Select committee: Public Accounts Committee
Conclusion 6
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 ↗
Conclusion (the committee's words)
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.
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".