Recommendation 2

The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services and do not give a clear overarching narrative on social care. The Department’s accounts contain very little information in key areas of interest to us, and to Parliament. This includes a lack of financial data on the prevention of ill health in the first place, which has the biggest long–term impact on health outcomes, and on technological advances, which are needed to improve future productivity for the NHS. While the Performance Report section of the Department’s Annual Report and Accounts contains some high level information on these areas, there is a lack of detailed financial data to set out how money has been spent in these areas. The Department’s accounts also do not provide information in enough detail to allow Parliament or the public to establish whether legal costs relating to exit packages and employment tribunals represent a good use of public funds, or provide the best outcomes. The Department is unable to tell us how much is spent on palliative and end–of–life care, nor what outcomes were delivered through this spending. recommendation a. In line with its Treasury Minute response, the Department should write to the Committee to set out its plans to improve the transparency and usability of its Annual Report and Accounts in the following areas: social care; productivity; prevention; digital and artificial intelligence; palliative and end–of–life care; severance and clinical negligence payments; and any new and emerging areas of Parliamentary and public interest. b. All future annual reports and accounts should be very clear about what productivity and efficiency gains have been made during the year and how. Also, a prediction for future years should be included.