial Officer, Chief Operating Officer, National Medical Director and Chief Delivery Officer and National Director for Vaccination and Screening would step down from their roles.13 During our evidence session, the Prime Minister announced that the Department and NHS England …
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It had previously been announced that NHS England’s Chief Executive, Chief Financial Officer, Chief Operating Officer, National Medical Director and Chief Delivery Officer and National Director for Vaccination and Screening would step down from their roles.13 During our evidence session, the Prime Minister announced that the Department and NHS England would merge. In the context of these changes, we asked how the institutional memory of NHS England would be preserved. NHS England could not explain specifically how this would be retained. It stated that those remaining at NHS England had a significant amount of experience, and that these people would give continuity of knowledge.14
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Government response AI summary
The government agrees with the committee's recommendation, outlining a process for the Department and NHS England merger that includes assessing functions, agreeing senior structures, and planning staff transfers. This structured approach aims to preserve institutional memory, with further details expected by Autumn 2025.
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HM Treasury
13
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
The need for a planned replacement to these facilities was initially identified in 2006 and Public Health England (UKHSA’s predecessor public body) was given approval to purchase the land in 2017. However, in February 2024 the NAO found that work on a replacement laboratory at Harlow had been intermittent since …
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The need for a planned replacement to these facilities was initially identified in 2006 and Public Health England (UKHSA’s predecessor public body) was given approval to purchase the land in 2017. However, in February 2024 the NAO found that work on a replacement laboratory at Harlow had been intermittent since the land was purchased, with the programme suspended from 2022 after the Department reallocated funding to other departmental priorities amid uncertainty about the programme. The earliest date at which the Harlow campus could be ready was estimated at 2036. The NAO found that estimates of the projected cost of building the facility had spiralled upward, from an initial estimate of £530 million in 2015 to £3.2 billion in 2023. This increase was partly due to factors such as rising inflation but also due to the numerous delays encountered by the programme.19 UKHSA’s 2023–24 Annual Report and Accounts show that it has so far spent some £400 million on work at Harlow, but has written off £297 million of this spend to date, reflecting the costs of building work already done that it cannot be certain will be completed.20 16 UKHSA Annual Report and Accounts 2023–24, HC 427, 16 December 2024, pages 4 and 35 17 Letter from Dame Meg Hillier to Shona Dunn and Professor Dame Jenny Harries, 24 May 2024 18 Report by the Comptroller and Auditor General, Investigation into the UK Health Security Agency’s health security campus programme, HC 553, 20 February 2024, page 14 19 C&AG’s Report, Investigation into the UK Health Security Agency’s health security campus programme, pages 8–11, 27 20 UKHSA Annual Report and Accounts 2023–24, page 141 13
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Government response AI summary
The government agrees with the committee's findings, recognizing the urgent need for a decision on UKHSA’s high-containment laboratories. A decision will be made following the spending review, with UKHSA finalizing the delivery model and commercial strategy by Spring 2026.
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HM Treasury
14
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
We asked UKHSA what progress it had made in deciding what it would do with the site. UKHSA told us that it was waiting for Ministers to decide whether to continue development at Harlow or to change course to a phased delivery option providing high containment facilities at Porton Down …
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We asked UKHSA what progress it had made in deciding what it would do with the site. UKHSA told us that it was waiting for Ministers to decide whether to continue development at Harlow or to change course to a phased delivery option providing high containment facilities at Porton Down with later refurbishment of supporting infrastructure at Porton Down and Colindale. UKHSA told us that this decision was under “active review” by Ministers and that it expected a decision to be made in the second part of the spending review. It recognised that this was “now quite a critical decision in terms of timeframe, because it takes a long time to build … [and] commission them into service.” UKHSA informed us that that the decision–making process was difficult and prolonged because the relative costs and benefits of each option are finely balanced and difficult to compare. To ensure that it was ready for a decision either way, UKHSA said that it was working with the Infrastructure and Projects Authority to ensure its model for overseeing the programme included sufficient technical expertise.21 The Department should clarify the arrangements for accountability, oversight, and the involvement and status of delivery partners as soon as possible. 21 Qq 47–50 14 2 Protecting taxpayers’ money The continuing impact of clinical negligence
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Government response AI summary
The government accepts the recommendation, committing to finalise the delivery model and associated commercial strategy, including accountability and oversight arrangements, by Spring 2026, following a decision on UKHSA's high-containment laboratory location and completion of a programme business case.
