NHS Supply Chain and efficiencies in procurement

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

Twenty-Fourth Report of Session 2023–24

Author: Committee of Public Accounts

Related inquiry: NHS Supply Chain and efficiencies in procurement

Date Published: 27 March 2024

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Contents

Introduction

The NHS collectively spends approximately £8 billion annually on buying medical equipment and consumables, from gloves and paper to stents and prosthetic hips. The Department of Health & Social Care (the Department) created NHS Supply Chain in 2018 in response to a report by Lord Carter which found greater scope for efficiencies in the NHS by aggregating its spending power and reducing the variation in prices that trusts pay for the same goods.

NHS Supply Chain is responsible for procuring products, warehousing, and delivering consumables and medical equipment on behalf of the NHS. It became fully operational in April 2019, under the ownership of the Secretary of State for Health and Social Care. Its key objectives were, by 2023–24, to deliver £2.4 billion of savings and have 80% of relevant NHS spending on medical equipment and consumables (known as ‘market share’) go through NHS Supply Chain. It has a catalogue of more than 600,000 products and its annual operating budget for 2023–24 was £240 million. Since 2021, NHS Supply Chain has been owned by NHSE.

Conclusions and recommendations

1. NHS Supply Chain has failed to persuade trusts to use it, meaning trusts are missing out on opportunities for savings. NHS Supply Chain was created as a national body through which trusts could make use of their collective purchasing power to secure better deals. This is not yet happening. Trusts spend approximately £7.9 billion on medical equipment and consumables, but £3.4 billion a year of this spend is outside of NHS Supply Chain. This means that NHS Supply Chain is only achieving around 57% of market share against a target of 62% (its original target was 80% by 2023–24). NHS Supply Chain estimates that, if trusts made greater use of NHS Supply chain using the existing contracts that are currently in place, they could save a further £60 million to £90 million by 2026. However, it considers that its capacity constraints as well as other operational reasons mean it would be difficult for it to grow more quickly and it needs to improve its infrastructure and modernise technology. NHS Supply Chain now expects it to take at least three years before it can reach 80% market share. It also needs to gain trusts’ confidence as their overall net satisfaction with NHS Supply Chain is in steady decline; from its peak of 67% in quarter two 2021–22 to 54% in quarter two 2023–24. This is a shockingly low level of net customer satisfaction.

Recommendation 1: NHS Supply Chain should set out how, and by when, it will get the NHS to use NHS Supply Chain for the original goal of 80% of its spending on consumables and medical equipment.

2. NHSE has been weak in its oversight and support of NHS Supply Chain. Both the Department and NHSE failed to validate the cumulative £3.3 billion savings claimed by NHS Supply Chain, instead, they relied on NHS Supply Chain to make these checks – effectively marking its own homework. This undermines the confidence we can have in these reported savings. NHSE has not given NHS Supply Chain the full financial support NHS Supply Chain considers it needs to transform and modernise its business. For 2023–24, NHS Supply Chain requested a £252 million revenue budget to operate the organisation and implement its transformation projects for the year. NHSE provided just £240 million. NHSE acknowledges that this shortfall would delay a new IT system but explains there are many other calls on NHS funding and that it must get the balance right between other competing priorities and NHS Supply Chain. We were surprised at the decision to reduce NHS Supply Chains request for an extra £12 million investment in IT when it is expected to save £500 million by 2026–27.

Recommendation 2: NHSE should set out how it will provide adequate challenge of and support for NHS Supply Chain, particularly regarding NHS Supply Chain’s plans to modernise and transform its business.

3. NHSE does not challenge trusts as to why they do not buy more products through NHS Supply Chain. Trusts submit data to NHSE on how much they spend on medical equipment and consumables, and through which suppliers (including NHS Supply Chain). NHSE makes this procurement data available to all trusts but relies on them to analyse the data and change their practices in response. Despite NHSE’s central role, it does not use this data to identify and generally challenge trusts as to why they do not purchase more using NHS Supply Chain. Instead, it told us it that, given its resources, it only challenges the trusts that are struggling most financially. In addition, NHSE does not analyse the data to identify what NHS Supply Chain could do differently to persuade trusts to use it more. It is disappointing that the information NHSE collects is also incomplete, as 55 trusts (out of more than 200) do not routinely provide this data. NHSE should work with trusts to improve the data available to it.

Recommendation 3: NHSE needs to use procurement data more systematically to challenge trusts to buy more consumables and medical equipment through NHS Supply Chain.

