Fourteenth Report: Readying the NHS and social care for the COVID-19 peak

Select Committee

Public Accounts Committee HC 405 29 July 2020

Report Status Government responded

Conclusions & Recommendations 26 items (6 recs)

Source View on Parliament website

Government Response (AI assessment · 24 of 26 classified)

Accepted 11

Accepted in Part 1

Acknowledged 6

Deferred 1

Not Addressed 5

Government response

Treasury minutes: Government response to the Committee of Public Accounts on the Fourteenth report from Session 2019-21 · published 18 Nov 2020

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Recommendations & Conclusions

6 results

13 Conclusion Acknowledged

We heard how frequently social care had taken second place to the NHS’s needs, particularly...

Conclusion

We heard how frequently social care had taken second place to the NHS’s needs, particularly in accessing test kits and results, and securing reliable PPE supply for care homes, which had been neither timely nor coordinated.33 When questioned, the Department … Read more

Government Response Summary

The government agrees with the committee's implied recommendation, stating its current priority is to place equal focus on the NHS and care sectors, and that it is actively considering a range of proposals for long-term social care reform, with updates to follow a future spending review.

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14 Conclusion Acknowledged

This Committee has also challenged the Department before over not delivering on its overarching responsibilities...

Conclusion

This Committee has also challenged the Department before over not delivering on its overarching responsibilities towards the care market, and having no credible plans to ensure the sector was sustainably funded.38 We note it was not until June 2020 that … Read more This Committee has also challenged the Department before over not delivering on its overarching responsibilities towards the care market, and having no credible plans to ensure the sector was sustainably funded.38 We note it was not until June 2020 that the Department appointed a director general for adult social care to lead on its social care policies, four years after the previous director general left the post.39 The Ministry of Housing, Communities & Local Government told us that it had provided £3.2 billion additional funding to local government with instructions to prioritise social care and, of the £1.25 billion spent so far, £500 million had gone on social care.40 On 15 May 2020 the 29 Committee of Public Accounts, Interface between health and adult social care, Sixty-Third Report of Session 2017–19, HC 1376, 19 October 2018 30 RSC0001 Care England submission 31 C&AG’s Report, foreword 32 Q 121 33 RSC0002 Local Government Association submission; RSC0005 Association of Anaesthetists submission 34 Qq 11–12, 27, 38 35 Q 42 36 Qq 11–12 37 Qq 31–38, 40; C&AG’s Report, para 13 38 Committee of Public Accounts, The adult social care workforce in England, Thirty-Eighth Report of Session 2017–19, HC 690, 9 May 2018 39 HSJ article: Government’s social care directorate restored after four-year gap, 15 June 40 Qq 28–29 Readying the NHS and social care for the COVID-19 peak 13 government also announced a £600 million Infection Control Fund for local government, to tackle the spread of COVID-19 in care homes in England, which was in addition to the £3.2 billion.41 Given reports of increased risk of provider failure and calls from the Local Government Association and NHS Providers to secure a sustainable future for social care, we pressed the Department on whether it would have to rescue any failing providers in the weeks ahead. It told us it was focusing on ensuring the continued provision of services to individuals but was looking closely at the evidence base to understa Show less

Government Response Summary

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15 Conclusion Acknowledged

The Department stressed that it had to respond quickly to the COVID-19 pandemic often with...

Conclusion

The Department stressed that it had to respond quickly to the COVID-19 pandemic often with “imperfect knowledge”, which was why its approach had altered over time.43 But Care England told us that PPE guidance had changed no fewer than 40 … Read more

Government Response Summary

The government states it is confident in its PPE supply for winter 2020-21, having strengthened and diversified supply chains, ordered over 32 billion items, and built stockpiles. It has also established a distribution system, including expanding the PPE portal for social and primary care, to ensure access.

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19 Conclusion Acknowledged

We were keen to know how the Department would ensure sufficient stockpiles of PPE and...

Conclusion

We were keen to know how the Department would ensure sufficient stockpiles of PPE and testing capacity as it rolls out its ambitious ‘track and trace’ programme and the NHS resumes routine services while continuing to deal with COVID-19 this … Read more

Government Response Summary

The government states it has significantly increased UK daily swab test capacity from 2,000 in March 2020 to over 500,000 by October 2020, through lab expansion, new partnerships, additional staff, and cutting-edge technologies.

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20 Conclusion Acknowledged

NHSE&I explained that the NHS was carrying 100,000 staff vacancies going into the pandemic.58 It...

Conclusion

NHSE&I explained that the NHS was carrying 100,000 staff vacancies going into the pandemic.58 It said the workforce had been boosted by around 20,000 students; retired NHS staff; and a further 600,000 volunteers (working across a range of public services, … Read more

Government Response Summary

The government responded to the committee's observation about NHS staff vacancies and the student nurse programme by referencing the NHS People Plan for 2020-21, which aims to support NHS staff in their recovery from the pandemic.

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26 Recommendation Acknowledged

Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up...

Recommendation

Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up demand, which will add to the substantial waiting lists that existed before the pandemic.77 NHSE&I told us that access to emergency and critical services, such … Read more Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up demand, which will add to the substantial waiting lists that existed before the pandemic.77 NHSE&I told us that access to emergency and critical services, such as cancer, has been maintained throughout the crisis although use of these services had been lower than usual. It also told us that it was now encouraging the NHS to resume more routine services.78 Stakeholders from the NHS and independent provider sectors have expressed concerns that resuming services, while the pandemic is still ongoing and with the potential for a second peak, will be challenging and will require full use of capacity across both sectors.79 We asked NHSE&I what plans it had to address these concerns in the near future. NHSE&I told us that the arrangements with the private sector were likely to continue for the rest of the year in order to provide a continuing ‘buffer’ for routine surgery, cancer care and other conditions but it noted that the basis on which it contracted with independent hospitals was likely to change and it was likely to follow a competitive procurement. As discussions are still ongoing, NHSE&I could not provide details on how independent hospital capacity would be allocated but assured us that it would be available for networks of hospitals and GPs in a given area to draw on. It also said that the Nightingale hospitals would be on standby in case of a second pandemic peak.80 72 Q 56; C&AG’s Report, para 10; RSC0007 Independent Healthcare Providers Network submission; RSC0010 NHS Confederation submission 73 Q 63; RSC0004 NHS Providers submission; RSC0007 Independent Healthcare Providers Network submission; RSC0006 Spire Healthcare submission 74 Qq 64–74 75 C&AG’s Report, para 2.7; RSC0011 Future Care Capital submission 76 Q 65 77 Q 59; C&AG’s Report, para 12; Committee of Public Accounts, NHS waiting times for elective and cancer treatment, One Hundredth Report of Se Show less

Government Response Summary

The government agreed with the committee's recommendation (implied to be about resuming services and managing demand) and responded by outlining initiatives for staff wellbeing and support through the NHS People Plan, without detailing specific plans for addressing patient backlogs or pent-up demand.

HM Treasury

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