A damning new report from the Public Accounts Committee (PAC) reveals that NHS England and the Department of Health and Social Care (DHSC) are failing to demonstrate the innovative thinking and decisive action required to tackle the NHS's deteriorating financial situation.
As the Government prepares to launch a crucial 10-year recovery plan, the PAC warns that senior health officials are reluctant to make the radical changes needed. Despite aligning with the Government's ambitious 'three big shifts' – transitioning from hospital-based to community care, moving from analogue to digital systems, and shifting focus from treating illness to preventing it – officials argue that these changes should be implemented gradually and not compromise current patient care.
This conservative approach risks missing a pivotal opportunity to secure the long-term health of the nation. The PAC's report calls for a well-funded, future-proofed NHS that prioritises prevention, community healthcare, and digital transformation.
Across three main areas, the report has made a number of specific recommendations. These are:
Community Healthcare: The report highlights the stagnation of efforts to transfer more care to community settings. It urges NHS England to increase year-on-year community healthcare funding, in line with its stated ambitions.
Prevention: Shifting focus from treatment to prevention is expected to require a similar reallocation of funds. The PAC recommends defining what constitutes prevention spending, identifying necessary funding increases, and granting local systems the autonomy to allocate resources effectively.
Digital Transformation: The report criticises the slow pace of digital adoption within the NHS. Many trusts still use outdated fax machines and paper records. The PAC calls for a reduction in paper reliance within 18 months and a clear deadline to eliminate fax machine use.
Chair of the Committee, Sir Geoggrey Clifton-Brown, said:
“The current Government has told the public that the NHS is broken. This will not come as news to NHS patients, nor to its hard-working staff across the country. Nor indeed does it to this Committee, which has long warned of the systemic issues plaguing the NHS, issues which the Government has transformative ambitions to address. We were aghast, then, to find amongst senior officials in charge of delivering these ambitions some of the worst complacency displayed to the PAC in my time serving on it.
“The evidence given to our inquiry exposes the perennial weaknesses with which those scrutinising this country’s health systems are now very familiar. We therefore have a simple message for those senior officials responsible for delivery. Truly fresh ideas and radical energy must be generated to meet the scale of what is required - on community healthcare, on prevention, on digital transformation. Given the position of the NHS, forcing this Committee to wade through treacle by mouthing the same stale platitudes of incremental change is simply not going to cut it.”
The PAC also notes overly optimistic assumptions underpinning current plans, such as annual productivity gains of 2% by 2028-29. The report urges the Government to provide earlier financial certainty to local health bodies and address funding incentives that disadvantage more deprived areas, particularly regarding GP surgery vaccination funding.
A spokesperson for NHS England has responded to the publication of the report, saying:
“The report from the PAC contains basic factual inaccuracies and a flawed understanding of how the NHS and the government’s financial processes work.
“While NHS productivity is now improving at double pre-pandemic levels – far from being complacent, NHS England has repeatedly been open about the problem and the actions being taken to address it, including in the December public board meeting, and we will be publishing further improvement measures later this week in planning guidance.
“Reform is part of the NHS’ DNA and has ensured performance improvements for patients in the past year, including innovations such as virtual wards – despite the huge challenges the NHS has faced, including capital starvation, unprecedented strikes and a fragile social care sector.
“Lord Darzi’s report was clear many of the solutions can be found in parts of the NHS today, and we are working closely with the government to drive this innovation forward as we develop the ambitious 10 Year Health Plan to build an NHS which is fit for the future.”
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