DHSC Annual Report & Accounts 2022-23

Public Accounts Committee Closed Inquiry
Opened: 10 Jan 2024 Closed: 29 May 2024 Parliament page
In 2023, the Committee reported that the Department for Health & Social Care (DHSC) had overpaid and overordered £14.9 billion of inventory, which included PPE (£9.9 billion), COVID-19 medicines (£2.6 billion) and COVID-19 vaccines (£1.9 billion). Vast quantities of unusable and unneeded PPE were in storage awaiting disposal by recycling … Read more
4 Recommendations
27 Conclusions
1 Report
1 Oral session
2 Letters
1 Event
Activity timeline 6 events
11 Jul
2025
Report published
10 May
2024
Report published
15 Apr
2024
Correspondence
15 Apr
2024
Correspondence
13 Mar
2024
Oral evidence
13 Mar
2024
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
Oral evidence sessions 1 session
13 Mar 2024
View on parliament.uk
DHSC Annual Report and Accounts 2022-23
Andy Brittain · Department of Health and Social Care (DHSC) Julian Kelly · NHS England Professor Dame Jenny Harries · UK Health Security Agency Shona Dunn · Home Office Sir Chris Wormald KCB · Department for Health and Social Care
Title HC No. Published Items Response
Thirty-First Report - Department of Health and Social Care 2022–… HC 459 10 May 2024 31 Responded
Recommendations & Conclusions
31 results
2 Conclusion Accepted
Thirty-First Report - Department o…
Return to publishing departmental group accounts by a pre-summer recess deadline with a clear timetable.
The Department’s continued failure to deliver its accounts to an earlier timetable hampers effective and timely accountability of taxpayers’ money. Weaknesses in basic financial accounting at UKHSA, together with delays in the completion of local NHS audits, and a lack … Read more
Government Response
The government agrees and targets a return to pre-summer recess laying for its Annual Report and Accounts by the 2026-27 financial year, with a specific plan to lay the 2023-24 accounts by early December 2024. It is also actively engaging with stakeholders to address local audit system capacity issues.
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3 Conclusion Accepted
Thirty-First Report - Department o…
Urgently grip and address financial management problems across the Departmental Group with a clear improvement plan.
We are concerned that the Department has still not put in place adequate oversight to ensure strong financial management and reporting across its group which are fundamental to the effective delivery of its policy and operational work. The Department is … Read more
Government Response
The government agrees and states the recommendation is implemented, detailing that it is working closely with UKHSA and NAO, providing strong financial oversight including regular governance and assurance meetings. It also reports £75 million recovered from PPE fraud and anticipates further matters settled before Autumn 2025.
HM Treasury
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4 Recommendation Acknowledged
Thirty-First Report - Department o…
Set out by summer 2024, key reasons and actions to reduce clinical patient harm.
We are concerned that the Department is spending £2.6 billion on clinical negligence payments without an effective plan to minimise future costs of the scheme. Incidences of clinical negligence continue to result in significant cost to the taxpayer, particularly in … Read more
Government Response
The government agrees with the recommendation and has identified various factors contributing to patient harm. It commits to prioritising continuous patient safety improvement and will write to the Committee later in 2024 to detail the specific actions it is taking with NHS England and partners to reduce harm.
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5 Conclusion Accepted
Thirty-First Report - Department o…
Develop and implement a clear plan for future pandemic stockpiling within six months.
We are disappointed that the Department lacks adequate controls over its inventory and, four years after the COVID-19 pandemic began, still does not have a plan for stockpiling for future pandemics. The Department does not know how much inventory it … Read more
Government Response
The government agrees and commits to implementing dynamic stockpiling for excess COVID-19 stock from autumn 2024 to reduce costs and improve value-for-money. It will also work with UKHSA to maintain existing medical countermeasure stockpiles and provide an update to the Committee on progress by the end of 2024.
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6 Conclusion Acknowledged
Thirty-First Report - Department o…
Implement planned changes to control framework to prevent further ineligible payments by summer 2024.
