Source · Select Committees · Public Accounts Committee
Recommendation 3
3
Accepted
Establish early data collection to track costs and benefits for new and transformed services.
Conclusion
NHS England’s approach to transformational change was deeply flawed in both monitoring of progress and the delivery of intended outcomes. NHS England’s diagnostic transformation programme displayed positive features of programme management and achieved planned increases in numbers of diagnostic tests. The planned number of Community Care Centres were also delivered on time. However, the programme did not deliver the intended outcomes of reducing waiting times. Internal NHS England analysis found that there was a shortfall of 3.6 million tests. This led to the recovery target of 5% of waits for diagnostic tests being no more than six weeks being missed, with 22% of patients waiting over six weeks. These flaws have been compounded by NHS England and the Department not setting up the surgical and outpatients transformation programmes effectively enough to measure their impacts and benefits. Ultimately, the Department has approved billions of pounds of spending without sufficient focus on what exactly these programmes will deliver. recommendation The Department of Health and Social Care and NHS England should: a. Set up data collections or processes for tracking costs and benefits as early as possible when setting up new services or transforming existing services including the recent extension of specialist telephone advice to GPs. b. Focus reporting on the achievement of policy aims (expected outcomes for patients) to ensure that the capital funding provided delivers intended outcomes. 3
Government Response Summary
The government agrees and will merge the Diagnostic and Elective capital boards into a single Planned Care Capital Assurance Board from January 2026 to consolidate monitoring of outcomes, benefits, and policy aims. A NIHR evaluation of 2022-2025 Targeted Investment Fund schemes will also start in January 2026 and report in 2028.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. physical capital assets. There are several capital elements to planned care: an electives programme and a cancer and diagnostics programme. Currently the National Diagnostic Board and the groups feeding into it play an important assurance role in the delivery of diagnostic capital projects and report on delivery milestones as well as their impact on performance targets and alignment with policy objectives. The monthly Elective Capital Programme Board has an important assurance function in the oversight of elective capital projects. This receives and scrutinises monthly reports on scheme completions, planned vs actual additional activity enabled from completed schemes and receipt of scheme post project evaluations. Additionally, the monthly Elective Hubs Oversight Group receives performance reports for all surgical hubs, including on capped theatre utilisation (a measure of theatre productivity). It also receives reports from the national GIRFT hubs accreditation programme. A National Institute for Health and Care Research (NIHR) Policy Research Programme evaluation of 2022-2025 Targeted Investment Fund schemes that are non-hubs will start in January 2026 and report in 2028. From January 2026, the Diagnostic and Elective capital boards will merge to form a single Planned Care Capital Assurance Board, which will also monitor the delivery of capital projects which support cancer. This will consolidate existing work done within programmes to monitor outcomes and benefits and to report on the achievement of policy aims.