Select Committee · Public Accounts Committee

DHSC Annual Report and Accounts 2023-24

Status: Closed Opened: 15 Jan 2025 Closed: 17 Jul 2025 21 recommendations 13 conclusions 1 report

In May 2024 , the PAC found that the Department of Health and Social Care (DHSC) and the UK Health Security Agency (UKHSA) had been getting the basics unacceptably wrong in their financial management and accountability for public spending – for the second year running. Its report expressed disappointment that, four years after the pandemic …

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Reports

1 report
Title HC No. Published Items Response
25th Report - DHSC Annual Report and Accounts 2023-24 HC 639 14 May 2025 34 Responded

Recommendations & Conclusions

7 items
7 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

Department plans "smaller and leaner" headcount reduction without specifying exact numbers.

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 …

Government response. 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 …
HM Treasury
9 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

NHS England unable to clarify application of 50% headcount reduction across ICBs.

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 …

Government response. 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 …
HM Treasury
11 Recommendation 25th Report - DHSC Annual Report and Ac… Acknowledged

Department expects Integrated Care Boards to maintain local accountability and stakeholder balance.

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 …

Government response. 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 …
HM Treasury
15 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

Clinical negligence cases impose significant monetary costs on taxpayers, totalling £2.8 billion.

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. …

Government response. 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 …
HM Treasury
16 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

Department's clinical negligence liability reaches £58.2 billion, ranking second largest across government.

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 …

Government response. 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 …
HM Treasury
30 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

Department's 2023–24 accounts published five months late, facing significant timetable challenges.

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

Government response. 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.
HM Treasury
31 Conclusion 25th Report - DHSC Annual Report and Ac… Acknowledged

Accounts delays result from UKHSA audit challenges and slow completion of local NHS audits.

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 …

Government response. 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.
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
13 Mar 2025 Andy Brittain · Department of Health and Social Care (DHSC), Julian Kelly · NHS England, Professor Dame Jenny Harries · UK Health Security Agency, Professor Sir Chris Whitty · Department for Health and Social Care View ↗

Correspondence

8 letters
DateDirectionTitle
15 Dec 2025 To cttee Letter from the Permanent Secretary at the Department for Health and Social Car…
8 Dec 2025 To cttee Letter from the Chief Executive of NHS England relating to the Committee’s Twen…
17 Nov 2025 To cttee Letter from the Permanent Secretary of the Department for Health and Social Car…
4 Sep 2025 To cttee Letter from the Secretary of State for Health and Social Care relating to the D…
8 May 2025 To cttee Letter from the Interim Permanent Secretary of the Department of Health and Soc…
28 Apr 2025 To cttee Letter from the Interim Permanent Secretary of the Department of Health and Soc…
24 Apr 2025 To cttee Letter from the Chief Financial Officer at NHS England relating to the oral evi…
20 Mar 2025 To cttee Letter from the Chief Executive of the Independent Healthcare Providers Network…