Source · Select Committees · Public Accounts Committee
Recommendation 24
24
The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an...
Conclusion
The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an Integrated Care Board (ICB), responsible for the commissioning of healthcare services and an Integrated Care Partnership (ICP), an alliance of organisations and representatives to improve care, health and wellbeing, jointly convened by local authorities and the NHS.44 Under these new arrangements the existing 106 Clinical Commissioning Groups (CCG’s) responsible for commissioning healthcare services for the people of England are planned to become 42 Integrated Care Boards (ICBs) on 1 July 2022. In addition, several changes are planned to take place at a national level. NHS Improvement will be merged into NHS England, the expanded NHS England will also take in the functions of the NHS Trust Development Authority and Monitor and the existing bodies will be abolished. The future abolition of Health Education England; NHS Digital; and NHS X has also been announced with these functions also transferring to NHS England at a future date.45 40 Q 102 41 DHSC 2020–21 ARA, page 134 42 Q101 43 Q105 44 Health and Care Bill, HL Bill 132 (as amended on Report), HM Government 45 Department of Health and Social Care, Major reforms to NHS workforce planning and tech agenda, 22 November 2021 16 Department of Health and Social Care 2020–21 Annual Report and Accounts
Government Response
Not Addressed
HM Government
Not Addressed
6: PAC conclusion: There have been inappropriate unauthorised payoffs made to staff by health bodies, and the planned large-scale NHS restructuring increases the risk of this happening again. 6: PAC recommendation: The Department should write to us alongside its Treasury Minute response setting out how it will monitor and control the approval of all redundancy payments made by entities within the Departmental Group to ensure such payments are properly authorised in advance and are not irregular. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: December 2022 6.2 The department has processes in place for monitoring and controlling the approval of exit payments. 6.3 ALBs are required to comply with schedules of delegation issued by the department, including approvals required in respect of special severance and redundancy payments. Updated ALB delegations were issued on 4 May 2022. Details regarding arrangements for commissioners and providers are set out below. 6.4 Longstanding published Clinical Commissioning Groups (CCGs) guidance on losses and special payments specified special severance payments must be approved by HM Treasury. 6.5 Guidance to Integrated Care Boards (ICBs) was issued on losses and special payments including severance payments through the ICB programme on 31 May 2022. Additionally, the importance of due process relating to exit payments was further emphasised to commissioners and providers at a series of roadshows and workshops over the last six months. 6.6 In April 2022, detailed written guidance relating to exit payment processes and approvals was circulated to CCGs and the proposed ICBs. 6.7 Special severance payments which occurred in CCGs were submitted via the Region to the NHS England Executive Human Resources Sub Group (EHRSG). The EHRSG is chaired by a National Director and reviews and scrutinises the appropriateness of such payments. Any CCG case which was approved was then submitted by NHS England to Treasury via the Department of Health and Social Care. The same process is to be applied for Integrated Care Boards (ICBs) with enhanced assurance reporting from regions over such payments 6.8 For NHS Trusts, NHS England has an internal process whereby the Trust Appointments and Approvals Committee (TAAC) scrutinises and approves certain proposed severance cases and contractual payments over £100,000 to all NHS Trust staff to ensure they are properly authorised in advance and are not irregular. 6.9 Regarding foundation trusts, NHS England conduct a due diligence check on all non- contractual severance payments to ensure probity and compliance with Managing Public Money. 6.10 All the above cases are reported quarterly to the NHS England Board to provide additional governance at senior level.