4. The way NHS Supply Chain has calculated and reported its savings has caused confusion and mistrust. NHS Supply Chain has used several different methods for calculating savings depending on the audience, for example, to government, trusts and suppliers. Each method gives a different result, risking clarity over how much NHS Supply Chain has actually saved. NHSE has shared with us NHS Supply Chain’s reported savings through two different methods. For the first, using the original method set by the Department, NHSE shared with us NHS Supply Chain’s reported savings of £3.3 billion from 2016–17 to 2022–23. For the second, using a method, which is more in line with trusts and does not re-count savings, NHSE shared reported savings of £1.7 billion over the same period. Trusts do not always recognise the savings that NHS Supply Chain reports, causing mistrust and frustration. NHS Supply Chain and NHSE have developed a new, more consistent, method for calculating savings, which is being rolled out across the NHS.

Recommendation 4: A year after implementing the new savings method, NHSE should assess whether trusts accept the savings that NHS Supply Chain reports. The new method for calculating savings should be used in all cases to ensure consistency.

5. It will be several years before the NHS sees the benefits from NHS Supply Chain’s efforts to improve its business. NHS Supply Chain’s main vehicle for improvement is a transformation programme which is expected to run from 2022–30. We are concerned that the risk to this transformation programme was rated red/amber in August 2023. NHS Supply Chain acknowledges the difficulties it faces in transforming its business. It told us that the seven projects it is running in 2023–24 to modernise the way it works are ‘exceptionally challenging’. NHS Supply Chain is also trying to improve its procurement route known as eDirect, which has had well-known problems since 2018. Most recently, between June 2022 and March 2023, NHS Supply Chain reported that on average more than one quarter (26.9%) of orders made through eDirect were delivered late, by an average of 22 days. It reports an improving picture with 8% of orders now 8 days late. However, NHS Supply Chain acknowledges that there will not be any further progress with eDirect in the next 12 months and estimates that improvements will take 18 months to appear once it has started the enhancement work. We were disappointed that no positive action appeared to be being taken to rectify the lack of warehousing in the South of England as a constraint on the business.

Recommendation 5: Alongside its Treasury Minute response, NHS Supply Chain should provide a clear and realistic road map setting out the timetable for transformation and modernisation and when benefits will materialise. In carrying out this exercise NHS Supply Chain should also examine whether the eight-year timetable should be reduced.

6. NHSE and NHS Supply Chain have not convinced clinicians that they value the quality of products above price. We are concerned that a focus on costs may impact on the quality of outcomes for patients. We can see the value in reducing unnecessary variation in the range of products that clinicians can choose, but this needs clinicians to be involved in those purchasing choices to make sure patient care is part of the value and cost considerations. Both NHS Supply Chain and NHSE consider that trusts and clinicians need to be free to make decisions about which products to buy in some instances and NHS Supply Chain contends that it offers an appropriate choice of products to trusts. While we find it reassuring that trusts have the freedom of choice over which products to buy, we are disappointed that there is no national leadership or analysis on which products lead to the best outcomes, other than for highly specialised equipment.

Recommendation 6: NHSE and NHS Supply Chain should set out how they will involve clinicians in purchasing choices to ensure that better patient care is considered alongside value and cost.

1 Increasing the use of NHS Supply Chain

1. On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), NHS England (NHSE) and NHS Supply Chain on NHS Supply Chain and efficiencies in procurement.2

2. The NHS collectively spends approximately £8 billion a year buying medical equipment and consumables, from gloves and paper to stents and prosthetic hips. Historically, both local trusts and national organisations have been responsible for buying such goods, with the balance shifting between the two over time. In 2016, the Carter report identified the scope for efficiencies through greater collaboration which would allow the NHS to aggregate its purchasing power, thus securing the best price.3

3. In 2017–18, the Department implemented a new operating model and delivery body for NHS procurement known as NHS Supply Chain. The new body was responsible for procuring products, warehousing and delivering consumables and medical equipment for the NHS. The new NHS Supply Chain model became fully operational in April 2019. Its key objectives were, by 2023–24, to deliver £2.4 billion of savings and achieve 80% of relevant NHS spending on medical equipment and consumables (known as ‘market share’) through NHS Supply Chain. It oversees a catalogue of more than 600,000 products and has an annual operating budget of £240 million for 2023–24. When it was originally set up, it was owned by the Department, but has been owned by NHSE since 2021.4

4. NHS Supply Chain is modernising its business through a transformation programme that is expected to run from 2022 to 2030. The programme focuses on reorganising NHS Supply Chain’s operating model to change the way it works with suppliers and replacing and upgrading key legacy IT systems. NHS Supply Chain estimates the cost of its transformation programme to be £144 million.5

The use of NHS Supply Chain by NHS trusts

5. In 2016, Lord Carter’s report found that there was considerable variation in the prices trusts paid for the same, or similar, products across several suppliers. In response, the Department set up NHS Supply Chain. By doing so, the Department aimed to create value for money by making the most of the tremendous buying power of the NHS. The original target for NHS Supply Chain was to have 80% of relevant NHS spending on medical equipment and consumables going through it by 2023–24. However as of September 2023 57% of relevant NHS spend went through NHS Supply Chain, against a revised target of 62%.6