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HM Treasury
19
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
Exit packages are payments made in relation to redundancy and other departure costs for employees. Special severance payments are a subset of exit packages, relating to any non–contractual payments to employees.31 We have repeatedly raised issues with the Department or its organisations making inappropriate or unapproved payments. In June 2022, …
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Exit packages are payments made in relation to redundancy and other departure costs for employees. Special severance payments are a subset of exit packages, relating to any non–contractual payments to employees.31 We have repeatedly raised issues with the Department or its organisations making inappropriate or unapproved payments. In June 2022, the previous Committee found that three Clinical Commissioning Groups (CCGs) had approved and paid special severance payments without following the required authorisation process. One of these payments resulted in the C&AG qualifying his regularity audit opinion on the NHS England 2020–21 Annual Report and Accounts. The previous Committee warned in 2022 that planned large–scale NHS restructuring increased the risk of future payoffs and further non–compliance with the rules. It recommended that the Department should set out how it would monitor and control the approval of all redundancy payments made by entities within the Departmental Group.32 The Department agreed with our recommendation, and told us in its response to our report that detailed written guidance relating to exit payment processes and approvals had been circulated to CCGs and the (then) proposed ICBs, and that separate arrangements were in place for NHS Trusts and Foundation Trusts.33
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Government response AI summary
The government accepts the recommendation, stating NHS England is redrafting guidance on exit packages and approval mechanisms, which will be communicated and impact exits from 2025-26.
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HM Treasury
20
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
Special severance payments always require prior HM Treasury approval, as they are usually novel or contentious.34 In 2023–24, two NHS Trusts and two NHS Foundation Trusts between them made five special severance payments totalling £180,868 without the required approval. In his report on the 2023–24 Consolidated Provider Account, the C&AG …
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Special severance payments always require prior HM Treasury approval, as they are usually novel or contentious.34 In 2023–24, two NHS Trusts and two NHS Foundation Trusts between them made five special severance payments totalling £180,868 without the required approval. In his report on the 2023–24 Consolidated Provider Account, the C&AG reported that, while most NHS providers were following the correct procedures when proposing to enter a special severance payment arrangement, some NHS providers were still not following the requirements set by HM Treasury.35
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Government response AI summary
The government agrees with the committee's findings, stating NHS England is redrafting guidance on all exit packages and approval mechanisms. This new guidance will be communicated by end of Summer 2025 via regional workforce teams and the NHS England website, to impact exits from 2025-26 …
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HM Treasury
21
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
We asked NHS England what progress it had made in addressing the approvals and ensuring that payments being made without being approved did not happen again. NHS England recognised that “every case that is 31 Report by the Comptroller and Auditor General, Consolidated NHS Provider Accounts 2023–24, HC 399, 26 …
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We asked NHS England what progress it had made in addressing the approvals and ensuring that payments being made without being approved did not happen again. NHS England recognised that “every case that is 31 Report by the Comptroller and Auditor General, Consolidated NHS Provider Accounts 2023–24, HC 399, 26 November 2024, page 47; Department of Health and Social Care Annual Report and Accounts 2023–24, pages 164, 189 32 Committee of Public Accounts, Sixth Report of Session 2022–23, Department of Health and Social Care 2020–21 Annual Report and Accounts, HC 253, 10 June 2022 33 HM Treasury, Treasury Minutes: Government Response to the Committee of Public Accounts on the Second, and the Fourth to the Eighth reports from Session 2022–23, CP 708, August 2022 34 HM Treasury, Managing Public Money, May 2023, page 142 35 Report by the Comptroller and Auditor General, Consolidated NHS Provider Accounts 2023–24, HC 399, 26 November 2024, page 47; Department of Health and Social Care Annual Report and Accounts 2023–24, HC 476, 17 December 2024, page 164 17 not properly approved is wrong”. It told us that it continued to work with providers and ICBs to “remind them of their duties” including through regular training sessions. NHS England told us that it considered its current approach of reminding NHS providers of the requirements to be proportionate, but was unable to guarantee that there will not be future examples where NHS bodies fail to follow the process and obtain the required approvals.36
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Government response AI summary
The government agrees with the committee's recommendation, stating NHS England is redrafting guidance on exit packages and approval mechanisms, which will be communicated by end of Summer 2025. This aims to improve compliance, reiterate rules, and ensure payments are properly approved.
