Source · Select Committees · Public Accounts Committee
Recommendation 10
10
Rejected
Department's oversight of NHS England's A&E performance targets remains ineffective and unachieved.
Conclusion
We raised concerns over the effectiveness of the Department’s oversight of NHS England’s performance against its targets, including the A&E target for 95% of patients to be admitted, transferred, or discharged within four hours.23 This target has not been achieved in the eight years since July 2015. In March 2023, the proportion of all A&E departments meeting the standard was 71.5%.24 The Department told us that it has a completely shared analysis with NHS England and that it was focused on joint problem- solving.25
Government Response Summary
The government disagrees with the Committee's concern over the effectiveness of its oversight of NHS England's performance, asserting it maintains close oversight through various mechanisms, including mandates and regular high-level meetings.
Government Response
Rejected
HM Government
Rejected
5.1 The government disagrees with the Committee’s recommendation. 5.2 While the department approaches all its work in a spirit of continuous improvement, the government nonetheless disagrees with the Committee's recommendation. Parliament has itself articulated the respective roles of the Secretary of State and NHS England in the NHS Act 2006 as subsequently amended (most recently by the Health and Care Act 2022). 5.3 The department maintains effective oversight of NHS England, including over urgent and emergency care and the actions being taken to address the impact of the pandemic and long-term sectoral challenges under the Delivery Plan for recovering urgent and emergency care services. 5.4 The Secretary of State for Health and Social Care is accountable to parliament and the public for health and care and sets objectives NHS England must seek to achieve through the mandate to NHS England, last published in June 2023. This is assessed annually, bringing together governance for performance against individual objectives in the mandate. The mandate for 2023-24 includes the achievement of urgent and emergency care recovery ambitions. 5.5 NHS England has responsibilities for the oversight and support of health service providers and intervening in the case of poor performance. The NHS Oversight Framework details the overall principles, responsibilities and ways of working for oversight, including the key metrics and factors NHS England will consider when determining support needs, and the circumstances in which it considers formal regulatory intervention may be necessary to address issues. NHS England has also implemented an urgent and emergency care tiering performance and improvement approach to support the delivery of recovery ambitions under the delivery plan, providing targeted support to challenged systems and ambulance trusts on performance issues. 5.6 The department maintains close oversight of NHS England’s delivery of emergency care recovery ambitions, including through regular ministerial progress meetings, ongoing engagement with No10 and regular stocktakes led by the Prime Minister. This oversight is underpinned by clear metrics agreed in the Urgent and Emergency Care recovery plan. Headline commitments to improve ambulance and accident and emergency waiting times are closely monitored through official public statistics and a wide range of management information. This informs discussions with the NHS on how to work together to address underperformance.