The pharmacy early payment and salary advance schemes in the NHS – Report Summary

This is a House of Commons Committee report, with recommendations to government. The Government has two months to respond.

Author: Committee of Public Accounts

Related inquiry: NHS supply chain finance

Date Published: 4 February 2022

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The Department of Health and Social Care and the NHS took up schemes Lex Greensill advised the government on and promoted through his company—Greensill Capital—from 2018 until the company’s collapse in March 2021. Neither scheme delivered what it promised and there was no clear rationale for why they were introduced.

The Department is now paying pharmacies earlier anyway and some NHS trusts are now paying salary advance scheme companies for services which were offered for free by Greensill Capital through its subsidiary company Earnd (UK) Limited. There was a considerable lack of curiosity in the Department about the benefits of the early payment for pharmacies, which in the end did not deliver the promised saving. It is extraordinary that in respect of the salary advance scheme, there was no apparent concern that one company could offer a free scheme to NHS trusts which could also have the effect of boosting its reputation by association with the NHS brand and scale in order to win business elsewhere.

There is also no evidence of the proper review of potential conflicts of interests arising from Lex Greensill’s various advisory roles between 2011 and 2017 and the commercial activities of Greensill Capital, including its role as the financial guarantor and key subcontractor to Taulia Inc1 —the company selected as the government supplier for the pharmacy early payment scheme in 2018. Other committees have reported on the relationship between Lex Greensill and Whitehall. This report covers just these two schemes.

The Pharmacy Earlier Payment Scheme (PEPS) was introduced to accelerate reimbursement through use of a private financing arrangement. Lex Greensill advised government that this would deliver savings of £100m per year. But the Department of Health and Social Care (the Department) cannot provide evidence of any realised benefits. Only 14% of pharmacies participated in the scheme, far fewer than the Department’s anticipated participation rates of 60–80%. In July 2020 the Department changed the scheme to provide loans prior to the dispensing of prescriptions, but no evaluation was made of this change. When Greensill Capital collapsed in March 2021 no other finance provider was willing to take on the scheme, and government had to step in to pay pharmacies. From November 2021, the Department introduced new arrangements to reimburse pharmacy claims in four business days and this new process does not involve private sector financing.

From 2019 Greensill Capital also marketed another scheme to NHS trusts—a salary advance scheme, which allowed NHS employees to access their wages in advance of payday at no cost. Government advice to avoid these sorts of schemes was never cascaded to NHS trusts. A number of NHS trusts subscribed to Greensill Capital’s ‘free’ scheme but the taxpayer has been left picking up the costs following the collapse of Greensill Capital and the subsequent move of some NHS trusts to paid-for services. The Department claims that NHS trusts were best placed to decide how different pay flexibilities, including salary advance schemes, fit with their overall reward strategies. However, developing a consistent approach for implementing salary advances and financial wellbeing matters of this nature across all of the NHS would reduce the risk of employer and employee exploitation by scheme providers and promote transparency in the process.


1 Taulia Inc is a US base company, referred to as Taulia in the rest of this report