Sixth Report - Department of Health and Social Care 2020–21 Annual Report and Accounts
Select Committee
Public Accounts Committee
HC 253
10 June 2022
Recommendations
20 results
2
Not Addressed
The procurement of PPE in response to the COVID-19 pandemic overwhelmed existing systems and has...
Recommendation
The procurement of PPE in response to the COVID-19 pandemic overwhelmed existing systems and has exposed weaknesses in the Department’s commercial contracting capability. At the start of the pandemic the Department faced significant challenges in sourcing and procuring PPE in …
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Government Response Summary
The response does not address the recommendation of outlining a 'commercial reset' plan and timeline for scaling up commercial capability, and instead discusses internal performance measures and consultations with the sector.
HM Treasury
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3
Accepted
There is no clear plan for how big the PPE stockpile needs to be and...
Recommendation
There is no clear plan for how big the PPE stockpile needs to be and how the Department will build greater resilience into the NHS supply chain so that it can respond at pace to future urgent needs. Having an …
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Government Response Summary
The department is undertaking a fundamental review of the clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease.
HM Treasury
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4
Accepted
The Department has regularly failed to follow public spending rules and across the Departmental Group...
Recommendation
The Department has regularly failed to follow public spending rules and across the Departmental Group there is a track record of failing to comply with the requirements of Managing Public Money. The Department is required to obtain approval from the …
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Government Response Summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs) and will provide a further update to the Committee by October 2022.
HM Treasury
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5
Accepted
The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how...
Recommendation
The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how it identifies and manages declarations of interests. A considerable amount of taxpayers’ money was spent on products from new suppliers, including those with no previous …
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Government Response Summary
The department has implemented the agreed revised process for identifying and disclosing interests and related parties, incorporating all lessons learned from the 2020-21 process and recommendations from the National Audit Office (NAO) and will continue to include a full list of interests in each and every annual report and accounts.
HM Treasury
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6
Accepted
There have been inappropriate unauthorised payoffs made to staff by health bodies, and the planned...
Recommendation
There have been inappropriate unauthorised payoffs made to staff by health bodies, and the planned large-scale NHS restructuring increases the risk of this happening again. Special severance payments when staff leave public service employment should be exceptional and they require …
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Government Response Summary
The department has processes in place for monitoring and controlling the approval of exit payments; ALBs are required to comply with schedules of delegation issued by the department, including approvals required in respect of special severance and redundancy payments and NHS England conduct a due diligence check on all non- contractual severance payments.
HM Treasury
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7
Accepted
With 23 days to go until the financial year end the UK Health Security Agency...
Recommendation
With 23 days to go until the financial year end the UK Health Security Agency did not have an agreed budget for the new financial year. The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as …
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Government Response Summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
HM Treasury
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8
Accepted in Part
There is no clear plan as to how the Department will bring forward the publication...
Recommendation
There is no clear plan as to how the Department will bring forward the publication date of its annual report and accounts. The Department prepared its 2020–21 Annual Report and Accounts in exceptional circumstances. The Department’s 2020–21 Annual Report and …
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Government Response Summary
The department has a plan to bring forward its accounts preparation process to allow pre-summer recess laying of its annual report and accounts (ARA), but will not be able to support pre-recess laying of the ARA for 2022-23, but aims to return to pre-recess laying of the ARA from 2023-24 onwards.
HM Treasury
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9
Accepted
We asked the Department what plans it had for disposal of the £4 billion of...
Recommendation
We asked the Department what plans it had for disposal of the £4 billion of PPE that it has identified cannot be used in the NHS. The Department told us that it had approached 75 different countries to see if …
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Government Response Summary
The Department of Health and Social Care (DHSC) is focusing efforts on accelerating the disposal programme, appointing two Lead Waste Providers (LWPs), Suez and Veolia, to assess the options for disposal, and will write to the Committee over the Summer to set out the detail in full.
HM Treasury
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10
Accepted
Prior to the COVID-19 pandemic, the Department held a stockpile of PPE to respond to...
Recommendation
Prior to the COVID-19 pandemic, the Department held a stockpile of PPE to respond to what it considered was a reasonable worst-case scenario of an outbreak of pandemic influenza.19 It was identified in the early stages of its COVID-19 pandemic …
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Government Response Summary
The department is undertaking a fundamental review of the clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease.
HM Treasury
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12
Accepted
We asked the Department about its commercial capability.
Recommendation
We asked the Department about its commercial capability. It confirmed that this was on its “worry list” prior to the arrival of the COVID-19 pandemic and continues to be a challenge.24 The Department stated that it has an ongoing programme …
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Government Response Summary
The department has undertaken a commercial reset with new structures implemented on 1 April 2022, aligned to the Government Commercial Function (GCF) standards, and is implementing a range of priority commercial capability activity for 2022-23, including a bespoke procurement capability programme.
