Public Accounts Committee report finds that NHS health officials are out of ideas and complacent
In its report published today, the Public Accounts Committee (PAC) has warned that, while Government’s forthcoming 10-year plan will be essential to the health service’s recovery, senior health officials seem to be unambitious when it comes to taking the radical steps to begin to implement it.
The PAC has warned that n the context of a worsening financial position for the NHS, the Government has laid out its planned ‘three big shifts’: from hospital-based to community care; from analogue to digital; and from treating ill health to prevention.
However, in questioning both the Department for Health and Social Care (DHSC) and NHS England (NHSE), the PAC found that officials do not seem ready to prioritise these shifts – agreeing with the Government’s aims, but arguing they are difficult and should take place only slowly, over the long-term, and not at the expense of patients now.
This risks letting slip a golden opportunity to take significant decisions for the longer-term benefit of the nation’s health, at precisely the moment where ideas to meet the level of change required would be highly desirable. The PAC’s report calls for the development of the 10-year plan to ensure enough funding is allocated to future-proofing the NHS, particularly on prevention, community healthcare, and digital technology.
The report makes specific recommendations in each of these three areas. On community healthcare, the report finds that the long-held ambition to move more care from hospitals has stalled. It recommends that NHSE ensure that more funding, year on year, is spent in the community, in line with its own ambitions.
On prevention, it is likely that refocusing from treating sickness to prevention will require a similar shift of funds in the same direction. The PAC recommends that a definition be reached for what counts as prevention spending; that officials set out the funding increases required to achieve it; and for local systems to be given the required flexibility and autonomy to direct funds to the right areas.
On the switch to digital, the PAC’s report warns of glacially slow progress in parts of the NHS. A number of trusts still work with fax machines, and NHS providers are often still too reliant on paper records. The report calls for plans to reduce this reliance on paper within 18 months, and a specific deadline to end the use of fax.
The report further notes unconvincingly optimistic assumptions underpinning current plans of annual productivity gains* of two per cent by 2028-29, calls on Government to give local health bodies earlier certainty about how much money they will have, and highlights perverse incentives around vaccination funding for GP surgeries which could be seeing more deprived areas losing out.
Sir Geoffrey Clifton-Brown MP, Chair of the Committee, 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.”