6. We asked NHS Supply Chain how well the organisation was working, given that £3.4 billion of medical equipment and consumables is purchased outside of the organisation. NHS Supply Chain noted that there has been significant growth since 2018 when market share was approximately 30%. It explained that it does not want to grow too quickly as it has capacity constraints, particularly in the south of the country. NHS Supply Chain added that it needs to improve its infrastructure and modernise technology before it ‘moves to a utopian position in the future’. Given these constraints, and other operational reasons NHS Supply Chain maintained that it would be difficult to grow more quickly.7 We also asked NHS England and NHS Supply Chain what the savings would be if the NHS only used NHS Supply Chain. NHS Supply Chain estimated that, if trusts made greater use of NHS Supply chain using the existing contracts that are currently in place, they could save a further £60 million to £90 million by 2026.8

7. We asked NHS Supply Chain when it expected to reach 80% market share. NHS Supply Chain first told us that it would not be at 80% until it submitted its business case this summer to NHS England to seek the broader funding required to build the capacity. It described logistical challenges in the south, notably warehousing and having to find between 900,000 and 1.1 million square feet.9 When pushed on whether it could say when it might reach the 80%, NHS Supply Chain said it “would like to see it as soon as possible” but that it was subject to infrastructure requirements and technology modernisation and how fast those could happen. Then it would go through a business case approval process for funding. It said that “As a minimum this will take at least three years to do. As a maximum I would hope not much more than three years, but that is the reality.”10

8. NHS Trusts largely have the choice whether or not to purchase equipment and consumables through NHS Supply Chain. NHS Supply Chain must therefore gain trusts’ confidence in its services. It carries out a customer satisfaction survey to measure how satisfied customers are with its service. The survey shows that overall net customer satisfaction is in steady decline, from its peak of 67% in quarter two 2021–22 to 54% in quarter two 2023–24. NHS Supply Chain calculates overall net satisfaction by subtracting the percentage of customers who give a ‘low’ rating from the percentage who rate overall satisfaction as ‘high’.11 NHS Supply Chain has revised its overall net customer satisfaction target from 66% to 56% but is still failing to achieve this new lower target. We asked NHS Supply Chain why customer satisfaction is below target and declining. NHS Supply Chain recognised that there is a long list of things it needs do, which should improve services for its customers, and expects to see customer satisfaction start to improve. However, NHS Supply Chain explained that it does not expect to see significant improvement until it has completed the modernisation of its infrastructure and technology.12

Oversight of NHS Supply Chain

9. NHSE is the owner and shareholder of NHS Supply Chain, and as such, approves NHS Supply Chain’s annual business plan and funding requests. NHS Supply Chain reports its savings and other performance indicators to NHSE, but neither NHSE nor the Department validate or check the savings data. Instead, NHSE confirmed that it has relied on NHS Supply Chain to make these checks, which undermines the confidence we can have in the reported savings.13 NHSE has shared with us NHS Supply Chain’s reported savings, which shows a cumulative £3.3 billion total from 2016–17 to 2022–23.14

10. When the Department set up NHS Supply Chain, it did not make it mandatory for trusts to use it and trusts are free to buy consumables and medical equipment directly from suppliers or other supply organisations. There are several reasons why the Department did not mandate the use of NHS Supply Chain, including legal barriers. NHSE explained it cannot mandate that foundation trusts buy through NHS Supply Chain, and NHSE noted that it was a very deliberate decision for trusts to use it voluntarily. Instead, the Department wanted to make NHS Supply Chain so ‘overwhelmingly attractive’ that trusts would not choose to go elsewhere.15 NHSE has tried to support NHS Supply Chain and increase trusts’ use of it, for example NHSE has not specifically mandated that all trusts buy all large diagnostic equipment through Supply Chain however, trusts must buy some specific specialised high value products through NHS Supply Chain.16

11. NHS Supply Chain recognises it needs to provide a better service to trusts, and increase trusts’ use of NHS Supply Chain, and has a programme of planned improvements that aim to transform and modernise the business.17 However, NHS Supply Chain considers that it needs NHSE’s support for this to be successful. NHS Supply Chain requested a £252 million revenue budget for 2023–24 to operate the organisation and implement its transformation projects for the year. NHSE did not approve the full amount requested but instead provided £240 million. We asked NHSE why it did not give NHS Supply Chain the full amount of funding requested. NHSE initially acknowledged that this shortfall would delay a new IT system but explained that there are a lot of calls on NHS funding and it has sought to get the balance right between other competing priorities and giving sufficient resource to NHS Supply Chain. It told us that, working with NHS Supply Chain it considers it has found a way to still target the original savings target of £500 million by 2026–27.18

NHSE’s role in challenging trusts use of NHS Supply Chain

12. Trusts submit data to NHSE on how much they spend on medical equipment and consumables, and through which suppliers (including NHS Supply Chain). NHSE makes this procurement data available to all trusts, but relies on them to analyse the data and change their practices in response. Despite its central role, NHSE does not use this data itself to identify and generally challenge trusts as to why they do not purchase more using NHS Supply Chain.19

