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DHSC Group Accounting Manual Updates

The Department of Health and Social Care is updating its group accounting manual to improve financial reporting and transparency in its annual accounts. The Treasury and Parliament have raised concerns that DHSC accounts lack sufficient detail on long-term financial pressures, particularly regarding social care liabilities, pension obligations, and clinical negligence provisions. The department is working with HM Treasury and the Government Actuary's Department to refine discounting methodologies and enhance narrative disclosure of health and social care system finances.

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Family: Scrutiny and evidence

2026

1 event
4 Mar 2026 | Committee report linked

We asked the Treasury to explain why undiscounted information had not been provided for all major liabilities in the WGA 2023–24 despite being asked to. The Treasury stated that it is considering extending this approach to pensions and clinical negligence however noted that the methodology is more complex, particularly for pension liabilities, but confirmed that it was consulting with the Government Actuary’s Department on the most appropriate approach to discounting future liabilities for in...

We asked the Treasury to explain why undiscounted information had not been provided for all major liabilities in the WGA 2023–24 despite being asked to. The Treasury stated that it is considering extending this approach to pensions and clinical negligence …

▤ View document · ↗ GOV.UK

2025

9 events
14 May 2025 | Committee report linked

The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services and do not give a clear overarching narrative on social care. The Department’s accounts contain very little information in key areas of interest to us, and to Parliament. This includes a lack of financial data on...

The Department’s accounts do not provide sufficient information on key long–term financial pressures facing the health and social care system. Despite it being jointly responsible for health and social care in England, the Department’s accounts overwhelmingly focus on health services …

▤ View document · ↗ GOV.UK
19 Mar 2025 | Committee report linked

The Treasury has made some improvements to the accessibility of WGA and the information it contains, but there is still more work to do. We recognise the efforts the Treasury has made to make the WGA more accessible. These measures include additional disclosure within the annual report, a new accounting spotlight section that addresses key areas such as consolidation, new accounting standards and discount rates, alongside teach–in sessions delivered as part of the new MP induction programme. ...

The Treasury has made some improvements to the accessibility of WGA and the information it contains, but there is still more work to do. We recognise the efforts the Treasury has made to make the WGA more accessible. These measures …

▤ View document · ↗ GOV.UK
19 Mar 2025 | Committee report linked

The impact of discount rate changes is obscuring the ability to identify meaningful trends in large public sector financial liabilities within the WGA. The discount rate is the rate of return used to discount future cash flows when calculating a liability’s present value. The WGA includes several large liabilities which are heavily impacted by changes in the discount rate. For example, the provision in WGA for future decommissioning of nuclear facilities decreased by £126.2 billion from £273....

The impact of discount rate changes is obscuring the ability to identify meaningful trends in large public sector financial liabilities within the WGA. The discount rate is the rate of return used to discount future cash flows when calculating a …

▤ View document · ↗ GOV.UK
19 Mar 2025 | Committee report linked

In the 2022–23 WGA, the Treasury has added new sections to the performance report, improving the quality and accessibility of reporting in the accounts.45 These include new accounting spotlight sections that address key areas such as consolidation, new accounting standards and discount rates.46 Another section added this year is the ‘year at a glance’, where the WGA highlights some examples of spend in the year, such as £1.84 billion committed to the European Space Agency and £2.6 billion pro...

In the 2022–23 WGA, the Treasury has added new sections to the performance report, improving the quality and accessibility of reporting in the accounts.45 These include new accounting spotlight sections that address key areas such as consolidation, new accounting standards …

▤ View document · ↗ GOV.UK
19 Mar 2025 | Committee report linked

We asked the Treasury how it would resolve information on given topics, such as pensions, being dispersed across the accounts. It replied that, whilst the notes and accounts are prepared in line with International Financial Reporting Standards (IFRS) and therefore have a prescribed format, it can bring information together in the performance report in future.48 We also questioned the Treasury on several areas of interest, such as liabilities to the EU, which we found lacked sufficient explana...

