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

2 results

7 Conclusion Rejected

5th Report - NHS financial sustain…

Publish plans to reduce NHS paper reliance and set deadline to end fax machines.

Despite ambitions to improve productivity through the introduction of new technologies, the switch to digital in parts of the NHS has been glacially slow. Digital and technological improvements could have a transformative effect on the NHS. However, NHSE’s investment in … Read more

Government Response

The government disagrees with the recommendation, arguing against providers being 'fully paperless' due to digital inclusion considerations. It reports that 91% of secondary care trusts have Electronic Patient Records, forecast to reach 96% by March 2026, and fax machines will be unusable by 2027 due to analogue switch-off.

HM Treasury

View details

26 Conclusion Rejected

5th Report - NHS financial sustain…

NHS still lacks consistent data infrastructure and technological maturity, delaying productivity gains.

We asked what was being done to improve productivity through the use of new technologies. NHSE told us the NHS currently lacks a consistent data infrastructure and that NHS providers varied in terms of their levels of technological maturity.50 NHSE … Read more

Government Response

The government disagrees that providers should be fully paperless, stating that some patient communications must be sent by letter and outlines investment in national IT systems, EPRs and the NHS app.

HM Treasury

View details

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