Seventy-Third Report - Access to urgent and emergency care
Select Committee
Public Accounts Committee
HC 1336
25 October 2023
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Seventy-third report from Session 2022-23 · published 14 Feb 2024
Recommendations & Conclusions
9 results
5
Conclusion
Rejected
Improve accountability for NHS England's urgent and emergency care performance, articulating roles and monitoring steps.
Conclusion
Given long-standing declines in performance, we are not convinced the Department has sufficiently held NHS England to account for meeting targets and improving urgent and emergency care. The Department holds the NHS to account for performance in urgent and emergency …
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Government Response Summary
The government disagrees with the recommendation, explaining that Parliament has already articulated the roles of the Department and NHS England. It asserts that the Department maintains effective oversight through mandates, annual assessments, regular ministerial meetings, and Prime Minister-led stocktakes, underpinned by clear metrics.
HM Treasury
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6
Conclusion
Rejected
Provide Committee with full 15-year cost estimates for NHS Long Term Workforce Plan implementation.
Conclusion
The unfunded and uncosted NHS Long Term Workforce Plan risks building in unsustainable financial pressures. The NHS Long Term Workforce Plan drawn up by NHS England only includes a commitment of an additional £2.4 billion to cover training costs for …
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Government Response Summary
The government disagrees with the recommendation to provide a full 15-year cost update to the Committee, stating that NHS England will submit its estimates for the full cost of the NHS from 2025-26 onwards to the government as part of the next Spending Review process, with outcomes published by HM Treasury.
HM Treasury
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10
Conclusion
Rejected
Department's oversight of NHS England's A&E performance targets remains ineffective and unachieved.
Conclusion
We raised concerns over the effectiveness of the Department’s oversight of NHS England’s performance against its targets, including the A&E target for 95% of patients to be admitted, transferred, or discharged within four hours.23 This target has not been achieved …
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Government Response Summary
The government disagrees with the Committee's concern over the effectiveness of its oversight of NHS England's performance, asserting it maintains close oversight through various mechanisms, including mandates and regular high-level meetings.
HM Treasury
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11
Conclusion
Rejected
NHS England confident in recovery plans despite significant challenges, especially upcoming winter.
Conclusion
The Department recognised that there is an element of accountability in its relationship with the NHS, and said it was holding NHS England to account through the trajectories set out in numerous recovery plans, from primary care to elective recovery. …
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Government Response Summary
The government disagrees with the Committee's implicit concern regarding its oversight of NHS England's performance, stating it maintains effective oversight through mandates, regular ministerial meetings, and stocktakes.
HM Treasury
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12
Conclusion
Rejected
Department rejects claims of excessive NHS management layers or unclear accountability structures.
Conclusion
The Department acknowledged that there were different sides of its approach to holding the NHS to account. It recognised that if there was a problem arising in a local authority it may fall to the Department to address, whereas problems …
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Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding NHS management levels and accountability, defending the existing structure as articulated by Parliament and detailing its effective oversight mechanisms and performance monitoring.
HM Treasury
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28
Conclusion
Rejected
Long-term funding for the NHS workforce plan remains undefined beyond five years
Conclusion
We pressed both the Department and NHS England on how the workforce plan would be paid for.80 NHS England stated that the current government’s commitment has been to fully fund the first five years of the plan.81 In future periods, …
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Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding the long-term funding of the workforce plan, reiterating its £2.4 billion commitment for the first five years and stating future funding estimates will be part of the next Spending Review.
HM Treasury
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29
Conclusion
Rejected
Initial £2.4 billion funds first five years of training; future expansion needs more
Conclusion
The Department and NHS England told us that government had made a firm commitment of £2.4 billion of new money to fully fund the first five years of additional training places set out in the plan, until 2028.84 A planned …
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Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation, reaffirming its £2.4 billion commitment to fund the first five years of the NHS Long Term Workforce Plan and stating that estimates for subsequent years will be submitted as part of the next Spending Review.
HM Treasury
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30
Conclusion
Rejected
No specific funding for staff retention, relying on other factors
Conclusion
NHS England confirmed that there is no specific funding for staff retention but said that it would be cost neutral. However, there are dependencies on several other factors that are important for retention. Staff wellbeing was outside the purview of …
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Government Response Summary
The government explicitly disagrees with the committee's finding/implied recommendation regarding staff retention funding, highlighting its £2.4 billion commitment for training and deferring future funding estimates to the next Spending Review.
HM Treasury
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31
Conclusion
Rejected
Plan requires sustained multi-year investment, especially in technology and digitisation
Conclusion
The Department emphasised the most important aspect of the plan was continued and sustained investment and that, particularly when thinking about technology and digitisation, it should be seen as a multiyear set of changes.88 NHS England added that there was …
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Government Response Summary
The government explicitly disagrees with the committee's finding or implied recommendation, stating it has committed £2.4 billion for the NHS Long Term Workforce Plan and will address future funding needs as part of the next Spending Review process.
HM Treasury
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