We asked the Treasury how it would resolve information on given topics, such as pensions, being dispersed across the accounts. It replied that, whilst the notes and accounts are prepared in line with International Financial Reporting Standards (IFRS) and therefore …

▤ View document · ↗ GOV.UK
26 Feb 2025 | Committee report linked

The Department’s Accounting Officer wrote to the Public Accounts Committee on 28 January 2025, setting out further detail behind the excess and the Comptroller & Auditor General’s qualification of his audit opinion on the Department’s 2023–24 Annual Report and Accounts.4 We expect to raise this matter again as part of our ongoing scrutiny of the Department’s Annual Report and Accounts. 4 Letter from Department for Business and Trade to PAC dated 18 January 2025 8

The Department’s Accounting Officer wrote to the Public Accounts Committee on 28 January 2025, setting out further detail behind the excess and the Comptroller & Auditor General’s qualification of his audit opinion on the Department’s 2023–24 Annual Report and Accounts.4 …

▤ View document · ↗ GOV.UK
29 Jan 2025 | Committee report linked

On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (DHSC), NHS England (NHSE), and HM Treasury (HMT) on the financial management and financial sustainability of the NHS in England.1

On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (DHSC), NHS England (NHSE), and HM Treasury (HMT) on the financial management and financial sustainability of the …

▤ View document · ↗ GOV.UK

2024

29 events
10 May 2024 | Committee report linked

The Department’s continued failure to deliver its accounts to an earlier timetable hampers effective and timely accountability of taxpayers’ money. Weaknesses in basic financial accounting at UKHSA, together with delays in the completion of local NHS audits, and a lack of resilience in the local audit market, meant the Department could not publish its 2022–23 group accounts until 25 January 2024, 10 months after the financial year-end. The Department set a deadline of 30 June 2023 for the com...

The Department’s continued failure to deliver its accounts to an earlier timetable hampers effective and timely accountability of taxpayers’ money. Weaknesses in basic financial accounting at UKHSA, together with delays in the completion of local NHS audits, and a lack …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We are disappointed that the Department lacks adequate controls over its inventory and, four years after the COVID-19 pandemic began, still does not have a plan for stockpiling for future pandemics. The Department does not know how much inventory it currently holds as it did not undertake inventory counting Department of Health and Social Care2022–23 Annual Report and Accounts 7 procedures for its 2022–23 accounts. The Department plans to dispose of COVID-19 inventory that it considers unusab...

We are disappointed that the Department lacks adequate controls over its inventory and, four years after the COVID-19 pandemic began, still does not have a plan for stockpiling for future pandemics. The Department does not know how much inventory it …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

On the basis of a report by the Comptroller and Auditor General (C&AG)2, we took evidence from the Department of Health and Social Care (the Department), the UK Health Security Agency (UKHSA) and NHS England on the Department’s Annual Report and Accounts for 2022–23.

On the basis of a report by the Comptroller and Auditor General (C&AG)2, we took evidence from the Department of Health and Social Care (the Department), the UK Health Security Agency (UKHSA) and NHS England on the Department’s Annual Report …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

As part of our examination of the Department’s 2021–22 accounts, we recommended that UKHSA should urgently ensure that it had in place robust financial controls and processes and there was a clear plan to deliver unqualified accounts. Government agreed with our recommendation, and in its response told us the UKHSA was working to urgently improve and strengthen its existing financial control, to evidence compliance with government functional standards and best practice. It explained that UKHSA...

As part of our examination of the Department’s 2021–22 accounts, we recommended that UKHSA should urgently ensure that it had in place robust financial controls and processes and there was a clear plan to deliver unqualified accounts. Government agreed with …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We asked UKHSA whether it had sufficient organisational understanding and acceptance of the level of cultural change and process improvement required to fix these issues with its accounts. UKHSA responded that it understood and accepted this. It drew a distinction between the issues which had resulted in its 2022–23 accounts being disclaimed, and those which had resulted in its 2021–22 accounts being disclaimed, which it asserted were “quite different”. It stressed that, in 2021–22, it was a ...

