In the September session, NHSE told us that the changes had been very dramatic and that a lot of work had been done very quickly to start to reduce the variation in running costs for ICBs as well as some of the key cost drivers.60 We were told that redundancies at the national level had been thought of and discussed at the outset. However NHSE confirmed that there was still no resolution with HM Treasury on the source of the 54 Qq 37-38 55 C&AG’s Report, para 4.10 56 Q 33 57 C&AG’s Report, para 6 58 Committee of Public Accounts evidence session on 13 March 2024, DHSC Annual Report and Accounts, see Q 9 59 Committee of Public Accounts evidence session on 13 March 2024, DHSC Annual Report and Accounts, see Q 9 and Q13 60 Q 2 15 significant sums that would be required to fund redundancy compensation payments.61 NHSE accepted that the uncertainty over job losses and cuts being faced by ICBs was unsatisfactory.62 We were, however, assured by NHSE that despite their scale, the cuts would be made without any direct implications for service provision.63