NHS England again made payments to suspended GPs who were not eligible to receive them and has failed to adequately recover these overpayments. NHS England has made overpayments worth £1.3 million to suspended medical practitioners since 2017–18, just £33,000 of … Read more
Government Response
The government agrees with the recommendation, stating that work is already underway to recover overpaid amounts from suspended GPs, and NHS England will oversee this progress. However, it does not detail specific planned changes to its control framework or explicitly confirm adherence to the summer 2024 deadlines.
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1 Conclusion Accepted
Thirty-First Report - Department o…
Examination of Department of Health and Social Care 2022-23 Annual Report and Accounts.
On the basis of a report by the Comptroller and Auditor General (C&AG)2, we took evidence from the Department of Health and Social Care (the Department), the UK Health Security Agency (UKHSA) and NHS England on the Department’s Annual Report … Read more
Government Response
The government has established a Finance and Control Improvement Programme and is actively working to produce auditable accounts for 2023-24 with NAO certification by November, targeting an unqualified opinion for the 2024-25 accounts. They have a comprehensive audit plan and engaged PWC for external support.
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22 Recommendation Accepted
Thirty-First Report - Department o…
UKHSA committed to improving financial controls and achieving unqualified accounts for 2022-23.
As part of our examination of the Department’s 2021–22 accounts, we recommended that UKHSA should urgently ensure that it had in place robust financial controls and processes and there was a clear plan to deliver unqualified accounts. Government agreed with … Read more
Government Response
The government agrees and is implementing a Finance and Control Improvement Programme, engaging PwC, and has an audit plan with the NAO, targeting an improved audit opinion for the 2023-24 accounts by January 2025.
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7 Conclusion Accepted
Thirty-First Report - Department o…
UKHSA claims understanding of financial control issues and progress on 2021-22 audit problems.
We asked UKHSA whether it had sufficient organisational understanding and acceptance of the level of cultural change and process improvement required to fix these issues with its accounts. UKHSA responded that it understood and accepted this. It drew a distinction … Read more
Government Response
The government agrees with the committee's observation and commits to achieving an improved (though qualified) audit opinion for UKHSA's 2023-24 accounts by November. It details a comprehensive audit plan, external support from PWC, and an ongoing Finance and Control Improvement Programme.
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8 Conclusion Accepted
Thirty-First Report - Department o…
C&AG notes UKHSA progress but significant work remains; 2023-24 accounts will be qualified.
The C&AG confirmed that UKHSA had introduced “quite a lot of important governance arrangements” following its 2021–22 accounts, and that it had made progress on being able to present a more manageable set of financial data for the NAO to … Read more
Government Response
The government agrees with the committee's observations and commits to achieving an improved (though qualified) audit opinion for UKHSA's 2023-24 accounts by November. It outlines a comprehensive audit plan, external support, and an ongoing Finance and Control Improvement Programme to resolve audit issues.
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9 Conclusion Accepted
Thirty-First Report - Department o…
UKHSA attributes financial control lapses to pandemic, prioritising health protection over standard processes.
We asked UKHSA what lessons could be learned from the setup of a complex new government body and the issues reported by the C&AG in 2021–22 and 2022–23.12 UKHSA responded that if setting up a similar new body it would … Read more
Government Response
The government has accepted the implicit recommendation to improve UKHSA's financial controls, detailing an ongoing Finance and Control Improvement Programme. UKHSA aims for an improved 2023-24 audit opinion with certification in November and subsequent pre-summer recess laying without qualifications, supported by a comprehensive audit plan and PWC engagement.
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10 Conclusion Accepted
Thirty-First Report - Department o…
UKHSA prioritised vaccine delivery over financial reporting, leading to significant audit challenges.
We asked UKHSA how it was going to fix the issue with the covid vaccine demand model that was one of the causes of the C&AG disclaiming his opinions on its 2022–23 accounts. The Department confirmed it had made a … Read more
Government Response
The government agrees and is implementing a Finance and Control Improvement Programme, engaging PwC, and has an audit plan with the NAO, targeting an improved audit opinion for the 2023-24 accounts by January 2025.