We asked UKHSA whether it had sufficient organisational understanding and acceptance of the level of cultural change and process improvement required to fix these issues with its accounts. UKHSA responded that it understood and accepted this. It drew a distinction …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

The C&AG confirmed that UKHSA had introduced “quite a lot of important governance arrangements” following its 2021–22 accounts, and that it had made progress on being able to present a more manageable set of financial data for the NAO to audit. But he stressed that there was still a long way to go. The C&AG told us that UKHSA remained in a challenging position, and that it was vital that UKHSA did not underestimate the scale of what remained to be done to implement normal accounting processes...

The C&AG confirmed that UKHSA had introduced “quite a lot of important governance arrangements” following its 2021–22 accounts, and that it had made progress on being able to present a more manageable set of financial data for the NAO to …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We asked UKHSA what lessons could be learned from the setup of a complex new government body and the issues reported by the C&AG in 2021–22 and 2022–23.12 UKHSA responded that if setting up a similar new body it would go about it ”in exactly the same way” and that the control issues that led to two consecutive disclaimers were a consequence of the operational challenges arising from the pandemic.13 The Department’s view, shared by UKHSA, was that it would take decisions on health protection i...

We asked UKHSA what lessons could be learned from the setup of a complex new government body and the issues reported by the C&AG in 2021–22 and 2022–23.12 UKHSA responded that if setting up a similar new body it would …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We asked UKHSA how it was going to fix the issue with the covid vaccine demand model that was one of the causes of the C&AG disclaiming his opinions on its 2022–23 accounts. The Department confirmed it had made a mistake in failing to communicate the detail of the model it was using to the NAO on a timely basis, and that this resulted in the NAO being unable to audit significant amounts in UKHSA’s accounts. UKHSA described the steps it had taken to produce auditable figures in 2023–24. It exp...

We asked UKHSA how it was going to fix the issue with the covid vaccine demand model that was one of the causes of the C&AG disclaiming his opinions on its 2022–23 accounts. The Department confirmed it had made a …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We questioned the Department on why it decided to transfer the CVU to UKHSA in October 2022, pushing additional responsibility on to a new and struggling organisation. The Department stated that, as an organisation of health protection experts who hold responsibility for established vaccination programmes, UKHSA was best placed to host the CVU. The Department told us that it thought that financial and accounting officer responsibilities had to be transferred alongside the operational responsi...

We questioned the Department on why it decided to transfer the CVU to UKHSA in October 2022, pushing additional responsibility on to a new and struggling organisation. The Department stated that, as an organisation of health protection experts who hold …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

As part of our inquiry in the Department’s 2021–22 Annual Report and Accounts, we found that the Department had prepared its accounts in exceptional circumstances for the previous two years but noted that it was imperative that it got back on track with the delivery of its accounts ahead of the Parliamentary summer recess. The Department laid its 2021–22 accounts on 26 January 2023, five days ahead of the statutory deadline, but planned to bring forward laying of its 2022–23 accounts to befor...

As part of our inquiry in the Department’s 2021–22 Annual Report and Accounts, we found that the Department had prepared its accounts in exceptional circumstances for the previous two years but noted that it was imperative that it got back …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

All Departments should aim to lay their accounts and those of their agencies by an administrative deadline of 30 June after the end of the financial year, and no later than the 15 Q 72 16 Qq 50–51 17 Q 49 18 Committee of Public Accounts, Sixty-Second Report of Session 2022–23, Department of Health and Social Care 2021–22 Annual Report and Accounts, HC 997, 5 July 2023, para 5; HM Treasury, Treasury Minutes – Government Response to the Committee of Public Accounts on the Sixty-first to the Six...

