Recommendation 5

Given long-standing declines in performance, we are not convinced the Department has sufficiently held NHS England to account for meeting targets and improving urgent and emergency care. The Department holds the NHS to account for performance in urgent and emergency care. It told us it works closely with NHS England and that, together, they hold a shared analysis of the key issues in urgent and emergency care and an agreed view on the solutions that are needed. However, the NHS has not met targets for ambulance handovers since November 2017 and for A&E waits since July 2015, with wider declines in performance across the board. Against this background, we asked how effective the Department has Access to urgent and emergency care 7 been in holding NHS England to account for the declining performance. While the Department was at pains to say how closely it worked with NHS England and had a shared analysis, it did not articulate how it was adding any value in holding NHS England to account for making meaningful improvements to services for patients. Recommendation 5: The Department must improve how effectively it holds NHS England to account for performance against targets for access to urgent and emergency care. It should clearly articulate the respective roles of the Department and NHS England and set out the key steps the Department takes when its monitoring highlights underperformance.