HM Treasury
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18
Accepted
When granting additional funding to assist with the Department’s COVID-19 pandemic response activity, HM Treasury...
Recommendation
When granting additional funding to assist with the Department’s COVID-19 pandemic response activity, HM Treasury set conditions to ensure appropriate use of the money, that the Department was required to follow. These were in areas such as: advance payments to …
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Government Response Summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs) and will provide a further update to the Committee by October 2022.
HM Treasury
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19
Accepted
The Department told us that in order to get money to where it thought it...
Recommendation
The Department told us that in order to get money to where it thought it was needed during the COVID-19 pandemic it deliberately loosened controls and thereby took on a lot of additional risk spending money without prior approval.35 It …
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Government Response Summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs), including updated financial delegations, a training programme for senior civil servants, and re-developed internal business case guidance, and will provide a further update to the Committee by October 2022.
HM Treasury
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20
Accepted
The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not...
Recommendation
The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not best support the current operating environment” and that “necessary adjustments are required to the framework of risk control and governance arrangements for them to be …
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Government Response Summary
The department is undertaking a finance reset programme, which is establishing robust financial controls and governance across the department and its arms’ length bodies (ALBs), including updated financial delegations, a training programme for senior civil servants, and re-developed internal business case guidance, and will provide a further update to the Committee by October 2022.
HM Treasury
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22
Accepted
We asked the Department how with such a large number of potential and potentially significant...
Recommendation
We asked the Department how with such a large number of potential and potentially significant conflicts of interest, within staff, non-executive directors or Ministers at the Department, they make sure that conflicts are identified and dealt with properly. The Department …
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Government Response Summary
The department will maintain and improve accountability by embedding their revised processes so that these are undertaken on a timely basis each and every year and normalise the transparency of the results by inclusion of the full list of interests identified in every Annual Report and Accounts.
HM Treasury
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23
Accepted
The Department set out in its Governance Statement that during the audit of the Department’s...
Recommendation
The Department set out in its Governance Statement that during the audit of the Department’s accounts, it became apparent the Department’s process for collating and assessing potential related parties and related party transactions did not provide the necessary completeness assurance …
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Government Response Summary
The government agrees to maintain and improve accountability by embedding their revised processes for identifying and disclosing interests and related parties and will continue to include a full list of interests in each annual report and accounts.
HM Treasury
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24
Accepted
The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an...
Recommendation
The Health and Care Bill introduces statutory Integrated Care Systems (ICSs), made up of an Integrated Care Board (ICB), responsible for the commissioning of healthcare services and an Integrated Care Partnership (ICP), an alliance of organisations and representatives to improve …
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Government Response Summary
The department will monitor and control the approval of all redundancy payments made by entities within the Departmental Group to ensure such payments are properly authorized in advance and are not irregular by using updated ALB delegations, the Exit and High Risk Sub Group (EHRSG), internal NHS England processes, and due diligence checks.
HM Treasury
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26
Accepted
Three Clinical Commissioning Groups (CCGs) paid special severance payments without obtaining the required approvals.47 The...
Recommendation
Three Clinical Commissioning Groups (CCGs) paid special severance payments without obtaining the required approvals.47 The C&AG qualified his regularity audit opinion on the NHS England 2020–21 Annual Report and Accounts in respect of one of these, a special severance payment …
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Government Response Summary
The department has processes in place for monitoring and controlling the approval of exit payments.
HM Treasury
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27
Accepted
We questioned the Department on what forward thinking it is doing to prevent unauthorised payments...
Recommendation
We questioned the Department on what forward thinking it is doing to prevent unauthorised payments being made to individuals leaving the NHS as a result of the planned re-organisation. The Department acknowledged there is a chance that the re-organisation of …
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Government Response Summary
The department will monitor and control the approval of all redundancy payments made by entities within the Departmental Group to ensure such payments are properly authorized in advance and are not irregular by using updated ALB delegations, the Exit and High Risk Sub Group (EHRSG), internal NHS England processes, and due diligence checks.
HM Treasury
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28
Accepted
The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as a...
Recommendation
The Department established the UK Health Security Agency (UKHSA) on 1 April 2021 as a new executive agency to be the UK leader for health protection responsible for ensuring the nation can respond quickly and at greater scale to deal …
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Government Response Summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
HM Treasury
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31
Deferred
To provide proper timely accountability on how public funds have been spent, the administrative deadline...
Recommendation
To provide proper timely accountability on how public funds have been spent, the administrative deadline set by Treasury for Departments to publish their Annual Report and Accounts is 30 June, where possible, and no later than the parliamentary summer recess …
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Government Response Summary
The department has a plan to bring forward its accounts preparation process, but will not be able to support pre-recess laying of the ARA for 2022-23 and is working to return to pre-recess laying of the ARA from 2023-24 onwards dependent upon the capacity of the national and local audit markets.
