Source · Select Committees · Public Accounts Committee
Recommendation 6
6
Deferred
Ensure greater NHSE funding for community services, preventing redirection to hospitals.
Conclusion
NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected funding to prop up the day-to-day spending of local NHS systems. Despite carrying out 15% more elective activity compared to before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered. NHSE makes trade-offs between spending that will yield benefits in the longer term and spending to meet current priorities, and it acknowledges funding increases for mental health and community services are slow. NHSE recognises there is value in considering whether best use is currently being made of funding for Continuing Healthcare assessments and the Better Care Fund, intended to support joint working between the NHS and social care. 6 recommendation NHSE should ensure that, year on year, a greater proportion of its funding is spent in the community, in line with its own policy ambition. Any review of Continuing Healthcare funding and the Better Care Fund, DHSC and NHSE should not make changes that will see these community-based funds redirected to hospitals.
Government Response Summary
The government is considering the recommendation, stating it will be addressed within the 10 Year Health Plan and multi-year Spending Review for decisions on shifting funding to community care. It highlights increased mental health spending in 2023-24 and the maintenance of Better Care Fund funding in 2025-26.
Government Response
Deferred
HM Government
Deferred
The government is considering this recommendation. care) increased faster than overall ICB spend in 2023-24. DHSC and NHSE have prioritised mental health in its plans for 2025-26, requiring ICBs to meet the Mental Health Investment Standard. To continue to reform and improve mental health services and improve value for money for the taxpayer, all mental health providers will be asked to submit, implement and report against a plan to enhance productivity during 2025- 26. In 2025-26 funding through the Better Care Fund is also being maintained, as set out in published revenue and contracting guidance. Through the 10 Year Health Plan and the multi-year Spending Review, NHSE, with DHSC, is focusing on enabling a greater shift from hospital to community – including considering how funding decisions over coming years can support this. This recommendation is therefore under consideration. The Committee will be notified of the response to this recommendation when it is confirmed.