DHSC Annual Report and Accounts 2023-24

Public Accounts Committee Closed Inquiry
Opened: 15 Jan 2025 Closed: 17 Jul 2025 Parliament page
In May 2024 , the PAC found that the Department of Health and Social Care (DHSC) and the UK Health Security Agency (UKHSA) had been getting the basics unacceptably wrong in their financial management and accountability for public spending – for the second year running. Its report expressed disappointment that, … Read more
21 Recommendations
13 Conclusions
1 Report
1 Oral session
8 Letters
1 Event
Activity timeline 12 events
15 Dec
2025
Correspondence
8 Dec
2025
Correspondence
17 Nov
2025
Correspondence
18 Sep
2025
Report published
4 Sep
2025
Correspondence
14 May
2025
Report published
8 May
2025
Correspondence
28 Apr
2025
Correspondence
24 Apr
2025
Correspondence
20 Mar
2025
Correspondence
13 Mar
2025
Oral evidence
13 Mar
2025
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
Oral evidence sessions 1 session
13 Mar 2025
View on parliament.uk
Andy Brittain · Department of Health and Social Care (DHSC) Julian Kelly · NHS England Professor Dame Jenny Harries · UK Health Security Agency Professor Sir Chris Whitty · Department for Health and Social Care
Title HC No. Published Items Response
25th Report - DHSC Annual Report and Accounts 2023-24 HC 639 14 May 2025 34 Responded
Recommendations & Conclusions
19 results
Clear
2 Conclusion Accepted
25th Report - DHSC Annual Report a…
Improve transparency and usability of Annual Report and Accounts for health and social care.
The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services … Read more
Government Response
The government agrees and commits to improving the transparency and usability of its Annual Report and Accounts (ARA) by covering the specified areas, including social care, productivity, and prevention, in its 2024-25 ARA. The department will provide an update to the Committee on this progress in September.
HM Treasury
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3 Recommendation Accepted
25th Report - DHSC Annual Report a…
Outline urgent plans for UKHSA's high containment laboratories including costs and timeline.
There is little to show for the £400 million spent so far on the development of Harlow Health Security Campus, with no decision yet on the future of the site. This is an example of a poorly overseen project to … Read more
Government Response
The government states the recommendation is implemented, explaining that the department already possesses well-established governance structures to oversee investment decisions and delivery of major health infrastructure projects. These existing structures include cost and value-for-money tests and are subject to regular review.
HM Treasury
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4 Recommendation Accepted
25th Report - DHSC Annual Report a…
Develop a plan to reduce patient harm and manage escalating clinical negligence costs.
It is unacceptable that the Department is yet to develop a plan to deal with the cost of clinical negligence claims, and so much taxpayers’ money is being spent on legal fees. The Department has set aside an astounding £58.2 … Read more
Government Response
The government agrees and outlines several specific actions to reduce patient harm and manage clinical negligence costs, including implementing NHS England's 3-year maternity plan. It has announced a national, independent investigation into maternity and neonatal care, expected to report by December 2025, and will establish a National Maternity and Neonatal Taskforce. It also accepted Dr. Penny Dash's nine patient safety recommendations.
HM Treasury
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5 Conclusion Accepted
25th Report - DHSC Annual Report a…
Develop credible plan to produce audited accounts before summer parliamentary recess by September 2025.
We are disappointed by the Department’s continued failure to return to publishing its accounts before the summer Parliamentary recess. Timely production of accounts is essential to understanding public finances and supporting accountability and Parliament expects Departments’ accounts to be published … Read more
Government Response
The government agrees and is working on a multi-year plan to publish audited accounts before the summer recess, acknowledging challenges due to private sector audit firm capacity. It commits to writing to the Committee in September 2025 with further details on this plan, associated risks, and actions being taken to address them.
HM Treasury
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6 Recommendation Accepted
25th Report - DHSC Annual Report a…
Ensure all NHS England exit packages receive appropriate advance approvals before payment.
NHS England does not have a coherent plan to better protect taxpayers’ money and prevent future unapproved exit packages. There remain far too many special severance payments where approval has only been sought after the payment has been made. Five … Read more
Government Response
The government commits to publishing new comprehensive guidance on all types of exit packages and communicating it via regional teams and the NHS England website, aiming for impact from 2025-26. It also outlines existing lesson-learning for non-compliance.
HM Treasury
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1 Conclusion Accepted
25th Report - DHSC Annual Report a…
Committee took evidence on DHSC Annual Report and Accounts for 2023–24.
On the basis of a report by the Comptroller and Auditor General (C&AG), 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 broadly aligns with the committee's general observation, describing ongoing initiatives to improve patient care through partnership working and system efficiency, and referring to upcoming plans in a 10 Year Health Plan.
