UK Inquiry Tracker

NHS financial sustainability

Public Accounts Committee Closed Inquiry

Opened: 31 Oct 2024 Closed: 16 May 2025 Parliament page

The scale of the challenge facing the NHS is unprecedented. Local NHS systems in England ended 2023/24 with a collective deficit of £1.4bn. NHS England (NHSE) received more than £4.5bn in extra funding in 2023/24, and reduced planned spending against its central budget by £1.7bn – but these actions did … Read more The scale of the challenge facing the NHS is unprecedented. Local NHS systems in England ended 2023/24 with a collective deficit of £1.4bn. NHS England (NHSE) received more than £4.5bn in extra funding in 2023/24, and reduced planned spending against its central budget by £1.7bn – but these actions did not prevent NHS systems’ deficits significantly increasing beyond what was planned at the start of the year. The NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness and accessibility, according to the National Audit Office’s (NAO) July 2024 report . The NAO has warned that, with an ageing and increasingly sick population, either much future demand for healthcare must be avoided, or the NHS will need a great deal more funding, or service levels will continue to be unacceptable and may even deteriorate further. The Committee found in 2020 that the pandemic had highlighted the need for the NHS to fundamentally transform services to ensure that it could meet rising demand in the future while maintaining vital service standards. Committee reports on NHS bodies since 2011 have highlighted a range of challenges, including rising demand, lack of capital investment, trust deficits and workforce issues. Based on the NAO report, the Committee will hear from senior Department of Health & Social Care and NHSE officials, on subjects including: - Operational improvements identified by the NAO to help the NHS do more with the resources it has; - How NHSE supports NHS bodies that are struggling; and - Longer-term challenges to the NHS’ financial sustainability. Please note that the Committee is unable to consider or assist with individual cases. If you need help with an individual problem you are having, you may wish to contact your constituency MP . Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. If you have evidence on these issues please submit it here by 23:59 on Thursday 14 November 2024. Show less

3 Recommendations

23 Conclusions

1 Report

1 Oral session

6 Letters

1 Event

Activity timeline 10 events

10 Sep
2025

Correspondence

Letter from the Permanent Secretary of the Department of Health and Social Care relating to the 5th Report of Session 2024-25, NHS financia…

4 Sep
2025

Correspondence

Letter to the Permanent Secretary of the Department for Health and Social Care relating to the Treasury Minute response follow up on NHS fi…

16 May
2025

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Fifth report from Session 2024-25

7 Apr
2025

Correspondence

Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to the delay to publication of Treasury Mi…

27 Mar
2025

Correspondence

Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England rela…

10 Mar
2025

Correspondence

Letter from the Chief Financial Officer and Deputy Chief Executive at NHS England relating to the oral evidence session held on 25 November…

4 Feb
2025

Correspondence

Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to a follow up on the oral evidence sessio…

29 Jan
2025

Report published

5th Report - NHS financial sustainability

25 Nov
2024

Oral evidence

NHS financial sustainability

25 Nov
2024

Formal meeting (oral evidence session) · The Boothroyd Room, Portcullis House

NHS financial sustainability

Oral evidence sessions 1 session

25 Nov 2024

View on parliament.uk

NHS financial sustainability

Amanda Pritchard · NHS England Andy Brittain · Department of Health and Social Care (DHSC) Antonia Williams · HM Treasury Julian Kelly · NHS England Sir Chris Wormald KCB · Cabinet Office

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
5th Report - NHS financial sustainability	HC 350	29 Jan 2025	26	Responded

Recommendations & Conclusions

5 results

10 Conclusion Acknowledged

5th Report - NHS financial sustain…

NHS systems recorded doubled deficit despite significant additional government funding in 2023-24.

NHSE received significant extra funding from the government during the course of 2023–24. This included £2.8 billion to support new pay deals for staff, and £1.7 billion to mitigate the impact of industrial action. Despite this extra money, NHS systems … Read more

Government Response

NHS England and DHSC continue to work together to enable planning guidance to be published well in advance of the start of the financial year, and ideally before Christmas.

HM Treasury

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12 Conclusion Acknowledged

5th Report - NHS financial sustain…

DHSC consistently diverted NHS capital funds to revenue, despite new fiscal rules.

Demand for capital in the NHS continues to outstrip supply and the UK lags behind other OECD countries in terms of capital investment in its health system. DHSC has maintained its recent track record of not fully investing the capital … Read more

Government Response

The government stated that the fiscal rules set out by the Chancellor at the Autumn Budget 2024 mean that no further capital-to-revenue transfers will be used, and the department welcomes this decision. In 2025-26, a budget of £13.6 billion for health capital investment has been agreed.

HM Treasury

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13 Conclusion Acknowledged

5th Report - NHS financial sustain…

DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.

DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would … Read more

Government Response

The government states that the financial position of NHS providers is significantly improved and that the 10 Year Health Plan will consider how to build a prevention-focused health system, shift the balance of care to community settings, and maximize the impact of digital technology.

HM Treasury

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14 Conclusion Acknowledged

5th Report - NHS financial sustain…

NHS productivity remains below pre-pandemic levels; future targets are significantly ambitious and challenging.

According to official ONS measures, long-term productivity gains in the NHS averaged 0.6% a year over the period 1996–97 to 2018–19. But productivity subsequently fell, both before and during the pandemic, and has yet to recover fully. In March 2024, … Read more

Government Response

The NHS is working hard to recover lost productivity caused by the Covid-19 pandemic, NHS productivity continues to recover and to support this NHSE are focused on increasing clinical and operational productivity, improving staff retention, technology-enabled transformation, moving care to the right setting and improving prevention and maximizing the value of our spending.

HM Treasury

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16 Conclusion Acknowledged

5th Report - NHS financial sustain…

NHSE confident in technology for productivity gains, but current metrics inadequately measure improvements.

We challenged NHSE on what it would do differently to achieve the ambitious annual productivity improvements it has committed to. NHSE told us annual productivity improvements were currently running at about 1.8% and it was confident that the annual gains … Read more

Government Response

HM Treasury

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Government Response AI assessment · 25 of 3 classified

Accepted 10

Acknowledged 5

Deferred 8

Rejected 2

Total 3 recs + 23 conclusions

Correspondence 6 letters

10 Sep 2025 To committee Letter from the Permanent Secretary of the Department of Health and Social Care relating to the 5th Report of Session 2024-25, NHS financial sustainability, recommendations 2a, 3, 4, 5a, 5b, 6, and 7, 02 September 2025

Parliament page

4 Sep 2025 From committee Letter to the Permanent Secretary of the Department for Health and Social Care relating to the Treasury Minute response follow up on NHS financial sustainability, recommendations 3, 4, 7, 2a, 5a, 5b, and 6, 24 July 2025

Parliament page

7 Apr 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to the delay to publication of Treasury Minute 5 NHS financial sustainability, 03 April 2025

Parliament page

27 Mar 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to a follow up on questions raised in the oral evidence session held on 25 November 2025 on NHS Financial Sustainability, 18 March 2025

Parliament page

10 Mar 2025 To committee Letter from the Chief Financial Officer and Deputy Chief Executive at NHS England relating to the oral evidence session held on 25 November 2024 on NHS Financial Sustainability, 05 March 2025

Parliament page

4 Feb 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to a follow up on the oral evidence session held on 25 November 2024 on NHS financial sustainability, 27 January 2025

Parliament page