Scrutiny of NHS spending and plans

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Earlier this month the Parliamentary Public Accounts Committee published a critical report on NHS financial sustainability and the NHS Long Term Plan, following evidence from NHS England, NHS Improvement, the Department of Health and Social Care (DHSC) and others.

Highlighting the significant disparities in financial performance of individual trusts and CCGs, they were not convinced that funding is reaching the right parts of the system. They further concluded that The NHS will not be able to deliver on the Long Term Plan unless it addresses staffing shortages. The Committee’s report also notes that the long-term funding settlement for the NHS was not accompanied by funding announcements for capital, social care, public health and education and training. They go on to point out that despite the uncertainty in funding for these areas, sustainability and transformation partnerships (STPs) and integrated care systems (ICS) have been asked to develop five-year plans by autumn 2019, to show how the priorities of NHS Long Term Plan will be delivered locally.

They have asked that DHSC write to the Committee by July 2019, setting out how issues with the recruitment and retention of NHS staff will be addressed and reflected in the workforce strategy. They further ask that when reporting back, DHSC, along with NHS England and NHS Improvement, clarify the assumptions that STPs and ICSs need to be working to while developing their long-term plans. These include the assumptions on capital, social care, education and training, and public health funding.

Further information is requested by September 2019, setting out how they will: help local bodies better understand the demand for services, what is driving that demand and how demand could be better met; ensure that a better understanding of how demand is reflected in resource allocation; and ensure that activity plans of local bodies are realistic and take account of the needs of patients.

Interestingly, they note that “STPs are designed to bring together CCGs, trusts and local authorities, to plan and address local challenges in their area.” With no reference to primary care providers or general practice.

Londonwide LMCs’ concerns

As advised last month, Londonwide LMCs also has concerns regarding the implementation of the NHS Long Term Plan, and some of the legislative changes proposed by NHS England in order to deliver the Plan.

We have submitted comments to the Parliamentary Health and Social Care Select Committee, which is currently considering NHS England’s proposed changes to the Health and Social Care Act, including the competition rules affecting CCGs, who can sit on their boards and how closely they can work with trusts. Our formal comments to the NHS England online consultation echo these concerns.

NHS England’s consultation closes on 25 April. If you decide to comment we would be grateful if you could share a copy with us at

The key points from Londonwide LMCs’ summary response can be seen here.

Last updated : 12 Apr 2019