19
Accepted
Surgical hub governance structures less developed, with metrics misaligned to actual activity outcomes.
Recommendation
The NAO report found that the diagnostic programme has the most established governance structure and there was evidence of in-depth reporting, while governance was less developed for surgical transformation hubs.40 The Department told us that whilst it had previously had two teams and two boards providing separate governance arrangements, it had now moved to a single oversight arrangement.41 The Department told us that NHSE was doing enough to track the impact of programmes in order to balance reporting and bureaucratic load.42 However, the NAO report outlined that for surgical hubs the programme measurements were misaligned with the intended outcomes as whilst it was tracking the number of delivered surgical hubs, the actual aim of the programme was to increase overall activity. The report found that NHSE does not know what contribution surgical hubs had actually made to total elective activity.43 39 Correspondence from NHS England, dated 6 November. 40 C&AG’s Report, para 3.2 41 Q 54 42 Q 69 43 C&AG’s Report, para 2.18 12 2 Achieving future elective care transformation The feasibility of current transformation plans
Government Response Summary
The government accepts the recommendation, committing to merge the National Diagnostic and Elective capital boards into a single Planned Care Capital Assurance Board by January 2026. This consolidated board will monitor the delivery of capital projects across planned care, including cancer, and report on outcomes and benefits.
Government Response
Accepted
Government Response
Accepted
HM Government
Accepted
3.9 The government agrees with the Committee’s recommendation. Target Implementation date: January 2026 3.10 DHSC and NHSE wish to note the importance of also reporting on the delivery of physical capital assets. There are several capital elements to planned care: an electives programme and a cancer and diagnostics programme. 3.11 Currently the National Diagnostic Board and the groups feeding into it play an important assurance role in the delivery of diagnostic capital projects and report on delivery milestones as well as their impact on performance targets and alignment with policy objectives. 3.12 The monthly Elective Capital Programme Board has an important assurance function in the oversight of elective capital projects. This receives and scrutinises monthly reports on scheme completions, planned vs actual additional activity enabled from completed schemes and receipt of scheme post project evaluations. 3.13 Additionally, the monthly Elective Hubs Oversight Group receives performance reports for all surgical hubs, including on capped theatre utilisation (a measure of theatre productivity). It also receives reports from the national GIRFT hubs accreditation programme. 3.14 A National Institute for Health and Care Research (NIHR) Policy Research Programme evaluation of 2022-2025 Targeted Investment Fund schemes that are non-hubs will start in January 2026 and report in 2028. 3.15 From January 2026, the Diagnostic and Elective capital boards will merge to form a single Planned Care Capital Assurance Board, which will also monitor the delivery of capital projects which support cancer. This will consolidate existing work done within programmes to monitor outcomes and benefits and to report on the achievement of policy aims.
Source
Committee
Public Accounts Committee
Report
55th Report - Reducing NHS waiting times for elective care
19 Nov 2025
HC 820
Addressee Bodies
HM Treasury
Timeline
Recommendation age
0.7 yr
Report published
19 Nov 2025