Recommendation 4

NHS England’s elective recovery programme partly relies on initiatives which have potential but for which there is so far limited evidence of effectiveness. NHSE has expanded some programmes because it believes them to be sufficiently promising, but there is currently a limited evidence base for their effectiveness, their impact on other parts of the health and social care system, and how they will work on a greatly expanded scale. NHSE told us it would ensure that capacity in surgical hubs, community diagnostic centres and the independent sector would be genuinely additional. However, it has more work to do to demonstrate how additional capacity will be sufficiently staffed without detracting from other NHS services. It is also concerning that NHSE could not provide the National Audit Office with its full evaluation of the 2021 elective accelerators programme, on which it spent £160 million. Recommendation: NHS England should know more about the conditions necessary for individual programmes to make the greatest contribution possible to recovery. Alongside its Treasury Minute response to this report, it should write to us more fully describing the real-world impact of community diagnostic centres, surgical hubs, increased use of the independent sector, and the advice and guidance programme. It should set out its understanding of the extent to which these initiatives have so far generated genuinely additional activity, rather than simply displacing activity elsewhere in the NHS.