Access to urgent and emergency care

Public Accounts Committee Closed Inquiry
Opened: 18 May 2023 Closed: 14 Feb 2024 Parliament page
In March this year the Public Accounts Committee reported that the first year of the NHS’ three year plan to recover its services was already falling short . People who need urgent or unplanned medical care can seek NHS help from several different services depending on the nature and severity … Read more
2 Recommendations
29 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
14 Feb
2024
Report published
25 Oct
2023
Report published
11 Sep
2023
Correspondence
11 Sep
2023
Correspondence
3 Jul
2023
Oral evidence
3 Jul
2023
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
Oral evidence sessions 1 session
3 Jul 2023
View on parliament.uk
Access to urgent and emergency care
Amanda Pritchard · NHS England Matthew Style · Department of Health and Social Care Professor Sir Stephen Powis · NHS England Sarah-Jane Marsh · NHS England Sir Chris Wormald · Department of Health and Social Care
Title HC No. Published Items Response
Seventy-Third Report - Access to urgent and emergency care HC 1336 25 Oct 2023 31 Responded
Recommendations & Conclusions
9 results
Clear
5 Conclusion Rejected
Seventy-Third Report - Access to u…
Improve accountability for NHS England's urgent and emergency care performance, articulating roles and monitoring steps.
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 … Read more
Government Response
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.
HM Treasury
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6 Conclusion Rejected
Seventy-Third Report - Access to u…
Provide Committee with full 15-year cost estimates for NHS Long Term Workforce Plan implementation.
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 … Read more
Government Response
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.
HM Treasury
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10 Conclusion Rejected
Seventy-Third Report - Access to u…
Department's oversight of NHS England's A&E performance targets remains ineffective and unachieved.
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 … Read more
Government Response
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.
HM Treasury
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11 Conclusion Rejected
Seventy-Third Report - Access to u…
NHS England confident in recovery plans despite significant challenges, especially upcoming winter.
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. … Read more
Government Response
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.
HM Treasury
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12 Conclusion Rejected
Seventy-Third Report - Access to u…
Department rejects claims of excessive NHS management layers or unclear accountability structures.
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 … Read more
Government Response
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.
HM Treasury
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28 Conclusion Rejected
Seventy-Third Report - Access to u…
Long-term funding for the NHS workforce plan remains undefined beyond five years
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, … Read more
Government Response
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.
HM Treasury
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29 Conclusion Rejected
Seventy-Third Report - Access to u…
Initial £2.4 billion funds first five years of training; future expansion needs more
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 … Read more
Government Response
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.
HM Treasury
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30 Conclusion Rejected
Seventy-Third Report - Access to u…
No specific funding for staff retention, relying on other factors
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 … Read more
Government Response
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.
HM Treasury
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31 Conclusion Rejected
Seventy-Third Report - Access to u…
Plan requires sustained multi-year investment, especially in technology and digitisation
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 … Read more
Government Response
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.
HM Treasury
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Government Response AI assessment · 29 of 2 classified
Accepted 15
Acknowledged 5
Rejected 9
Total 2 recs + 29 conclusions
Correspondence 2 letters
11 Sep 2023 Correspondence from Matthew Style, Director General, NHS Policy and Performance, Department for Health, and Social Care, re Access to Urgent and Emergency Care, dated 17 July 2023
Parliament page
11 Sep 2023 Correspondence from Sarah Jane Marsh, National Director for integrated Urgent and Emergency Care Deputy Chief Operating Officer, NHS England, re access to urgent and unplanned care, dated 19 July 2023
Parliament page