13. We asked NHSE why it does not do more to understand the reasons trusts purchase through routes other than NHS Supply Chain. NHS told us that, given the resources it has, it only challenges the trusts that are struggling the most financially. NHSE explained, for those trusts struggling the most financially, they could be put under ‘legal undertakings’, and NHSE can require them to use NHS Supply Chain. NHSE does, however, make data available to all trusts so they can work out themselves where they can get better value for money. NHSE does not analyse the data to identify what NHS Supply Chain could do differently to persuade trusts to use it more.20

14. The data NHSE collects is incomplete, as 55 trusts (out of more than 200) do not routinely provide this data. When we asked NHSE about the completeness of the data, NHSE told us it is working with trusts that are not routinely submitting and considering what other actions and levers it might have available to require people to submit in a timely fashion. It confirmed that one consequence of incomplete returns is that it has to make an estimate of the value of potential procurement savings and recognised that there is more it can do to improve the quality of data.21

2 Improving the business for the future

NHS Supply Chain’s transformation programme

15. NHS Supply Chain recognises that it needs to make considerable improvements to its business if it is to give trusts a better service. While it has a programme of planned improvements, it will be several years before the NHS sees the benefits from these plans and starts to use NHS Supply Chain more as a result.22

16. NHS Supply Chain has started a transformation programme which aims to bring key improvements to the business. This programme runs from 2022–30 and its focus includes replacing or upgrading legacy IT and improving inventory management and supply chain capacity.23 The transformation programme was rated red/amber by NHS Supply Chain in its risk register as at August 2023, recognising the complex delivery challenges involved.24 NHS Supply Chain acknowledged the difficulties with transformation, in particular how to modernise while continuing to run the day-to-day business. It told us about the seven ‘cornerstone’ projects happening this year which it described as ‘incredibly challenging’ and outlined the challenges of moving from old technology to new. More positively, it noted good progress with a new warehouse near Gorsey Point which it expects will resolve capacity problems in the North.25 It did however confirm it will be unable to achieve 80% market share until it has procured more warehousing space in the South of England, along with technology modernisation, and that will take at least three years.26

17. There are some weaknesses and strengths in how NHS Supply Chain is managing the transformation programme. Most notably, there are questions about the capacity and resilience of NHS Supply Chain to deliver the necessary change, particularly in light of the heavy reliance on the Chief Executive Officer for NHS Supply Chain and delays in getting the appropriate approvals for recruiting a chief delivery officer.27 NHSE acknowledged that the process has taken longer than it would want and that the necessary approval currently was ‘sitting between’ NHSE and the Department. The Department informed us that it is working with NHSE to streamline the approvals process.28

18. NHS Supply Chain is also trying to improve its procurement route known as eDirect, which has had well-known problems since 2018. Some £1.5 billion of orders came through this channel in 2022–23.29 NHS Supply Chain acknowledged that from a trust’s perspective, while eDirect is working as it was designed, it is no longer what is needed to match the technology in some hospitals. NHS Supply Chain will therefore have to modernise at the same pace as NHS trusts are modernising their technology.30 NHS Supply Chain reported that, over the period from June 2022 to March 2023, on average more than one quarter (26.9%) of orders made through eDirect were delivered late, by an average of 22 days.31 NHS Supply Chain reported that there had been further improvements since, with 8% of orders now eight days late. It is aware that there is still some way to go and that, further improvements will be slow to materialise. It told us that there will not be any further progress with eDirect in the next 12 months when it can put in place a new service provider and start to replace the old technology. From then, it estimates that improvements will take 18 months to appear.32

Reporting savings

19. NHS Supply Chain has in the past used multiple methods to calculate and report its savings depending on its audience, for example, to government, trusts and suppliers. Each method gives a different result, risking clarity over how much NHS Supply Chain has actually saved. The method for calculating savings reported to government re-counted its savings from previous years. Separately, to show the savings trusts made individually, NHS Supply Chain calculated in-year savings for each trust, using prices paid the previous year as the baseline. The NAO report noted the mistrust and frustration caused by the differences in how NHS Supply Chain and trusts calculate savings.33

20. NHSE considers that the NHS Supply Chain has delivered real savings and that the method to show its savings against its original target to save £2.4 billion by 2023–24 is clear.34 NHSE shared with us figures setting out NHS Supply Chain’s reported savings through two different methods. For the first, using the original method set by the Department, NHSE shared with us NHS Supply Chain’s reported savings of £3.3 billion from 2016–17 to 2022–23. For the second, using a method which is more in line with trusts and does not re-count savings, NHSE shared reported savings of £1.7 billion over the same period.35