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11 Conclusion Accepted
Thirty-First Report - Department o…
Department transferred CVU to UKHSA, prioritising public health despite known control issues.
We questioned the Department on why it decided to transfer the CVU to UKHSA in October 2022, pushing additional responsibility on to a new and struggling organisation. The Department stated that, as an organisation of health protection experts who hold … Read more
Government Response
The government has accepted the implicit recommendation concerning UKHSA's financial controls, outlining the ongoing Finance and Control Improvement Programme, targets for an improved 2023-24 audit opinion with November certification, and engagement of PWC for external support.
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12 Recommendation Accepted
Thirty-First Report - Department o…
Department committed to restoring timely financial reporting, targeting pre-summer recess by 2025-26.
As part of our inquiry in the Department’s 2021–22 Annual Report and Accounts, we found that the Department had prepared its accounts in exceptional circumstances for the previous two years but noted that it was imperative that it got back … Read more
Government Response
The government has accepted and is implementing a multi-year plan to publish its Annual Report and Accounts by at least one month earlier each year, targeting a return to pre-summer recess laying by Summer 2027. For 2023-24, certification is planned for November 2024 and laying in early December 2024.
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13 Recommendation Accepted in Part
Thirty-First Report - Department o…
DHSC published 2022-23 accounts six months after deadline, missing pre-summer recess target.
All Departments should aim to lay their accounts and those of their agencies by an administrative deadline of 30 June after the end of the financial year, and no later than the 15 Q 72 16 Qq 50–51 17 Q … Read more
Government Response
The government agrees with the recommendation and is implementing a multi-year plan to gradually bring forward the publication of accounts, targeting a return to pre-summer recess laying for the 2026-27 financial year, acknowledging significant external challenges.
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14 Conclusion Accepted
Thirty-First Report - Department o…
Department's accounts delayed by UKHSA issues and widespread missed local NHS audit deadlines.
The delays to the accounts were the combined result of issues with the accounts of a key arm’s-length body (UKHSA) and delays in completion of local NHS audits. The accounts for UKHSA, NHS England and the Consolidated NHS Provider Accounts … Read more
Government Response
The government has accepted the implicit recommendation and implemented a multi-year plan to publish its Annual Report and Accounts by at least one month earlier each year, targeting a pre-summer recess laying by Summer 2027. For 2023-24, certification is planned for November 2024 and laying in early December 2024, and the department is engaging with stakeholders to address local audit capacity issues.
HM Treasury
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15 Conclusion Accepted
Thirty-First Report - Department o…
Department plans to accelerate account certification, but timely delivery needs increased local audit capacity.
We asked the Department about its plans to certify its accounts earlier in future. The Department advised us that producing its accounts is a difficult task and the expenditure included represents approximately 8% of the UK economy. It told us … Read more
Government Response
The government has accepted the implicit recommendation to accelerate account certification, stating its multi-year plan to publish Annual Report and Accounts earlier, targeting a pre-summer recess laying by Summer 2027, and aiming for 2023-24 certification in November 2024.
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16 Conclusion Accepted
Thirty-First Report - Department o…
C&AG disclaimed UKHSA's audit opinion two years running, causing serious concern and departmental intervention.
The C&AG disclaiming his audit opinion is very rare. The fact that this has happened two years in a row for UKHSA gives us great cause for concern. While UKHSA has its own Chief Finance Officer, the Department has taken … Read more
Government Response
The government states the recommendation is implemented, highlighting its robust financial management framework and ongoing close work with UKHSA and the NAO through governance meetings and an audit plan to address disclaimed opinions.
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17 Conclusion Accepted
Thirty-First Report - Department o…
Department acknowledges limited control over local NHS audit issues, relying on NHS England for frontline work.
A large proportion of the Departmental Group expenditure flows through from NHS commissioning bodies into NHS England and NHS providers into the Consolidated Provider Accounts, both of which are prepared by NHS England. Given their impact on the timeliness of … Read more
Government Response
The government has accepted the implicit recommendation to improve the timeliness of audits for NHS bodies, outlining its multi-year plan to accelerate the publication of its Annual Report and Accounts and its engagement with stakeholders to address local audit capacity issues.