All Departments should aim to lay their accounts and those of their agencies by an administrative deadline of 30 June after the end of the financial year, and no later than the 15 Q 72 16 Qq 50–51 17 Q …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report Context · primary home: NHS policy linked

The delays to the accounts were the combined result of issues with the accounts of a key arm’s-length body (UKHSA) and delays in completion of local NHS audits. The accounts for UKHSA, NHS England and the Consolidated NHS Provider Accounts all need to be complete before the Department’s group accounts can be finalised. NHS England and the Consolidated NHS Provider Accounts in turn rely on the individual audits of 148 NHS commissioners and 212 NHS providers, which are incorporated into their o...

The delays to the accounts were the combined result of issues with the accounts of a key arm’s-length body (UKHSA) and delays in completion of local NHS audits. The accounts for UKHSA, NHS England and the Consolidated NHS Provider Accounts …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We asked the Department about its plans to certify its accounts earlier in future. The Department advised us that producing its accounts is a difficult task and the expenditure included represents approximately 8% of the UK economy. It told us that every year it faced a new challenge that was not predicted. The Department told us that it was “confident that we are doing the right things” and that it expected to be able to produce its 2023–24 accounts more quickly. It confirmed that it was wor...

We asked the Department about its plans to certify its accounts earlier in future. The Department advised us that producing its accounts is a difficult task and the expenditure included represents approximately 8% of the UK economy. It told us …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

The C&AG disclaiming his audit opinion is very rare. The fact that this has happened two years in a row for UKHSA gives us great cause for concern. While UKHSA has its own Chief Finance Officer, the Department has taken steps for its Director General Finance to undertake a formal role within the UKHSA finance function. No other organisations within the Department have this degree of involvement in their day to day running. We questioned how long this arrangement would be in place. The Departm...

The C&AG disclaiming his audit opinion is very rare. The fact that this has happened two years in a row for UKHSA gives us great cause for concern. While UKHSA has its own Chief Finance Officer, the Department has taken …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

A large proportion of the Departmental Group expenditure flows through from NHS commissioning bodies into NHS England and NHS providers into the Consolidated Provider Accounts, both of which are prepared by NHS England. Given their impact on the timeliness of the Department’s accounts, we asked the Department and NHS England what they were doing to ensure a more timely audit of NHS commissioners and NHS providers. The Department explained that the issues faced last year were in part because m...

A large proportion of the Departmental Group expenditure flows through from NHS commissioning bodies into NHS England and NHS providers into the Consolidated Provider Accounts, both of which are prepared by NHS England. Given their impact on the timeliness of …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report Context · primary home: NHS policy linked

We challenged NHS England and the Department on the extent they were acting on the proposals to improve audit timeliness set out in their 2022–23 governance statements. NHS England stated that it had regular update meetings with all audit firms, as well as working with the Department and cross-government groups looking at local audit delivery. 24 Q 58 25 Qq 79, 84 26 Q 81 27 Q 94 28 Qq 83–84 29 Q 84; Report by the Comptroller and Auditor General, NHS England Annual Report and Accounts 2022–23...

We challenged NHS England and the Department on the extent they were acting on the proposals to improve audit timeliness set out in their 2022–23 governance statements. NHS England stated that it had regular update meetings with all audit firms, …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

We recommended in our reports on the Department’s 2020–21 and 2021–22 Annual Reports and Accounts that the Department should develop a clear plan for a stockpile for a future pandemic. In response to our report on the 2021–22 Annual Report and Accounts, in September 2023 the Department told us that it was working closely with SCCL on the necessary volumes of PPE that were needed to provide resilience to future pandemics and was preparing advice on both short-term procurements and longer-term ...

We recommended in our reports on the Department’s 2020–21 and 2021–22 Annual Reports and Accounts that the Department should develop a clear plan for a stockpile for a future pandemic. In response to our report on the 2021–22 Annual Report …

▤ View document · ↗ GOV.UK
10 May 2024 | Committee report linked

NHS England can make payments to medical practitioners who have been suspended, in accordance with the relevant statutory regulations and conditions. The C&AG qualified his opinion on NHS England’s accounts for the second time, as a result of it making ineligible suspension payments to medical practitioners. NHS England made payments to 12 medical practitioners who did not meet the eligibility conditions, worth £1.3 million between 2017–18 and 2022–23. NHS England has not recovered most of th...

