Source · Select Committees · Public Accounts Committee
Seventy-Third Report - Access to urgent and emergency care
Public Accounts Committee
HC 1336
Published 25 October 2023
Conclusions (9)
5
Conclusion
Rejected
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 …
Government Response Summary
The government disagrees with the recommendation, explaining that Parliament has already articulated the roles of the Department and NHS England. It asserts that the Department maintains effective oversight through mandates, annual assessments, regular ministerial meetings, and Prime Minister-led stocktakes, underpinned by clear metrics.
6
Conclusion
Rejected
The unfunded and uncosted NHS Long Term Workforce Plan risks building in unsustainable financial pressures. The NHS Long Term Workforce Plan drawn up by NHS England only includes a commitment of an additional £2.4 billion to cover training costs for the first five years of the 15-year plan. The plan …
Government Response Summary
The government disagrees with the recommendation to provide a full 15-year cost update to the Committee, stating that NHS England will submit its estimates for the full cost of the NHS from 2025-26 onwards to the government as part of the next Spending Review process, with outcomes published by HM Treasury.
10
Conclusion
Rejected
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, …
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.
11
Conclusion
Rejected
The Department recognised that there is an element of accountability in its relationship with the NHS, and said it was holding NHS England to account through the trajectories set out in numerous recovery plans, from primary care to elective recovery. The Department believed that the NHS was on trajectory to …
Government Response Summary
The government disagrees with the Committee's implicit concern regarding its oversight of NHS England's performance, stating it maintains effective oversight through mandates, regular ministerial meetings, and stocktakes.
12
Conclusion
Rejected
The Department acknowledged that there were different sides of its approach to holding the NHS to account. It recognised that if there was a problem arising in a local authority it may fall to the Department to address, whereas problems in local trusts would be the responsibility of NHS England.29 …
Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding NHS management levels and accountability, defending the existing structure as articulated by Parliament and detailing its effective oversight mechanisms and performance monitoring.
28
Conclusion
Rejected
We pressed both the Department and NHS England on how the workforce plan would be paid for.80 NHS England stated that the current government’s commitment has been to fully fund the first five years of the plan.81 In future periods, there would be decisions for the then government to take …
Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding the long-term funding of the workforce plan, reiterating its £2.4 billion commitment for the first five years and stating future funding estimates will be part of the next Spending Review.
29
Conclusion
Rejected
The Department and NHS England told us that government had made a firm commitment of £2.4 billion of new money to fully fund the first five years of additional training places set out in the plan, until 2028.84 A planned expansion of medical school places up to 15,000 would be …
Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation, reaffirming its £2.4 billion commitment to fund the first five years of the NHS Long Term Workforce Plan and stating that estimates for subsequent years will be submitted as part of the next Spending Review.
30
Conclusion
Rejected
NHS England confirmed that there is no specific funding for staff retention but said that it would be cost neutral. However, there are dependencies on several other factors that are important for retention. Staff wellbeing was outside the purview of the workforce plan and other measures, such as pension changes, …
Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding staff retention funding, highlighting its £2.4 billion commitment for training and deferring future funding estimates to the next Spending Review.
31
Conclusion
Rejected
The Department emphasised the most important aspect of the plan was continued and sustained investment and that, particularly when thinking about technology and digitisation, it should be seen as a multiyear set of changes.88 NHS England added that there was a commitment and request from Treasury to refresh the plan …
Government Response Summary
The government explicitly disagrees with the committee's finding or implied recommendation, stating it has committed £2.4 billion for the NHS Long Term Workforce Plan and will address future funding needs as part of the next Spending Review process.