HM Treasury
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10 Recommendation Accepted
25th Report - DHSC Annual Report a…
NHS England unable to explain preservation of institutional memory amid leadership changes and merger.
It had previously been announced that NHS England’s Chief Executive, Chief Financial Officer, Chief Operating Officer, National Medical Director and Chief Delivery Officer and National Director for Vaccination and Screening would step down from their roles.13 During our evidence session, … Read more
Government Response
The government agrees with the committee's recommendation, outlining a process for the Department and NHS England merger that includes assessing functions, agreeing senior structures, and planning staff transfers. This structured approach aims to preserve institutional memory, with further details expected by Autumn 2025.
HM Treasury
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13 Conclusion Accepted
25th Report - DHSC Annual Report a…
Harlow health campus project plagued by spiralling costs, delays, and substantial written-off expenditure.
The need for a planned replacement to these facilities was initially identified in 2006 and Public Health England (UKHSA’s predecessor public body) was given approval to purchase the land in 2017. However, in February 2024 the NAO found that work … Read more
Government Response
The government agrees with the committee's findings, recognizing the urgent need for a decision on UKHSA’s high-containment laboratories. A decision will be made following the spending review, with UKHSA finalizing the delivery model and commercial strategy by Spring 2026.
HM Treasury
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14 Recommendation Accepted
25th Report - DHSC Annual Report a…
Clarify accountability, oversight, and delivery partner arrangements for the Harlow health security campus programme.
We asked UKHSA what progress it had made in deciding what it would do with the site. UKHSA told us that it was waiting for Ministers to decide whether to continue development at Harlow or to change course to a … Read more
Government Response
The government accepts the recommendation, committing to finalise the delivery model and associated commercial strategy, including accountability and oversight arrangements, by Spring 2026, following a decision on UKHSA's high-containment laboratory location and completion of a programme business case.
HM Treasury
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19 Recommendation Accepted
25th Report - DHSC Annual Report a…
Persistent issues with unapproved special severance payments continue across Departmental Group entities.
Exit packages are payments made in relation to redundancy and other departure costs for employees. Special severance payments are a subset of exit packages, relating to any non–contractual payments to employees.31 We have repeatedly raised issues with the Department or … Read more
Government Response
The government accepts the recommendation, stating NHS England is redrafting guidance on exit packages and approval mechanisms, which will be communicated and impact exits from 2025-26.
HM Treasury
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20 Conclusion Accepted
25th Report - DHSC Annual Report a…
Several NHS providers continue making special severance payments without required HM Treasury approval.
Special severance payments always require prior HM Treasury approval, as they are usually novel or contentious.34 In 2023–24, two NHS Trusts and two NHS Foundation Trusts between them made five special severance payments totalling £180,868 without the required approval. In … Read more
Government Response
The government agrees with the committee's findings, stating NHS England is redrafting guidance on all exit packages and approval mechanisms. This new guidance will be communicated by end of Summer 2025 via regional workforce teams and the NHS England website, to impact exits from 2025-26 and address non-compliance.
HM Treasury
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21 Recommendation Accepted
25th Report - DHSC Annual Report a…
NHS England unable to guarantee future compliance on special severance payment approvals.
We asked NHS England what progress it had made in addressing the approvals and ensuring that payments being made without being approved did not happen again. NHS England recognised that “every case that is 31 Report by the Comptroller and … Read more
Government Response
The government agrees with the committee's recommendation, stating NHS England is redrafting guidance on exit packages and approval mechanisms, which will be communicated by end of Summer 2025. This aims to improve compliance, reiterate rules, and ensure payments are properly approved.
HM Treasury
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22 Conclusion Accepted
25th Report - DHSC Annual Report a…
No specific action taken against individuals for making unapproved special severance payments.
We noted that the accounts showed there had been 240 cases where retrospective approval had been sought for special severance payments, and asked NHS England whether there were any consequences for making these payments without the necessary approvals. NHS England … Read more
Government Response
The government agrees with the committee's findings, stating NHS England is redrafting guidance on exit packages and approval mechanisms, to be communicated by end of Summer 2025. This new guidance aims to improve compliance and reduce instances of payments made without the necessary approvals.
HM Treasury
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23 Recommendation Accepted
25th Report - DHSC Annual Report a…
Department lacks new mechanism to approve severance payments amidst large-scale NHS restructuring.
When the previous Committee reported on this in June 2022, it warned that that the (then planned) large–scale restructuring of commissioning within the NHS could increase the risk of further unapproved payments being made.38 Given the announcements about the restructuring … Read more
Government Response
The government agrees with the committee's recommendation, stating NHS England is redrafting guidance on exit packages and associated approval mechanisms. This new guidance, to be communicated by end of Summer 2025, aims to strengthen oversight during restructuring and potential redundancies.
