Source · Select Committees · Public Accounts Committee
Recommendation 28
28
Accepted
Lack of documentation for HIP scheme selection severely hindered transparency and NAO scrutiny.
Conclusion
Selection of the 27 HIP schemes was carried out by DHSC and NHS England. NHS England produced a long list of 56 possible schemes, and DHSC reduced this to a shortlist of 20 schemes using clear, evidence-based criteria.63 However, to arrive at that 27 schemes that were announced, DHSC included only 13 of the 20 shortlisted schemes, and removed the other seven. DHSC added another 14 schemes. These had previously been considered but had not scored highly enough in the assessment exercise. Officials told the National Audit Office (NAO) that there was no further documentation available to explain how this final selection was arrived at. This failure of documentation practices meant the NAO had no basis to determine why DHSC selected the 27 HIP schemes and not some of the other shortlisted schemes.64 NHS Providers noted that all NHS trust leaders would be concerned about this and would expect such decisions to be made transparently, using clear criteria to evaluate all schemes that applied.65
Government Response Summary
The government accepts the recommendation, acknowledging a past omission in record-keeping for HIP scheme selections. It commits to ensuring its practices result in rational decisions with appropriate documentation and will be able to provide evidence on future decision outcomes, balanced with protecting sensitive information.
Government Response
Accepted
HM Government
Accepted
2.1 The government agrees with the Committee’s recommendation. Recommendation implemented 2.2 The department accepts that there was an omission in record keeping around the final selection of schemes that would be included in the Health Infrastructure Plan in 2019. However, the process was based on clear criteria and the department, NHSE, HM Treasury and No10 Downing Street agreed that the final list of schemes was the right one. 2.3 The government regularly sets out the selection process for major capital programmes before bids are invited and decisions are made. Selection criteria for schemes to take forward will vary but will consistently consider the strategic context, economic impact and risks, commercial factors, financial factors and deliverability; in line with HM Treasury’s Five Case Model as recommended by the Green Book. Scheme selection decisions in major capital programmes are inherently complex, requiring comparison between different criteria and consideration of their relative value. The department also considers the advice of NHSE when allocating funding for major capital programmes. 2.4 The department is committed to ensuring its practices, procedures, and advice result in rational decisions made through an appropriate process that take account of the right criteria. As a result, the department will be able to provide evidence on decision outcomes as needed, balanced against its responsibilities to protect certain types of information, such as commercially sensitive information.