Sixth Report - Department of Health and Social Care 2020–21 Annual Report and Accounts

Select Committee

Public Accounts Committee HC 253 10 June 2022

Report Status Government responded

Conclusions & Recommendations 33 items (20 recs)

Source View on Parliament website

Government Response (AI assessment · 28 of 33 classified)

Accepted 20

Accepted in Part 1

Deferred 1

Not Addressed 5

Recommendations

17 results

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

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

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 … Read more

Government Response Summary

The department has processes in place for monitoring and controlling the approval of exit payments.

HM Treasury

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 … Read more

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

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 … Read more

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

Conclusions (3) Observations and findings — click to expand

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.

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.