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

7 results

6 Recommendation Not Addressed

Policies designed to create additional capacity quickly, while necessary, have resulted in a lack of...

Recommendation

Policies designed to create additional capacity quickly, while necessary, have resulted in a lack of transparency about costs and value for money. The NHS boosted its potential maximum capacity for the peak in April by building Nightingale hospitals across the … Read more

Government Response Summary

The government response completely failed to address the recommendation regarding transparency on the costs and utilisation of private hospital contracts and Nightingale hospitals, instead providing information about the Restoration and Renewal of the Palace of Westminster.

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1 Conclusion Not Addressed

On the basis of a report by the Comptroller and Auditor General, we took evidence...

Conclusion

On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department), NHS England & NHS Improvement (NHSE&I), the Ministry of Housing, Communities & Local Government (the … Read more

Government Response Summary

The government response lists various officials responsible for areas like NHS resilience, social care, PPE supply, Test and Trace, and vaccines. It also notes that adult social care provision is a local government responsibility without a single equivalent to an NHS Chief Executive.

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10 Conclusion Not Addressed

Some organisations such as Care England highlighted to us the flawed nature of this policy...

Conclusion

Some organisations such as Care England highlighted to us the flawed nature of this policy and reported that, given the absence of testing and inadequate PPE, social care felt abandoned.21 When we challenged the Department and the NHS on such … Read more

Government Response Summary

The government response only restates the committee's conclusion that discharging patients without testing was an appalling error, without providing any further information or action.

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11 Conclusion Not Addressed

We remained concerned that the Department had continued its policy of discharging people untested into...

Conclusion

We remained concerned that the Department had continued its policy of discharging people untested into care homes even once it was clear there was an emerging problem.26 The number of first-time outbreaks in individual care homes peaked at 1,009 in … Read more

Government Response Summary

The government response provided is a restatement of a PAC conclusion regarding discharge policy, and does not specifically address the content or concerns raised in conclusion #11.

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12 Conclusion Not Addressed

This Committee has warned before that the Department lacked an effective overall strategy or plan...

Conclusion

This Committee has warned before that the Department lacked an effective overall strategy or plan to integrate health and care and that poor outcomes could arise as a result.29 As Care England told us, for too long “adult social care … Read more

Government Response Summary

The government response provided is a restatement of a PAC conclusion regarding delayed social care reform, and does not specifically address the content or past warnings raised in conclusion #12.

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24 Conclusion

Under its reasonable worst-case scenario, the Government expected over 4% of the population might require...

Conclusion

Under its reasonable worst-case scenario, the Government expected over 4% of the population might require hospital admission for COVID-19 and 30% of those would require critical care. NHSE&I told us that the number of COVID-19 patients admitted to hospital had … Read more

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25 Conclusion

Between mid-March and mid-April, the NHS and armed forces are to be commended for increasing...

Conclusion

Between mid-March and mid-April, the NHS and armed forces are to be commended for increasing the number of beds available for Covid-19 patients from 12,600 to 53,700 in 63 C&AG’s Report, para 3.16 64 RSC0012 National Institute for Health Research … Read more Between mid-March and mid-April, the NHS and armed forces are to be commended for increasing the number of beds available for Covid-19 patients from 12,600 to 53,700 in 63 C&AG’s Report, para 3.16 64 RSC0012 National Institute for Health Research (NIHR) Health Protection Research Unit in Merging and Zoonotic Infections; University of Liverpool, Institute of Infection and Global Health, and University of Oxford, Nuffield Department of Primary Care Health Sciences submission; RSC0010 NHS Confederation submission; RSC0004 NHS Providers submission; RSC0005 Association of Anaesthetics submission 65 Qq 98–101 66 Qq 102–105, 108–111; C&AG’s Report, para 4.30; RSC0010 NHS Confederation submission; RSC0004 NHS Providers submission 67 Q 57 68 Qq 102, 105, 111 69 Qq 14,109, 116 70 RSC0004 NHS Providers submission 71 C&AG’s Report, paras 10, 2.6, 2.7, 4.4; Ev Independent Healthcare Providers Network submission Readying the NHS and social care for the COVID-19 peak 17 a very short space of time. The additional capacity inside existing NHS hospitals helped to ensure that at no point during the pandemic did the number of patients exceed the number of available beds.72 Independent and Nightingale capacity created a ‘buffer’ on top of that, and NHS Providers also welcomed the private sector support which had been offered to date.73 We recognise the need to have moved at speed to set up these arrangements. However, we were also concerned about the trade-offs with securing value for money and an apparent lack of transparency. We asked NHSE&I about the use and cost of the capacity secured through independent hospitals. NHSE&I told us that “several hundred thousand patient treatments”, such as chemotherapy and diagnostic tests, had been delivered as well as equipment. Despite the open book accounting arrangements in the contract, NHSE&I would not provide even a rough estimate of costs until these had been audited and said it might be “several weeks” before it could share the data with u Show less

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