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HM Treasury
22
Conclusion
25th Report - DHSC Annual Report and Ac…
Accepted
We noted that the accounts showed there had been 240 cases where retrospective approval had been sought for special severance payments, and asked NHS England whether there were any consequences for making these payments without the necessary approvals. NHS England said that this was down to “a judgement about how …
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We noted that the accounts showed there had been 240 cases where retrospective approval had been sought for special severance payments, and asked NHS England whether there were any consequences for making these payments without the necessary approvals. NHS England said that this was down to “a judgement about how proportionate the response is in each case”. It said that, depending on the sum involved and what had happened, it would “talk to the organisation and make sure that people are spoken to”. We therefore asked whether any action had been taken against anyone for making payments without the proper approval. NHS England did not identify any specific actions beyond reminding individuals of the authorisations required, and that it could not guarantee that this would not happen in future given the size of the NHS.37
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Government response AI summary
The government agrees with the committee's findings, stating NHS England is redrafting guidance on exit packages and approval mechanisms, to be communicated by end of Summer 2025. This new guidance aims to improve compliance and reduce instances of payments made without the necessary approvals.
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HM Treasury
23
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
When the previous Committee reported on this in June 2022, it warned that that the (then planned) large–scale restructuring of commissioning within the NHS could increase the risk of further unapproved payments being made.38 Given the announcements about the restructuring of NHS England and the potential for large numbers of …
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When the previous Committee reported on this in June 2022, it warned that that the (then planned) large–scale restructuring of commissioning within the NHS could increase the risk of further unapproved payments being made.38 Given the announcements about the restructuring of NHS England and the potential for large numbers of redundancies, we asked the Department whether it planned to introduce a new mechanism to approve these. Given the potential for many more unapproved payments being made due to the scale of the redundancies the enforcement of this mechanism needs to be carefully considered. The Department told us that this had yet to be decided, but that when it had run similar schemes, HM Treasury had approved the overarching business case for the overall numbers, cost and time of the people due to leave the organisation, and then processes had been set up inside the Department and NHS England to manage it and ensure that appropriate governance was in place. It told us that it “imagine[d] that … will happen again”.39 36 Qq 52–3, 55 37 Q 55 38 Committee of Public Accounts, Sixth Report of Session 2022–23, Department of Health and Social Care 2020–21 Annual Report and Accounts, HC 253, 18 May 2022 39 Qq 53–55 18 3 Transparency and accountability for the Department’s spending Usability of the Department’s Annual Report and Accounts document
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Government response AI summary
The government agrees with the committee's recommendation, stating NHS England is redrafting guidance on exit packages and associated approval mechanisms. This new guidance, to be communicated by end of Summer 2025, aims to strengthen oversight during restructuring and potential redundancies.
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HM Treasury
24
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
The Department was renamed the Department of Health and Social Care (from the Department of Health) in January 2018, with the intention of delivering a greater focus on adult social care.We observed that social care is only reflected in “a lot of little bits” in the Department’s Annual Reports and …
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The Department was renamed the Department of Health and Social Care (from the Department of Health) in January 2018, with the intention of delivering a greater focus on adult social care.We observed that social care is only reflected in “a lot of little bits” in the Department’s Annual Reports and Accounts. We therefore asked how social care delivery for users was being improved. NHS England told us that “a lot of work is already going on” including moving towards having joint social care and NHS assessment teams. It explained that this created a single process for assessing the care package needed for each patient and how it should be delivered, which should also result in earlier discharge from hospital. It also told us that it had undertaken work over the last 18 months to consider how it could improve intermediate care, focusing on physical rehabilitation when patients were leaving hospital, which it planned to roll out in 2026.40
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Government response AI summary
The government commits to improving the transparency and informativeness of its 2024-25 Annual Report and Accounts to include coverage of social care delivery, with an update to the Committee by September 2025.
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HM Treasury
25
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
The Department’s Annual Report and Accounts also does not contain analysis of the Department’s progress in improving productivity and efficiency. We asked, given the importance of productivity to ensuring that NHS expenditure was sustainable, if it would pay more attention to this in future. The Department told us that productivity …
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The Department’s Annual Report and Accounts also does not contain analysis of the Department’s progress in improving productivity and efficiency. We asked, given the importance of productivity to ensuring that NHS expenditure was sustainable, if it would pay more attention to this in future. The Department told us that productivity was “absolutely one of the top priorities” as part of the 10–year plan and the spending review, and committed to addressing this issue.41
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Government response AI summary
The government commits to improving its 2024-25 Annual Report and Accounts to include analysis of the Department's progress in improving productivity and efficiency, and will provide an update to the Committee by September 2025.
