5th Report - NHS financial sustainability
Select Committee
Public Accounts Committee
HC 350
29 January 2025
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Fifth report from Session 2024-25 · published 16 May 2025
Recommendations & Conclusions
8 results
5
Recommendation
Deferred
Define government health prevention spending and increase flexible funding for local systems.
Recommendation
Given the constraints on public spending, it is highly likely that re- focusing attention from sickness to prevention cannot be achieved without re-allocating existing NHS funds in the same direction. Senior ICB leaders report a continued lack of progress with …
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Government Response Summary
The government is considering defining health prevention spending, deferring to the upcoming 10 Year Health Plan and Spending Review Phase 2. It notes that 2025-26 planning guidance has removed many ringfences for local flexibility and NHS England will soon publish a revised oversight framework.
HM Treasury
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6
Conclusion
Deferred
Ensure greater NHSE funding for community services, preventing redirection to hospitals.
Conclusion
NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected …
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Government Response Summary
The government is considering the recommendation, stating it will be addressed within the 10 Year Health Plan and multi-year Spending Review for decisions on shifting funding to community care. It highlights increased mental health spending in 2023-24 and the maintenance of Better Care Fund funding in 2025-26.
HM Treasury
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1
Conclusion
Deferred
Committee scrutinised NHS financial management and sustainability with key departments.
Conclusion
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (DHSC), NHS England (NHSE), and HM Treasury (HMT) on the financial management and financial sustainability of the …
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Government Response Summary
The government states it is working with NHS England to publish planning guidance earlier and aims to improve the planning process for future years. It defers further consideration of this recommendation to the upcoming 10 Year Health Plan.
HM Treasury
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19
Conclusion
Deferred
Government aims for three NHS shifts, balancing long-term transformation with current patient care.
Conclusion
DHSC described how the new government had set out three shifts that they want to see in the NHS: from analogue to digital; from treatment to prevention; and from acute to community. DHSC said that it wanted “to see those …
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Government Response Summary
The government is considering measures for supporting the prevention shift in the context of the work of the 10 Year Health Plan and does not wish to pre-empt the content, but will consider defining health prevention spend as an enabler and will notify the Committee of the response when it is confirmed.
HM Treasury
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20
Conclusion
Deferred
Progress on health prevention hindered by acute care focus and reduced public health grants.
Conclusion
Senior ICB leaders reported to the National Audit Office a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than treating it. One of the most important reasons cited by ICBs has been …
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Government Response Summary
The government states that measures for supporting the prevention shift are being considered in context of the work of the 10 Year Health Plan.
HM Treasury
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21
Conclusion
Deferred
DHSC believes prevention requires cultural and legislative change, not solely additional resource allocation.
Conclusion
DHSC told us it did not view providing more resources, or redirecting them from elsewhere, as a substantive part of the solution to the lack of progress with prevention. Instead, it considers that a shift towards prevention might be achieved …
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Government Response Summary
The government is considering measures for supporting the prevention shift in the context of the work of the 10 Year Health Plan and does not wish to pre-empt the content, but will consider defining health prevention spend as an enabler and will notify the Committee of the response when it is confirmed.
HM Treasury
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22
Conclusion
Deferred
Inadequate definition and tracking of prevention spending impedes accurate assessment of policy progress.
Conclusion
Currently, NHSE does not even track spend and activity on prevention by ICBs at local levels, due to unavailability of data and the lack of consistency about what counts as prevention spending. While DHSC funds some prevention activities that sit …
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Government Response Summary
The government states that defining health prevention spend could enable a shift from sickness to prevention, and that this recommendation will be considered in the context of developing the 10 Year Health Plan.
HM Treasury
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24
Conclusion
Deferred
Overall NHS productivity remains low despite increased elective activity and community investments.
Conclusion
Despite carrying out 15% more elective activity than before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered.42 NHSE told us that, while government has had a long-term …
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Government Response Summary
NHSE, with DHSC, is focusing on enabling a greater shift from hospital to community – including considering how funding decisions over coming years can support this through the 10 Year Health Plan and the multi-year Spending Review. This recommendation is therefore under consideration and The Committee will be notified of the response when it is confirmed.
HM Treasury
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