21. NHSE, NHS Supply Chain and stakeholders including NHS trusts have developed a new way to calculate savings which will be aligned with a savings methodology it has rolled out across the whole of commercial in the NHS. NHSE told us that this method will mean that trusts are all going to be looking at their savings, calculating their savings and inputting them into the system consistently.36

Balancing cost with good outcomes for patients

22. Both NHS Supply Chain and NHS England told us that trusts and clinicians need to be free to make decisions about which products to buy in some instances and NHS Supply Chain maintained that it offers an appropriate choice of products to trusts. However, there is a risk of tensions and disconnect between cost, clinical choice and patient care and there is no organisation with clear responsibility for managing that disconnect.37 NHS Supply Chain told us that its role is to ensure it always has products available that are safe for use by clinicians but that it does not monitor the use of products by trusts.38 NHSE considered that the choice of product was for local rather than national leadership.39

23. NHSE described how it has established an evidence base for which specialised products are best to use (formerly known as high cost tariff excluded devices and now known as the Specialised Services Devices Programme). NHSE explained in written evidence that products purchased through this route are effectively free to trusts, with any consequent savings being available for spending elsewhere in the NHS. The resulting financial incentive for the trust is to purchase the ‘free’ device, creating the potentially perverse incentive of local financial incentives being in tension with local clinical preference or clinical judgement and not therefore always in the best interests of patients.40

24. NHSE acknowledged that it does not direct or constrain local decision-making or monitor the use of, or outcomes from use of, a product. As a result, while trusts have the freedom of choice over which products to buy, there is no national leadership or analysis on which products lead to the best outcomes, other than for highly specialised equipment.41 NHS Supply Chain has recently appointed a clinical director but NHSE has not yet appointed a position giving national clinical leadership that can get clinicians to follow agreed national category strategies, as requested by NHS Supply Chain in December 2022.42

25. The Urology Trade Association told us in written evidence that it was concerned that the current focus by NHS procurement on acquisition costs alone is failing to acknowledge the importance of value for money across the whole patient pathway, and that lowest price does not always translate to best value for patients.43 The Medical Technology Group (MTG) argued that the overall value of products is often overlooked by NHS Supply Chain compared to the costs of the initial procurement of the product. It noted that medical devices could provide the NHS with longer-term savings, as well as providing patients with better outcomes, which has a positive impact on patient lives and the economy as well as reducing engagement with health and care services. MTG recommended increased efforts within NHS Supply Chain to develop and deliver ‘Value-Based Procurement models’, capturing the whole system savings necessary for the NHS.44

Formal minutes

Wednesday 20 March 2024

Members present

Dame Meg Hillier, in the Chair

Paula Barker

Peter Grant

Mr Mark Francois

Ben Lake

Anne Marie Morris

Matt Warman

Declaration of interests

The following declarations of interest relating to the inquiry was made:

7 February 2024

Anne Marie Morris declared the following interest: Chair of the All-Party Parliamentary Group on Access to Medicines and Medical Devices.

NHS Supply Chain and efficiencies in procurement

Draft Report (NHS Supply Chain and efficiencies in procurement), proposed by the Chair, brought up and read.

Ordered, That the draft Report be read a second time, paragraph by paragraph.

Paragraphs 1 to 25 read and agreed to.

Summary agreed to.

Introduction agreed to.

Conclusions and recommendations agreed to.

Resolved, That the Report be the Twenty-fourth Report of the Committee to the House.

Ordered, That the Chair make the Report to the House.

Ordered, That embargoed copies of the Report be made available (Standing Order No. 134).

Adjournment

Adjourned till Monday 25 March at 3.30 p.m.


Witnesses

The following witnesses gave evidence. Transcripts can be viewed on the inquiry publications page of the Committee’s website.

Wednesday 7 February 2024

Shona Dunn, Second Permanent Secretary, Department of Health and Social Care; Amanda Pritchard, CEO, NHS England; Jacqui Rock, Chief Commercial Officer, NHS England; Julian Kelly, Chief Financial Officer, NHS England; Andrew New, CEO, NHS Supply ChainQ1–126


Published written evidence

The following written evidence was received and can be viewed on the inquiry publications page of the Committee’s website.

NHS numbers are generated by the evidence processing system and so may not be complete.

1 Association of British HealthTech Industries (NHS0003)

2 British Healthcare Trades Association (BHTA) (NHS0008)

3 CMR Surgical Ltd (NHS0004)

4 Cook, Mr Nigel (NHS0009)

5 Essity (NHS0006)

6 Sanchez-Graells, Professor Albert (Professor of Economic Law, University of Bristol Law School) (NHS0001)

7 Smith, Chris (NHS0002)

8 The Health Tech Alliance (NHS0011)

9 The Medical Technology Group (NHS0007)

10 Urology Trade Association (NHS0005)


List of Reports from the Committee during the current Parliament

All publications from the Committee are available on the publications page of the Committee’s website.

