Recommendations & Conclusions
7 items
7
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
We asked the Department about reports that its headcount would also be cut by 50%. The Department told us that it aimed to become “smaller and leaner”. It said that it was not in a position to put a number on the reduction in size of its headcount, confirming only …
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We asked the Department about reports that its headcount would also be cut by 50%. The Department told us that it aimed to become “smaller and leaner”. It said that it was not in a position to put a number on the reduction in size of its headcount, confirming only that there would be a reduction. The Department told us that it had announced a voluntary exit scheme in early March 2025 and that it was also operating a cap on new external appointments. It anticipated that these actions would equate to savings worth £15 million per year which could then be used for frontline services.10
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Government response AI summary
The government agrees with the observation, describing ongoing work to create a single new organization and develop staff transfer plans. Specific headcount information is likely to be confirmed in Autumn 2025, with further details provided to the Committee Chair in July 2025.
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HM Treasury
9
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
We asked how the 50% headcount reduction will be applied to ICBs, noting that some were already working efficiently and the importance of the place–based approach in ensuring effective working between local councils, directors of public health and local GPs. The Department expected that the changes to ICBs would not …
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We asked how the 50% headcount reduction will be applied to ICBs, noting that some were already working efficiently and the importance of the place–based approach in ensuring effective working between local councils, directors of public health and local GPs. The Department expected that the changes to ICBs would not lead to more centralisation. However, NHS England was unable to clarify whether the 50% reduction in ICBs represented a 50% reduction for each ICB individually or across system as a whole. NHS England explained that the detail of the expectations on ICBs would become clear as the 10–year plan for the NHS was finalised.12
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Government response AI summary
The government agrees with the observation, reiterating principles of empowering local leaders and strong partnerships. However, specific details on how the headcount reduction will apply to ICBs remain linked to the forthcoming 10 Year Health Plan and are subject to future primary legislation.
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HM Treasury
11
Recommendation
25th Report - DHSC Annual Report and Ac…
Acknowledged
We asked the Department whether the current locally–led approaches would be retained as part of the new structure to allow better local accountability, and whether previous commitments about public health and prevention would also be retained. The Department said that the ideal set–up for an ICB to meet its commitments …
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We asked the Department whether the current locally–led approaches would be retained as part of the new structure to allow better local accountability, and whether previous commitments about public health and prevention would also be retained. The Department said that the ideal set–up for an ICB to meet its commitments and be held to account was through a good balance of stakeholders, including local authorities, primary, secondary, community, and other care providers, to maintain local, but joined up, accountability.15 11 Qq 9–10, 14 12 Q 17 13 NHS England, NHS Chief to stand down at end of March, 25 February 2025; NHS England, England’s top doctor to stand down after over seven years, 6 March 2025; NHS England, NHS England board members stepping down, 10 March 2025 14 Qq 20, 27 15 Q 26 12 The development of the Harlow Health Security Campus
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Government response AI summary
The government agrees to retain locally-led approaches, stating that reforms empower local leaders and NHS England has already clarified that Integrated Care Boards should foster strong relationships with local government to improve outcomes. The 10 Year Health Plan will further address shifting healthcare to the …
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HM Treasury
15
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
The Department recognised that each incidence of clinical negligence has a tragedy behind it involving a patient. It told us that while the optimal number of clinical negligence cases would be zero, this will never be a practical target. Clinical negligence also comes with a monetary cost to the taxpayer. …
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The Department recognised that each incidence of clinical negligence has a tragedy behind it involving a patient. It told us that while the optimal number of clinical negligence cases would be zero, this will never be a practical target. Clinical negligence also comes with a monetary cost to the taxpayer. The Department is required to make compensation payments for pain suffered and the impact on the everyday lives of those who have suffered negligence. In 2023–24, NHS Resolution, which administers claims of clinical negligence for the Department, paid £2.8 billion in cash to claimants.22
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Government response AI summary
The government agrees with the committee's findings, stating it will continue to prioritize patient safety and a learning culture through ongoing work under the NHS Patient Safety Strategy. This strategy, which aims to reduce harmful patient events, will be reviewed and updated in autumn 2025.