HM Treasury
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Conclusions (13) Observations and findings — click to expand
1
Conclusion
Not Addressed
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) on its Annual Report and Accounts for 2020–21.1
Government Response Summary
Acknowledgement of the report.
11
Conclusion
Not Addressed
Most of the PPE was bought at speed early in the pandemic. This was at a time when there was a surge in demand in other countries, and at the same time as a temporary decline in global supply as factories temporarily shut to help reduce COVID-19 infections. This resulted …
Government Response Summary
Conclusion about PPE procurement.
13
Conclusion
We asked the Department for an update on the current position of contracts it had entered into in response to the COVID-19 pandemic. The Department has now identified 17 Q 43 18 Q 79 19 Q 88; DHSC 2020–21 ARA, page 123 20 C&AG’s Report, The supply of personal protective …
14
Conclusion
The Department has also identified a contract for 3.5 billion gloves where there are allegations of modern slavery. When we questioned the Department about this matter, it was unable to confirm the value of the contract. However, it believed that should evidence become available that supports the modern slavery allegations, …
15
Conclusion
Accepted
The Department told us that the stockpile it held at the beginning of the pandemic was exceptionally useful and that there would have been PPE shortages without it. This stockpile was established in 2009, after the swine flu outbreak.28 We questioned the Department on its plans for holding a PPE …
Government Response Summary
The department is undertaking a fundamental review of clinical countermeasures, including PPE, that need to be readily accessible in event of a future pandemic or emerging infectious disease and is working with the UK Health Security Agency (UKHSA) and NHS Supply Chain on the product mix and amounts.
16
Conclusion
Accepted
We asked the Department why it had started disposing of PPE before it had made a decision on the size of the stockpile to hold for future emergencies. It told us that it will not need or be able to use all of the PPE it currently holds. As an …
Government Response Summary
The Department of Health and Social Care is focusing efforts on accelerating the disposal programme of personal protective equipment (PPE) and will write to the Committee over the Summer to set out the detail in full, providing regular updates on the volume of PPE that has been disposed of and the associated costs and benefits.
17
Conclusion
Not Addressed
The Department said that in addition to holding a much larger stockpile, another alternate strategy it could have previously adopted was to buy British and therefore creating a resilient, flexible PPE manufacturing industry in this country, rather than buying from abroad. It advised us that its future plans for a …
Government Response Summary
The Department said that in addition to holding a much larger stockpile, another alternate strategy it could have previously adopted was to buy British and therefore creating a resilient, flexible PPE manufacturing industry in this country, rather than buying from abroad.
21
Conclusion
There has been considerable public and political interest in the Department’s COVID-19 pandemic procurement including how significant amounts of taxpayers’ money had been spent- especially where products had been sourced from new suppliers including from companies with no previous experience in these types of products. Such procurement- undertaken at pace- …
25
Conclusion
Acknowledged
We asked the Department what plans it had put in place to prepare for this large-scale structural change in the NHS. The Department said the NHS had “extensive plans” and it was looking for radical change in how these organisations and their people work together to put flexibility into the …
Government Response Summary
The Department said the NHS had “extensive plans” and it was looking for radical change in how these organisations and their people work together to put flexibility into the system and its use of health and social care funding.
29
Conclusion
On 21 February 2022 the Prime Minister outlined the Government’s strategy for living with COVID-19 including the scaling back of testing, tracing and isolation.54 The Government’s intention is to put an end to the free supply of lateral flow testing kits. We asked the Department on its assessment of the …
30
Conclusion
Accepted
Given the uncertainty and plan to reduce test and trace activity we asked the Department whether UKHSA would have enough funding to operate going forward. The Department replied that this was under discussion.58 We asked the Department when we took evidence on 7 March 2022 when the UKHSA 2022–23 financial …
Government Response Summary
The Department has written to the Committee setting out the steps implemented to ensure the department’s Financial Planning and Budgeting process allows its Arm’s Length Bodies sufficient time to plan for the year ahead.
32
Conclusion
At the time of our evidence session, one NHS Trust, University Hospitals of Leicester NHS Trust (UHL), had yet to publish its 2019–20 or 2020–21 Annual Report and Accounts. The C&AG reported last year that as a result of the issues identified by its auditor, UHL’s management were not prepared …
33
Conclusion
Not Addressed
We asked the Department what it was doing to assure itself that the situation at UHL would be resolved and whether it was an isolated occurrence or indicative of similar issues that may surface elsewhere in the NHS in the future. The Department acknowledged the fact that annual report and …
Government Response Summary
The government response details NHS England's process for scrutinizing severance cases and contractual payments for NHS and foundation trusts, which is unrelated to the original query about resolving governance issues at UHL and systemic issues within the NHS.