Value for Money
NHSE's management of elective care transformation programmes
Recommendations (5)
Source: NAO Recommendations Tracker
Department of Health and Social Care; NHS England and NHS Improvement
Rec 1
Accepted
Implemented
NHSE plans to reset its central oversight arrangements for elective recovery.
As it establishes its new national level oversight board for the transformation
programmes it should:
? ensure that performance information reported to the board is prioritised,
clear and consistent so that the board has a clear view of trends over time
and issues arising. Performance indicators should relate to the outcomes
that the programmes are aiming to achieve;
? include programme costs in board reporting to enable the assessment
of the relative cost and value of elements of the recovery plan, and to
support decision making on the allocation of resources;
? ensure that the risk information reported to the board is up to date and
timely and reflects current performance and progress on each programme
against planned trajectories; and
? when a programme is not delivering, as the outpatients transformation
programme was not, highlight this in reports to the board. The board
should document decisions about what it has done to address this.
Department of Health and Social Care; NHS England and NHS Improvement
Rec 2
Accepted
Work in Progress
The national level oversight board should assess whether it has the right
balance of investment across the transformation programmes and other
initiatives, including capital and resource spending, to achieve the required
reduction in elective care waiting times. It should assess:
? the level of both capital and resource expenditure on the programmes;
? the contribution the transformation programmes have made to date to
reduce waiting times and modelling to understand how they are expected
to achieve outcomes in future, including the relationship between meeting
performance targets and reducing waiting times; and
? the dependencies between the transformation programmes and other
initiatives for reducing waiting times, including how they will work
together to bring elective recovery back on track.
Department of Health and Social Care; NHS England and NHS Improvement
Rec 3
Accepted
Implemented
The national level oversight board should play an active role in ensuring
that lessons are learned on and between the transformation programmes.
Practical steps may include reviews, workshops or problem-solving sessions
to allow everyone involved to share their perspectives and experiences,
and giving people the opportunity to work alongside other teams.
Department of Health and Social Care; NHS England and NHS Improvement
Rec 4
Accepted
Implemented
NHSE should do more to secure buy-in from clinicians across its programmes.
It should achieve this by:
? continuing to build support and endorsement nationally by strengthening
its work with Royal Colleges and through national clinical directors
embedded in the elective recovery programme;
? aligning national and local clinical ambitions and expectations;
? using data and modelling to demonstrate the case for change; and
? building support locally through peer-to-peer engagement.
Department of Health and Social Care; NHS England and NHS Improvement
Rec 5
Accepted
Work in Progress
Having brought oversight of the outpatients transformation into the wider
elective recovery programme, NHSE should:
? make a full assessment of the lessons learned to date. NHSE should
set out how these lessons will be incorporated in its plans for taking the
transformation forward;
? strengthen risk and programme management; and
? set out how it expects achievement of targets to translate into reduced
waiting times and assess their deliverability. This deliverability assessment
should set out the key actions that are needed to ensure that targets are
delivered and an implementation plan including the resources required
and the milestones NHSE will need to meet. NHSE should be clear on
how this plan differs from its previous activity which has not delivered a
reduction in outpatient appointments.