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HM Treasury
26
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
We similarly asked about the Department’s progress on technological and digital developments and the use of artificial intelligence (AI), as key areas which could improve productivity. We were surprised that the Department’s Annual Report and Accounts contains such little information on those 40 Q 71; National Audit Office, Departmental Overview: …
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We similarly asked about the Department’s progress on technological and digital developments and the use of artificial intelligence (AI), as key areas which could improve productivity. We were surprised that the Department’s Annual Report and Accounts contains such little information on those 40 Q 71; National Audit Office, Departmental Overview: Department of Health & Social Care, October 2018, page 3 41 Q 68 19 areas and asked for fuller details to be provided in future. The Department explained that it was “absolutely developing a refreshed tech plan as part of the productivity plan” and committed to place more focus on these areas in its next Annual Report and Accounts.42
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Government response AI summary
The government commits to improving its 2024-25 Annual Report and Accounts to include fuller details on technological and digital developments and the use of AI, and will provide an update to the Committee by September 2025.
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HM Treasury
27
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
The NHS Long Term Plan states that ill health prevention helps the public to stay healthy, as well as moderating demands on the NHS. The Department recognised in its 2023–24 Annual Report that there “is still much work to do to make a shift towards prevention in the NHS”.43 We …
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The NHS Long Term Plan states that ill health prevention helps the public to stay healthy, as well as moderating demands on the NHS. The Department recognised in its 2023–24 Annual Report that there “is still much work to do to make a shift towards prevention in the NHS”.43 We observed that, with the exception of a very short paragraph, the Department’s 2023–24 Annual Report does not include a section on preventative work, or information on outcomes arising from this spend. We asked the Department to ensure that next year’s accounts had more importance paid to prevention, which it agreed to.44 We also commented that it was difficult to find information in its Annual Report and Accounts on how much the Department was spending on palliative and end–of–life care, or what outcomes this spend was delivering, which felt like a “huge omission”. The Department was unable to provide a figure for this spending on our session, but told us that it would “definitely change that for next year … [and] add more prominence to it”.45
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Government response AI summary
The government commits to improving its 2024-25 Annual Report and Accounts to include more information on preventative work and spending/outcomes for palliative and end-of-life care, and will provide an update to the Committee by September 2025.
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HM Treasury
28
Recommendation
25th Report - DHSC Annual Report and Ac…
Accepted
NHS England’s Annual Report and Accounts and the Consolidated NHS Provider Accounts show that there were 3,877 exit packages in the NHS in 2023–24, costing a total of £98 million. We asked NHS England whether the use of exit packages had been increasing or decreasing. NHS England was unable to …
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NHS England’s Annual Report and Accounts and the Consolidated NHS Provider Accounts show that there were 3,877 exit packages in the NHS in 2023–24, costing a total of £98 million. We asked NHS England whether the use of exit packages had been increasing or decreasing. NHS England was unable to provide this information in our session but told us that it would confirm the precise number separately. Some 96 exit packages arose following employment tribunals or court orders against NHS England, NHS Trusts or NHS Foundation Trusts, at a cost of £1.3 million. We observed that there was no breakdown of the legal costs relating to employment tribunals and exit packages at NHS bodies within the Department’s or NHS England’s Annual Reports and Accounts. We requested that the Department provide this information to enable us to determine whether these were a good use of public funds.46 42 Q 69; Department of Health and Social Care Annual Report and Accounts 2023–24, HC 476, 17 December 2024, pages 38–39 43 Department of Health and Social Care Annual Report and Accounts 2023–24, HC 476, 17 December 2024, page 78; The NHS Long Term Plan, January 2019, page 7 44 Qq 28, 72 45 Qq 28, 72 46 Q 53; NHS England Annual Report and Accounts 2023–24, HC 251, 10 October 2024, pages 96–97; Consolidated NHS Provider Accounts 2023/24, HC 399, 26 November 2024, pages 82–83 20 Lack of timeliness of reporting
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Government response AI summary
The government commits to improving its 2024-25 Annual Report and Accounts to include a breakdown of legal costs relating to employment tribunals and exit packages, and will provide an update to the Committee by September 2025.
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HM Treasury