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18 Conclusion Accepted
Thirty-First Report - Department o…
Department struggles to ensure sufficient local NHS auditors, despite some improvements for 2023-24.
We observed that the Department appeared to be “slightly skating over the problem” in saying that it did not have the levers needed to address the local audit issues affecting its accounts. Whilst we accepted that the Department did not … Read more
Government Response
The government has accepted the implicit recommendation to address local audit capacity issues affecting NHS accounts, outlining its multi-year plan to accelerate Annual Report and Accounts publication and its engagement with stakeholders to address these challenges.
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19 Conclusion Accepted in Part
Thirty-First Report - Department o…
NHS England and Department are addressing audit timeliness, but external factors still impact progress.
We challenged NHS England and the Department on the extent they were acting on the proposals to improve audit timeliness set out in their 2022–23 governance statements. NHS England stated that it had regular update meetings with all audit firms, … Read more
Government Response
The government agrees with the committee's findings and is implementing a multi-year plan to gradually improve audit timeliness, targeting a return to pre-summer recess laying for the 2026-27 financial year, while acknowledging external challenges in the local audit system.
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20 Conclusion Acknowledged
Thirty-First Report - Department o…
NHS clinical negligence costs significantly exceed international comparators, lacking litigation trend data.
The Department recognised that each incidence of clinical negligence is a tragedy for an individual and their families.31 They also come with a monetary cost to the taxpayer, in compensation payments for pain suffered and the impact on people’s everyday … Read more
Government Response
The government agrees with the committee's observations on clinical negligence and patient safety. It commits to prioritising continuous improvement in patient safety and will write to the committee later in 2024 to detail actions being taken with partners to reduce harm and improve outcomes.
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21 Conclusion Accepted
Thirty-First Report - Department o…
Maternity and neonatal cases account for 65% of £69.3 billion clinical negligence liability.
NHS Resolution’s 2022–23 accounts include a liability of £69.3 billion to cover the potential costs of clinical negligence. Of this, £45 billion, some 65% of the £69.3 billion total, related to maternity and neonatal liabilities. The Department told us that … Read more
Government Response
The government agrees with the committee's findings and commits to prioritizing patient safety, writing to the new Committee by the end of 2024 to outline specific actions taken with NHS England and partners to reduce patient harm.
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23 Conclusion Accepted
Thirty-First Report - Department o…
£14.9 billion of public money written off due to excess PPE and COVID-19 supplies.
When we examined the Department’s 2021–22 Annual Report and Accounts, we found that it had written off £14.9 billion of public money as a result of overpaying and over ordering significant volumes of Personal Protective Equipment (PPE), COVID-19 medicines and … Read more
Government Response
The government agrees with the committee's findings, noting past reviews and a future PPE strategy, and commits to ceasing storage costs for excess PPE by January 2025, providing an update by the end of January 2025.
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24 Conclusion Accepted
Thirty-First Report - Department o…
Department lacks adequate controls over PPE inventory, unable to perform comprehensive stocktakes.
In 2023, we found that the Department did not have adequate controls over its PPE inventory and was unable to perform proper stocktakes to confirm what it held and the condition of these items. The Department did not perform full … Read more
Government Response
The government agrees with the committee's findings, has replenished pandemic preparedness PPE stockpiles using excess stock, and will begin dynamic stockpiling from autumn 2024, committing to update the committee by the end of 2024.
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25 Conclusion Accepted
Thirty-First Report - Department o…
Estimated £319 million cost for PPE storage and disposal, donation efforts explored.
In 2023, the Department estimated that it would cost £319 million to store and dispose of unusable or unneeded PPE. The Department told us that it had accelerated its disposal programme, to save £130 million in storage costs that it … Read more
Government Response
The government has accepted the implicit recommendation, confirming that storage costs for excess PPE will cease by January 2025. It also committed to continue examining lessons learned from the pandemic, including engagement with the Covid-19 inquiry, with an update to the Committee by January 2025.
