An NHS spokesperson said: “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."
Background
NHS “complacency” on productivity
- The NHS is far from complacent about productivity. We
regularly discuss the challenges with productivity at our board
meetings, including at our most recent December board meeting.
- Examples of where we have been open about productivity
include:
Community shift stalling
- NHS investment in primary medical care and community services
increased faster than overall ICB spend in 2023/24.
- The NHS continues to improve mental health services in the
community. In 2023/24 the NHS increased investment in mental
health by £1.3bn compared to 2022/23, and saw 425k adults in
transformed MH community services, exceeding the annual target of
370k.
Earlier allocations
- It is incorrect to suggest it is within NHS' power to avoid
delays to budgets. As Kelly said during his PAC
appearance, “we clearly try to give early informal indications
of what people should be expecting, but we actually need to
know what our budget is in order to be able to give a budget.”
- NHS England's publication of annual priorities and planning
guidance for the NHS, alongside ICB financial allocations, is
subject to cross government clearance.
- NHSE publishes the guidance as soon as clearance is granted,
and in recent years this has happened the very same day.
Tech spend falling
- NHS England and DHSC consistently prioritise resources to
support patients and frontline services – however, it is not
accurate to say spending adjustments were made specifically to
mitigate ICB's spending deficits - decisions were made on a range
of factors and to support various priorities, including staff pay
deals.
- While we accept there is much further to go on technology -
we have made real progress in improving our digital offering to
patients and digitising the NHS itself. For example - patients at
95% of GP surgeries in England can use all the features of the
NHS App and over 92% of practices allow patients to use the app
to register.
NHSE's payment mechanisms can mean that local systems do
not receive financial recognition when they prioritise
hard-to-reach patients.
- NHS allocations for primary care are adjusted to reflect
their deprivation, so areas with more deprived groups get
additional funding to support outreach. ICB allocations are also
increased for deprivation to help tackle health inequalities.
- NHS investment in lung scans is benefitting deprived
populations most - the Targeted Lung Health Check programme,
which seeks to diagnose lung cancer at an early stage has now
invited nearly 30% of the eligible population. The Rapid Cancer
Registration Dataset shows that people from disadvantaged
backgrounds are now most likely to be diagnosed with lung cancer
at an early stage when it is more treatable.
- The NHS is investing in early intervention in mental health:
Half of pupils in England will have access to Mental Health
Support Teams as of Spring 2025 - exceeding the original
commitment to cover 20%-25% of the country.
