Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Accepted
Review NHSE payment systems and processes to incentivise local systems supporting hard-to-reach patients.
Recommendation
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.
Government Response Summary
The government agrees and states that NHS England regularly reviews and updates funding formulas, committing to do so again before 2026-27 allocations to ensure greater deprivation receives higher funding. It also cites existing programmes like Targeted Lung Health Checks and Mental Health Support Teams as evidence of reaching those most in need.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. deprivation and health inequalities. Areas with populations of relatively greater deprivation and higher premature mortality receive a relatively higher level of funding to recognise greater need and help tackle health inequalities, for example through supporting outreach activity. NHSE regularly reviews and updates the formula used to set allocations and will do so again ahead of setting financial allocations for 2026-27. There is also evidence that NHSE investment in a range of interventions is reaching those most in need of help, for example: • Targeted Lung Health Checks programme, which seeks to diagnose lung cancer at an early stage, has now invited nearly 30% of the eligible population and is diagnosing around 200 cancers per month, 75% at an early stage. The Rapid Cancer Registration Dataset shows that people from disadvantaged backgrounds are now most likely to be diagnosed with lung cancer at an early stage. • Early intervention in mental health: 44% of pupils and learners have access to Mental Health Support Teams as of Spring 2024, exceeding the original commitment to cover 20%-25% of the country and 50% coverage is expected in Spring 2025.