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26 Conclusion Acknowledged
Thirty-First Report - Department o…
£569 million ventilator stockpile to be disposed of, with no NHS purchasing restrictions.
The Department also procured 20,900 individual ventilators at a cost of £569 million, held in stock as “an ICU reserve”. In February 2024 the Department decided to close the reserve and dispose of these ventilators. We asked the Department why … Read more
Government Response
The Department has not yet determined how it will dispose of the stockpile of ventilators, but a hierarchy will be used to ensure sale or donation before disassembly for recycling.
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27 Conclusion Accepted
Thirty-First Report - Department o…
Department still lacks a clear plan for future pandemic stockpile requirements.
We recommended in our reports on the Department’s 2020–21 and 2021–22 Annual Reports and Accounts that the Department should develop a clear plan for a stockpile for a future pandemic. In response to our report on the 2021–22 Annual Report … Read more
Government Response
The government agrees with the committee's findings, has replenished pandemic preparedness PPE stockpiles using excess stock, and will begin dynamic stockpiling from autumn 2024, committing to update the committee by the end of 2024.
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28 Conclusion Accepted
Thirty-First Report - Department o…
Fewer than twenty COVID-19 procurement contracts remain in dispute, with £202 million fraud identified.
We asked the Department how many contracts relating to COVID-19 procurement were still in dispute. The Department stated that 45 contracts were in dispute at 31 March 2023, and that the number at the time of the evidence session was … Read more
Government Response
The government agrees, providing updated estimates of COVID-19 PPE fraud at £324 million, with £75 million recovered and £163 million prevented, and anticipates settlement of all matters by Autumn 2025 with a target implementation date for the recommendation of December 2025.
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29 Conclusion Accepted
Thirty-First Report - Department o…
NHS England made £1.3 million ineligible payments to suspended practitioners, with minimal recovery.
NHS England can make payments to medical practitioners who have been suspended, in accordance with the relevant statutory regulations and conditions. The C&AG qualified his opinion on NHS England’s accounts for the second time, as a result of it making … Read more
Government Response
The government has accepted the implicit recommendation, implementing a new national process with additional checks for suspended practitioner payments from April 2024 and requesting a review of eligibility determinations. For overpayments, work is underway to recover amounts where there is a legal basis, with NHS England maintaining oversight by September 2024.
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30 Conclusion Accepted
Thirty-First Report - Department o…
NHS England establishing a national team to enhance controls over suspension payments.
We asked NHS England why it did not have adequate controls in place to prevent ineligible payments of this nature and what controls it was putting in place to ensure that this does not happen again. NHS England confirmed that … Read more
Government Response
The government has accepted the implicit recommendation to improve controls for suspended practitioner payments, confirming a new national process with additional verification and central oversight was implemented from April 2024, and a submission made to DHSC to review and simplify eligibility determinations.
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31 Conclusion Accepted in Part
Thirty-First Report - Department o…
NHS England faces challenges in fully recovering identified overpayments from 2022-23.
We asked NHS England whether it was pursuing recovery of the overpaid amounts identified in 2022–23. NHS England told us that it was still seeking to recover more of the overpayments, but that it did not think that it would … Read more
Government Response
The government agrees to pursue recovery of overpaid amounts where legal grounds exist and work is underway, with NHS England retaining oversight of progress, targeting completion by September 2024.
HM Treasury
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Government Response AI assessment · 31 of 4 classified
Accepted 24
Accepted in Part 3
Acknowledged 4
Total 4 recs + 27 conclusions
Correspondence 2 letters
15 Apr 2024 Correspondence from Andy Brittain, Director General Finance, Department of Health and Social Care, re Public Accounts Committee hearing: Department for Health and Social Care’s Annual Report and Accounts 2022-23, dated 27 March 2024
Parliament page
15 Apr 2024 Correspondence from Julian Kelly, Chief Financial Officer, NHS England, re DHSC Annual Report and Accounts 2022-23, dated 26 March 2024
Parliament page