HM Treasury
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24 Recommendation Accepted
25th Report - DHSC Annual Report a…
Social care delivery for users inadequately reflected in Department's Annual Reports and Accounts.
The Department was renamed the Department of Health and Social Care (from the Department of Health) in January 2018, with the intention of delivering a greater focus on adult social care.We observed that social care is only reflected in “a … Read more
Government Response
The government commits to improving the transparency and informativeness of its 2024-25 Annual Report and Accounts to include coverage of social care delivery, with an update to the Committee by September 2025.
HM Treasury
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25 Recommendation Accepted
25th Report - DHSC Annual Report a…
Annual Report and Accounts lacks analysis of Department’s progress in improving productivity.
The Department’s Annual Report and Accounts also does not contain analysis of the Department’s progress in improving productivity and efficiency. We asked, given the importance of productivity to ensuring that NHS expenditure was sustainable, if it would pay more attention … Read more
Government Response
The government commits to improving its 2024-25 Annual Report and Accounts to include analysis of the Department's progress in improving productivity and efficiency, and will provide an update to the Committee by September 2025.
HM Treasury
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26 Recommendation Accepted
25th Report - DHSC Annual Report a…
Department’s Annual Report and Accounts provides insufficient detail on digital and AI developments.
We similarly asked about the Department’s progress on technological and digital developments and the use of artificial intelligence (AI), as key areas which could improve productivity. We were surprised that the Department’s Annual Report and Accounts contains such little information … Read more
Government Response
The government commits to improving its 2024-25 Annual Report and Accounts to include fuller details on technological and digital developments and the use of AI, and will provide an update to the Committee by September 2025.
HM Treasury
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27 Recommendation Accepted
25th Report - DHSC Annual Report a…
Departmental annual report shows significant omissions on preventative and end-of-life care.
The NHS Long Term Plan states that ill health prevention helps the public to stay healthy, as well as moderating demands on the NHS. The Department recognised in its 2023–24 Annual Report that there “is still much work to do … Read more
Government Response
The government commits to improving its 2024-25 Annual Report and Accounts to include more information on preventative work and spending/outcomes for palliative and end-of-life care, and will provide an update to the Committee by September 2025.
HM Treasury
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28 Recommendation Accepted
25th Report - DHSC Annual Report a…
Require NHS England to provide data on exit package trends and legal costs for tribunals.
NHS England’s Annual Report and Accounts and the Consolidated NHS Provider Accounts show that there were 3,877 exit packages in the NHS in 2023–24, costing a total of £98 million. We asked NHS England whether the use of exit packages … Read more
Government Response
The government commits to improving its 2024-25 Annual Report and Accounts to include a breakdown of legal costs relating to employment tribunals and exit packages, and will provide an update to the Committee by September 2025.
HM Treasury
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Government Response AI assessment · 34 of 21 classified
Accepted 19
Accepted in Part 1
Acknowledged 7
Deferred 7
Total 21 recs + 13 conclusions
Correspondence 8 letters
15 Dec 2025 To committee Letter from the Permanent Secretary at the Department for Health and Social Care relating to recommendations of the Committee’s Twenty-fifth Report on DHSC Annual Report and Accounts 2023–24, 04 December 2025
Parliament page
8 Dec 2025 To committee Letter from the Chief Executive of NHS England relating to the Committee’s Twenty-fifth Report on DHSC Annual Report and Accounts 2023-24, 01 December 2025
Parliament page
17 Nov 2025 To committee Letter from the Permanent Secretary of the Department for Health and Social Care relating to TM25 DHSC Annual Reports and Accounts 23-24, Recommendations 2 and 5, 07 November 2025
Parliament page
4 Sep 2025 To committee Letter from the Secretary of State for Health and Social Care relating to the DHSC-NHSE Transformation and PAC’s DHSC’s 2023-24 ARA Report recommendations, 04 July 2025
Parliament page
8 May 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to the oral evidence session held on 13 March 2025, DHSC ARA 2023-24, follow up on NHS productivity, 29 April 2025
Parliament page
28 Apr 2025 To committee Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to the oral evidence session held on 13 March 2025 on DHSC Annual Report and Accounts 2023-24, 23 April 2025
Parliament page
24 Apr 2025 To committee Letter from the Chief Financial Officer at NHS England relating to the oral evidence session held on 13 March 2025 on DHSC Annual Report and Accounts 2023-24, 10 April 2025
Parliament page
20 Mar 2025 To committee Letter from the Chief Executive of the Independent Healthcare Providers Network relating to the DHSC Annual Report and Accounts 2023-24 inquiry, NHS payment caps, 07 March 2025
Parliament page