Session 2023–24

Number

Title

Reference

1st

The New Hospital Programme

HC 77

2nd

The condition of school buildings

HC 78

3rd

Revising health assessments for disability benefits

HC 79

4th

The Department for Work & Pensions Annual Report and Accounts 2022–23

HC 290

5th

Government’s programme of waste reforms

HC 333

6th

Competition in public procurement

HC 385

7th

Resilience to flooding

HC 71

8th

Improving Defence Inventory Management

HC 66

9th

Whole of Government Accounts 2020–21

HC 65

10th

HS2 and Euston

HC 67

11th

Reducing the harm from illegal drugs

HC 72

12th

Cross-government working

HC 75

13th

Preparedness for online safety regulation

HC 73

14th

Homes for Ukraine

HC 69

15th

Managing government borrowing

HC 74

16th

HMRC performance in 2022–23

HC 76

17th

Cabinet Office functional savings

HC 423

18th

Excess Votes 2022–23

HC 589

19th

MoD Equipment Plan 2023–2033

HC 451

20th

Monitoring and responding to companies in distress

HC 425

21st

Levelling up funding to local government

HC 424

22nd

Reforming adult social care in England

HC 427

23rd

Civil service workforce: Recruitment, pay and performance management

HC 452

Session 2022–23

Number

Title

Reference

1st

Department for Business, Energy & Industrial Strategy Annual Report and Accounts 2020–21

HC 59

2nd

Lessons from implementing IR35 reforms

HC 60

3rd

The future of the Advanced Gas-cooled Reactors

HC 118

4th

Use of evaluation and modelling in government

HC 254

5th

Local economic growth

HC 252

6th

Department of Health and Social Care 2020–21 Annual Report and Accounts

HC 253

7th

Armoured Vehicles: the Ajax programme

HC 259

8th

Financial sustainability of the higher education sector in England

HC 257

9th

Child Maintenance

HC 255

10th

Restoration and Renewal of Parliament

HC 49

11th

The rollout of the COVID-19 vaccine programme in England

HC 258

12th

Management of PPE contracts

HC 260

13th

Secure training centres and secure schools

HC 30

14th

Investigation into the British Steel Pension Scheme

HC 251

15th

The Police Uplift Programme

HC 261

16th

Managing cross-border travel during the COVID-19 pandemic

HC 29

17th

Government’s contracts with Randox Laboratories Ltd

HC 28

18th

Government actions to combat waste crime

HC 33

19th

Regulating after EU Exit

HC 32

20th

Whole of Government Accounts 2019–20

HC 31

21st

Transforming electronic monitoring services

HC 34

22nd

Tackling local air quality breaches

HC 37

23rd

Measuring and reporting public sector greenhouse gas emissions

HC 39

24th

Redevelopment of Defra’s animal health infrastructure

HC 42

25th

Regulation of energy suppliers

HC 41

26th

The Department for Work and Pensions’ Accounts 2021–22 – Fraud and error in the benefits system

HC 44

27th

Evaluating innovation projects in children’s social care

HC 38

28th

Improving the Accounting Officer Assessment process

HC 43

29th

The Affordable Homes Programme since 2015

HC 684

30th

Developing workforce skills for a strong economy

HC 685

31st

Managing central government property

HC 48

32nd

Grassroots participation in sport and physical activity

HC 46

33rd

HMRC performance in 2021–22

HC 686

34th

The Creation of the UK Infrastructure Bank

HC 45

35th

Introducing Integrated Care Systems

HC 47

36th

The Defence digital strategy

HC 727

37th

Support for vulnerable adolescents

HC 730

38th

Managing NHS backlogs and waiting times in England

HC 729

39th

Excess Votes 2021–22

HC 1132

40th

COVID employment support schemes

HC 810

41st

Driving licence backlogs at the DVLA

HC 735

42nd

The Restart Scheme for long-term unemployed people

HC 733

43rd

Progress combatting fraud

HC 40

44th

The Digital Services Tax

HC 732

45th

Department for Business, Energy & Industrial Strategy Annual Report and Accounts 2021–22

