Source · Select Committees · Public Accounts Committee
Recommendation 28
28
Accepted
Uncertainty persists regarding funding for NHSE and ICB redundancy compensation payments
Conclusion
In the September session, NHSE told us that the changes had been very dramatic and that a lot of work had been done very quickly to start to reduce the variation in running costs for ICBs as well as some of the key cost drivers.60 We were told that redundancies at the national level had been thought of and discussed at the outset. However NHSE confirmed that there was still no resolution with HM Treasury on the source of the 54 Qq 37-38 55 C&AG’s Report, para 4.10 56 Q 33 57 C&AG’s Report, para 6 58 Committee of Public Accounts evidence session on 13 March 2024, DHSC Annual Report and Accounts, see Q 9 59 Committee of Public Accounts evidence session on 13 March 2024, DHSC Annual Report and Accounts, see Q 9 and Q13 60 Q 2 15 significant sums that would be required to fund redundancy compensation payments.61 NHSE accepted that the uncertainty over job losses and cuts being faced by ICBs was unsatisfactory.62 We were, however, assured by NHSE that despite their scale, the cuts would be made without any direct implications for service provision.63
Government Response Summary
The department accepts the Committee’s recommendation and will deliver a modernised health system through the integration of NHS England into DHSC and the associated restructuring of Integrated Care Boards (ICBs). The government will publish proportionate assessments to support the scale of reforms, to enable scrutiny.
Government Response
Accepted
HM Government
Accepted
6.6 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2026 6.7 The department accepts the Committee’s recommendation and will deliver a modernised health system through the integration of NHS England into DHSC and the associated restructuring of Integrated Care Boards (ICBs). 6.8 The department is committed to transparent, responsible, evidence-based policy making. The government will publish proportionate assessments to support the scale of reforms, to enable scrutiny. 6.9 The department plans to publish an impact assessment to support the required primary legislation. This impact assessment will focus on legislative changes to enable the transfer of functions from NHS England to the centre, or wider system. 6.10 The department is developing the operating model for the new centre at pace, together with the plans for transfer of people, functions and responsibilities. These secondary policy decisions and impacts, related to headcount reductions or structural changes, will be considered separately to the impact of the legislative changes. The decisions will be made in slower time and are dependent on the end-state agreed in Parliament. 6.11 ICBs will focus on strategic commissioning and move to the new operating model described in the model ICB blueprint. 6.12 The department’s ambition is to halve headcount across DHSC, NHS England, and ICBs, by approximately 18,000 posts, saving over £1 billion annually by the end of Parliament. Further financial information will be disclosed in line with reporting and transparency commitments. 6.13 In the Autumn Budget 2025, the Chancellor announced that the Treasury would bring forward £860 million of the department’s Spending Review 2025 (SR25) settlement to support with the upfront costs.