Recommendation 22

We noted that the accounts showed there had been 240 cases where retrospective approval had been sought for special severance payments, and asked NHS England whether there were any consequences for making these payments without the necessary approvals. NHS England said that this was down to “a judgement about how proportionate the response is in each case”. It said that, depending on the sum involved and what had happened, it would “talk to the organisation and make sure that people are spoken to”. We therefore asked whether any action had been taken against anyone for making payments without the proper approval. NHS England did not identify any specific actions beyond reminding individuals of the authorisations required, and that it could not guarantee that this would not happen in future given the size of the NHS.37