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HM Treasury
16
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
The Department recognises an amount for potential future compensation payments for incidents of clinical negligence in its financial statements as a liability. This is reported in the accounts of NHS Resolution and is consolidated into the Departmental Group accounts. The Department recognised a liability of £58.2 billion in its 2023–24 …
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The Department recognises an amount for potential future compensation payments for incidents of clinical negligence in its financial statements as a liability. This is reported in the accounts of NHS Resolution and is consolidated into the Departmental Group accounts. The Department recognised a liability of £58.2 billion in its 2023–24 accounts to cover the expected potential future costs of compensation for clinical negligence, which included £9.3 billion set aside to cover incidents that occurred in 2023–24. The Department has identified a further £24.6 billion of clinical negligence claims which it does not recognise as a liability but may need to pay in the future.23 The Department’s clinical negligence liability is the second largest liability across government.24 22 Q 59; Department of Health and Social Care Annual Report and Accounts 2023–24, pages 262, 308; NHS Resolution, Annual Report and Accounts 2023/24, HC 73, 23 July 2024, pages 29, 166–167 23 Department of Health and Social Care Annual Report and Accounts 2023–24, pages 262, 306; NHS Resolution, Annual Report and Accounts 2023/24, HC 73, 23 July 2024, pages 166–167, 188–189 24 Whole of Government Accounts, year ended 31 March 2023, HC 289, 26 November 2024, page 67 15
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Government response AI summary
The government agrees with the committee's findings, stating it will continue to prioritize patient safety and a learning culture through ongoing work under the NHS Patient Safety Strategy. This strategy, which aims to reduce harmful patient events, will be reviewed and updated in autumn 2025.
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HM Treasury
30
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
The Department published its 2023–24 accounts on 17 December 2024, five months after the summer Parliamentary recess deadline. The Department has reported that there continues to be significant challenges in bringing the laying of its accounts back to a pre–summer recess timetable.50
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The Department published its 2023–24 accounts on 17 December 2024, five months after the summer Parliamentary recess deadline. The Department has reported that there continues to be significant challenges in bringing the laying of its accounts back to a pre–summer recess timetable.50
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Government response AI summary
The government agrees with the committee's observation and highlights its existing multi-year plan to return to a pre-recess timetable, stating it will provide further details on the plan and risks to the Committee in September 2025.
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HM Treasury
31
Conclusion
25th Report - DHSC Annual Report and Ac…
Acknowledged
The delays to the accounts were the result of challenges in preparing the accounts of UKHSA and delays in completion of local NHS audits.51 UKHSA was subject to a disclaimed audit opinion in 2021–22 and 2022–23, with significant remedial work being required to complete the 2023–24 accounts, causing delays. NHS …
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The delays to the accounts were the result of challenges in preparing the accounts of UKHSA and delays in completion of local NHS audits.51 UKHSA was subject to a disclaimed audit opinion in 2021–22 and 2022–23, with significant remedial work being required to complete the 2023–24 accounts, causing delays. NHS England and the Consolidated NHS 47 Committee of Public Accounts, Thirty–First Report of Session 2023–24, Department of Health and Social Care 2022–23 Annual Report and Accounts, HC 459, 10 May 2024 48 HM Treasury, Dear Accounting Officer letter, Accounts Directions 2023–24, 14 December 2023 49 Committee of Public Accounts, Thirty–First Report of Session 2023–24, Department of Health and Social Care 2022–23 Annual Report and Accounts, HC 459, 10 May 2024 50 Report by the Comptroller and Auditor General, Department of Health and Social Care Annual Report and Accounts 2023–24, page 3; Department of Health and Social Care Annual Report and Accounts 2023–24, page 138 51 Department of Health and Social Care Annual Report and Accounts 2023–24, HC 476, 17 December 2024, page 138 21 Provider Accounts rely on the individual audits of 42 NHS Commissioners and 211 NHS providers respectively, which are incorporated into their own group accounts.52
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Government response AI summary
The government agrees with the committee's observation, detailing its multi-year plan to accelerate accounts publication, while noting dependency on private sector audit firms. It commits to providing further plan details to the Committee in September 2025.
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HM Treasury