HC 1254

46th

BBC Digital

HC 736

47th

Investigation into the UK Passport Office

HC 738

48th

MoD Equipment Plan 2022–2032

HC 731

49th

Managing tax compliance following the pandemic

HC 739

50th

Government Shared Services

HC 734

51st

Tackling Defra’s ageing digital services

HC 737

52nd

Restoration & Renewal of the Palace of Westminster – 2023 Recall

HC 1021

53rd

The performance of UK Security Vetting

HC 994

54th

Alcohol treatment services

HC 1001

55th

Education recovery in schools in England

HC 998

56th

Supporting investment into the UK

HC 996

57th

AEA Technology Pension Case

HC 1005

58th

Energy bills support

HC 1074

59th

Decarbonising the power sector

HC 1003

60th

Timeliness of local auditor reporting

HC 995

61st

Progress on the courts and tribunals reform programme

HC 1002

62nd

Department of Health and Social Care 2021–22 Annual Report and Accounts

HC 997

63rd

HS2 Euston

HC 1004

64th

The Emergency Services Network

HC 1006

65th

Progress in improving NHS mental health services

HC 1000

66th

PPE Medpro: awarding of contracts during the pandemic

HC 1590

67th

Child Trust Funds

HC 1231

68th

Local authority administered COVID support schemes in England

HC 1234

69th

Tackling fraud and corruption against government

HC 1230

70th

Digital transformation in government: addressing the barriers to efficiency

HC 1229

71st

Resetting government programmes

HC 1231

72nd

Update on the rollout of smart meters

HC 1332

73rd

Access to urgent and emergency care

HC 1336

74th

Bulb Energy

HC 1232

75th

Active travel in England

HC 1335

76th

The Asylum Transformation Programme

HC 1334

77th

Supported housing

HC 1330

78th

Resettlement support for prison leavers

HC 1329

79th

Support for innovation to deliver net zero

HC 1331

80th

Progress with Making Tax Digital

HC 1333

1st Special Report

Sixth Annual Report of the Chair of the Committee of Public Accounts

HC 50

2nd Special Report

Seventh Annual Report of the Chair of the Committee of Public Accounts

HC 1055

Session 2021–22

Number

Title

Reference

1st

Low emission cars

HC 186

2nd

BBC strategic financial management

HC 187

3rd

COVID-19: Support for children’s education

HC 240

4th

COVID-19: Local government finance

HC 239

5th

COVID-19: Government Support for Charities

HC 250

6th

Public Sector Pensions

HC 289

7th

Adult Social Care Markets

HC 252

8th

COVID 19: Culture Recovery Fund

HC 340

9th

Fraud and Error

HC 253

10th

Overview of the English rail system

HC 170

11th

Local auditor reporting on local government in England

HC 171

12th

COVID 19: Cost Tracker Update

HC 173

13th

Initial lessons from the government’s response to the COVID-19 pandemic

HC 175

14th

Windrush Compensation Scheme

HC 174

15th

DWP Employment support

HC 177

16th

Principles of effective regulation

HC 176

17th

High Speed 2: Progress at Summer 2021

HC 329

18th

Government’s delivery through arm’s-length bodies

HC 181

19th

Protecting consumers from unsafe products

HC 180

20th

Optimising the defence estate

HC 179

21st

School Funding

HC 183

22nd

Improving the performance of major defence equipment contracts

HC 185

23rd

Test and Trace update

HC 182

24th

Crossrail: A progress update

HC 184

25th

The Department for Work and Pensions’ Accounts 2020–21 – Fraud and error in the benefits system

HC 633

26th

Lessons from Greensill Capital: accreditation to business support schemes

HC 169

27th

Green Homes Grant Voucher Scheme

HC 635

28th

Efficiency in government

HC 636

29th

The National Law Enforcement Data Programme

HC 638

30th

Challenges in implementing digital change

HC 637

31st

Environmental Land Management Scheme

HC 639

32nd

Delivering gigabitcapable broadband

HC 743

33rd

Underpayments of the State Pension

HC 654

34th

Local Government Finance System: Overview and Challenges

HC 646

35th

The pharmacy early payment and salary advance schemes in the NHS

HC 745

36th

EU Exit: UK Border post transition

HC 746

37th

HMRC Performance in 2020–21

HC 641

38th

COVID-19 cost tracker update

HC 640

39th

DWP Employment Support: Kickstart Scheme

HC 655

40th

Excess votes 2020–21: Serious Fraud Office

HC 1099

41st

Achieving Net Zero: Follow up

HC 642

42nd

Financial sustainability of schools in England

HC 650

43rd

Reducing the backlog in criminal courts

HC 643

44th

NHS backlogs and waiting times in England

HC 747

45th

Progress with trade negotiations

HC 993

46th

Government preparedness for the COVID-19 pandemic: lessons for government on risk

