Source · Select Committees · Public Accounts Committee
Recommendation 6
6
Accepted
Ensure all NHS England exit packages receive appropriate advance approvals before payment.
Recommendation
NHS England does not have a coherent plan to better protect taxpayers’ money and prevent future unapproved exit packages. There remain far too many special severance payments where approval has only been sought after the payment has been made. Five such unapproved payments 7 totalling £180,868 were made by NHS trusts in 2023–24. Without approval, this expenditure has not been spent in line with Parliament’s expectations. NHS England’s plan to stop such payments occurring in future has been to remind providers of the rules in place. However, it has acknowledged that solely reminding providers is not enough to guarantee future unapproved payments will not happen. NHS England is also unable to identify any meaningful consequences for trusts that would act as a deterrent. recommendation As part of its Treasury Minute response, NHS England should set out how it will ensure that all exit packages receive the appropriate approvals in advance of payment being made, including details of consequences for non–compliance with the rules. Given the proposed scale of redundancies it should set out how its new approvals mechanism can be enforced to prevent even more unauthorised severance payments. This should include how it will ensure that this corporate knowledge and any lessons learned are not lost when it is abolished and its functions are taken on by the Department. 8 1 The operation of the Department and its reporting Introduction
Government Response Summary
The government commits to publishing new comprehensive guidance on all types of exit packages and communicating it via regional teams and the NHS England website, aiming for impact from 2025-26. It also outlines existing lesson-learning for non-compliance.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation associated approval mechanisms. This guidance will include instruction on all types of exit packages including voluntary severance, Mutually Agreed Resignation schemes (MARS), compulsory redundancies, and special severance cases. This guidance will be communicated via the regional workforce teams as well as via the NHS England external website. This should have an impact on exits agreed from 2025-26. Where instances arise with compliance with the approval mechanism for exit packages, NHSE conducts a lesson-learnt exercise and reiterates the approval rules via several avenues. For example, NHSE directly liaises with the organisations involved to ensure the rules are understood, and through financial control events where NHSE promotes good practice and reminds delegates of the governance arrangements for certain types of transactions. So far for 2024-2025 NHSE has seen fewer instances of non-compliance, but the final assurance process on this is not fully complete as of May 2025. Regarding the future arrangements for exit packages, the oversight mechanism will depend on where the legal powers reside after the integration of NHSE into the future Department of Health and Social Care. NHSE will ensure it is picked up in the transition process.