Select committee: Public Accounts Committee
Recommendation 4
5th Report - NHS financial sustainability
Published 29 Jan 2025
Addressed to HM Treasury
Public Accounts Committee NHS financial sustainability All items in this report Report on parliament.uk ↗ Inquiry on parliament.uk ↗
Recommendation (the committee's words)
In some cases, NHSE’s payment mechanisms can mean that local systems do not receive financial recognition when they prioritise hard-to-reach patients. GP surgeries receive a payment for every child vaccination. This vaccination funding mechanism favours areas where parents are more willing to inoculate their children, while areas with higher levels of vaccine hesitancy, which may be more deprived areas, receive less funding and therefore have fewer resources to carry out much-needed activities such as outreach and education, potentially leading to even fewer patients being vaccinated in those areas. NHS Providers notes that tackling wider determinants of health must involve the specific targeting of poor health in the most deprived areas. recommendation NHSE should review current payment systems and processes to ensure they incentivise local systems to work with those most in need of help.
From: Public Accounts Committee, 5th Report - NHS financial sustainability (HC 350), 29 January 2025
Government response
Latest Treasury Minutes progress report to the Committee of Public Accounts on the Fifth Report of Session 2024-26
The government responded to the whole report on 4 June 2026.
Treasury minutes: Government response to the Committee of Public Accounts on the Fifth report from Session 2024-25
Published 16 May 2025.
Summary written by Accountability Index from the government's response. It is not the government's own words.The government agrees with several of the Committee's recommendations, including on earlier planning guidance, productivity and capital-to-revenue switches, is still considering others, and disagrees with the recommendation on paperless providers.
- On planning, the government agrees that guidance should be issued earlier, with a target implementation date of December 2025. NHSE and DHSC are working so guidance is published "ideally before Christmas".
- On the ten-year plan, prevention spending definitions and community funding, the government "is considering" the recommendations and says it will notify the Committee of its response "when it is confirmed".
- The government agrees that NHSE should set out its productivity actions (target: Autumn 2025). It says the plan for productivity improvements from 2026-27 "will be set out following Phase 2 of the Spending Review".
- The government disagrees with the recommendation on paper reduction, saying it "does not agree that providers should be fully paperless" as some patient communications must be sent by letter. It expects trusts and ICBs "to restrict fax machine use".