HC 952

47th

Academies Sector Annual Report and Accounts 2019/20

HC 994

48th

HMRC’s management of tax debt

HC 953

49th

Regulation of private renting

HC 996

50th

Bounce Back Loans Scheme: Follow-up

HC 951

51st

Improving outcomes for women in the criminal justice system

HC 997

52nd

Ministry of Defence Equipment Plan 2021–31

HC 1164

1st Special Report

Fifth Annual Report of the Chair of the Committee of Public Accounts

HC 222

Session 2019–21

Number

Title

Reference

1st

Support for children with special educational needs and disabilities

HC 85

2nd

Defence Nuclear Infrastructure

HC 86

3rd

High Speed 2: Spring 2020 Update

HC 84

4th

EU Exit: Get ready for Brexit Campaign

HC 131

5th

University technical colleges

HC 87

6th

Excess votes 2018–19

HC 243

7th

Gambling regulation: problem gambling and protecting vulnerable people

HC 134

8th

NHS capital expenditure and financial management

HC 344

9th

Water supply and demand management

HC 378

10th

Defence capability and the Equipment Plan

HC 247

11th

Local authority investment in commercial property

HC 312

12th

Management of tax reliefs

HC 379

13th

Whole of Government Response to COVID-19

HC 404

14th

Readying the NHS and social care for the COVID-19 peak

HC 405

15th

Improving the prison estate

HC 244

16th

Progress in remediating dangerous cladding

HC 406

17th

Immigration enforcement

HC 407

18th

NHS nursing workforce

HC 408

19th

Restoration and renewal of the Palace of Westminster

HC 549

20th

Tackling the tax gap

HC 650

21st

Government support for UK exporters

HC 679

22nd

Digital transformation in the NHS

HC 680

23rd

Delivering carrier strike

HC 684

24th

Selecting towns for the Towns Fund

HC 651

25th

Asylum accommodation and support transformation programme

HC 683

26th

Department of Work and Pensions Accounts 2019–20

HC 681

27th

Covid-19: Supply of ventilators

HC 685

28th

The Nuclear Decommissioning Authority’s management of the Magnox contract

HC 653

29th

Whitehall preparations for EU Exit

HC 682

30th

The production and distribution of cash

HC 654

31st

Starter Homes

HC 88

32nd

Specialist Skills in the civil service

HC 686

33rd

Covid-19: Bounce Back Loan Scheme

HC 687

34th

Covid-19: Support for jobs

HC 920

35th

Improving Broadband

HC 688

36th

HMRC performance 2019–20

HC 690

37th

Whole of Government Accounts 2018–19

HC 655

38th

Managing colleges’ financial sustainability

HC 692

39th

Lessons from major projects and programmes

HC 694

40th

Achieving government’s long-term environmental goals

HC 927

41st

COVID 19: the free school meals voucher scheme

HC 689

42nd

COVID-19: Government procurement and supply of Personal Protective Equipment

HC 928

43rd

COVID-19: Planning for a vaccine Part 1

HC 930

44th

Excess Votes 2019–20

HC 1205

45th

Managing flood risk

HC 931

46th

Achieving Net Zero

HC 935

47th

COVID-19: Test, track and trace (part 1)

HC 932

48th

Digital Services at the Border

HC 936

49th

COVID-19: housing people sleeping rough

HC 934

50th

Defence Equipment Plan 2020–2030

HC 693

51st

Managing the expiry of PFI contracts

HC 1114

52nd

Key challenges facing the Ministry of Justice

HC 1190

53rd

Covid 19: supporting the vulnerable during lockdown

HC 938

54th

Improving single living accommodation for service personnel

HC 940

55th

Environmental tax measures

HC 937

56th

Industrial Strategy Challenge Fund

HC 941


Footnotes

1 Q 17

2 C&AG’s Report, NHS Supply Chain and efficiencies in procurement, Session 2023–24, HC 390, 12 January 2024

3 C&AG’s Report, para 1

4 C&AG’s Report, paras 2–3

5 C&AG’s Report, paras 19, 3.6–3.7

6 C&AG’s Report, paras 1.3–1.5, 2.11

7 Q 23

8 Qq 19–20; C&AG’s Report, Figure 11

9 Qq 119–124

10 Q 126

11 C&AG’s Report, paras 16, 2.17

12 Q 96

13 Q 116; C&AG’s Report, paras 1.9, 2.5

14 Correspondence from NHSE to the Public Accounts Committee, 15 February 2024.

15 Q 17; C&AG’s Report para 6

16 C&AG’s Report, Figure 12

17 Q 64; C&AG’s Report, para 3.3

18 Q113; C&AG’s Report, paras 3.8–3.9

19 Qq 72–73; C&AG’s Report, para 15

20 Qq 72–75; C&AG’s Report, para 2.13

21 Qq 76–79

22 Q 126

23 Q 64; C&AG’s Report, paras 3.3–3.5

24 Q 64; C&AG’s Report, Figure 10

25 Q 64

26 Qq 119–126

27 Qq 105–106; C&AG’s Report, Figure 13

28 Q 106

29 C&AG’s Report, para 2.21

30 Q 100

31 C&AG’s Report, para 2.21

32 Qq 27, 101–104

33 Q 83; C&AG’s Report, para 2.7

34 Q 83

35 Correspondence from NHSE to the Public Accounts Committee, 15 February 2024

36 Q 82; C&AG’s Report, para 2.9

37 Qq 28, 53–62

38 Qq 53–54

39 Qq 55–56

40 Qq 59–60, 107; Correspondence from NHSE to the Public Accounts Committee, 15 February 2024

41 Qq 53–58

42 Q 107; C&AG’s Report, Figure 12

43 NHS0005

44 NHS0007