Recommendation 23

When the previous Committee reported on this in June 2022, it warned that that the (then planned) large–scale restructuring of commissioning within the NHS could increase the risk of further unapproved payments being made.38 Given the announcements about the restructuring of NHS England and the potential for large numbers of redundancies, we asked the Department whether it planned to introduce a new mechanism to approve these. Given the potential for many more unapproved payments being made due to the scale of the redundancies the enforcement of this mechanism needs to be carefully considered. The Department told us that this had yet to be decided, but that when it had run similar schemes, HM Treasury had approved the overarching business case for the overall numbers, cost and time of the people due to leave the organisation, and then processes had been set up inside the Department and NHS England to manage it and ensure that appropriate governance was in place. It told us that it “imagine[d] that … will happen again”.39 36 Qq 52–3, 55 37 Q 55 38 Committee of Public Accounts, Sixth Report of Session 2022–23, Department of Health and Social Care 2020–21 Annual Report and Accounts, HC 253, 18 May 2022 39 Qq 53–55 18 3 Transparency and accountability for the Department’s spending Usability of the Department’s Annual Report and Accounts document