NHS England can make payments to medical practitioners who have been suspended, in accordance with the relevant statutory regulations and conditions. The C&AG qualified his opinion on NHS England’s accounts for the second time, as a result of it making …

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10 May 2024 | Committee report linked

We asked NHS England whether it was pursuing recovery of the overpaid amounts identified in 2022–23. NHS England told us that it was still seeking to recover more of the overpayments, but that it did not think that it would recover all the money paid. It reported that it needed to ensure it has sound legal grounds to pursue recovery. It explained that there were one or two cases where recovery might not be possible, due to “things said and done in the past”.55 54 Qq 73, 76–78 55 Qq 73–75 20 D...

We asked NHS England whether it was pursuing recovery of the overpaid amounts identified in 2022–23. NHS England told us that it was still seeking to recover more of the overpayments, but that it did not think that it would …

▤ View document · ↗ GOV.UK
26 Jan 2024 | Committee report linked

HM Treasury is not making the most of the information available within the WGA. As the balance sheet of the nation and an economic snapshot of the economy, the WGA has the potential to be an important and useful document in explaining where taxpayers’ money is spent and where are the government’s financial liabilities. Given this, there is more that HM Treasury could do to help Parliament read the accounts, and understand what the implications are of the information presented. This could, for...

HM Treasury is not making the most of the information available within the WGA. As the balance sheet of the nation and an economic snapshot of the economy, the WGA has the potential to be an important and useful document …

▤ View document · ↗ GOV.UK
26 Jan 2024 | Committee report linked

The Treasury published the 2020–21 WGA on 20 July 2023, 27 months after the end of the financial year. The Treasury did not provide the first complete draft of the accounts to the NAO until April 2023, nearly 14 months after the statutory deadline. The delay meant that the accounts were not laid until 20 July 2023, more than six months after the statutory deadline. In comparison, HM Treasury provided the complete first draft of the 2019–20 Whole of Government Accounts to the NAO in March 2022...

The Treasury published the 2020–21 WGA on 20 July 2023, 27 months after the end of the financial year. The Treasury did not provide the first complete draft of the accounts to the NAO until April 2023, nearly 14 months …

▤ View document · ↗ GOV.UK
26 Jan 2024 | Committee report linked

We therefore asked the Treasury why publication of the 2020–21 WGA was so delayed. The Treasury told us that it had assumed that collecting the data needed for the WGA would take two to three months, that preparing the accounts would take five to six months, and that the C&AG’s audit would take three to four months. It explained that the process was prolonged by delays to the accounts that feed into the WGA and delays to receiving the data needed for the WGA, which resulted in it having to ex...

We therefore asked the Treasury why publication of the 2020–21 WGA was so delayed. The Treasury told us that it had assumed that collecting the data needed for the WGA would take two to three months, that preparing the accounts …

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26 Jan 2024 | Written evidence linked

In its written evidence to us, the ICAEW told us that the WGA was not yet filling its full potential as it was not being used as the multi-purpose tool that it should be. The Institute maintained that annual financial reporting is a multi-purpose tool that underpins effective financial management, strategic decision-making, risk management, governance processes, and regulatory and legal compliance. It told us that the WGA had enabled progress to be made in many of the above areas. However, it...

In its written evidence to us, the ICAEW told us that the WGA was not yet filling its full potential as it was not being used as the multi-purpose tool that it should be. The Institute maintained that annual financial …

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2023

27 events
29 Nov 2023 | Committee report linked

It is not acceptable that the Department has spent £168 million on the Programme, and is about to commit to a further £2 billion for the Functional Assessment Service, without being transparent to Parliament about whether it is meeting Accounting Officer standards. All programmes in the Government Major Projects Portfolio (GMPP) should have an Accounting Officer (AO) assessment conducted and summary published at the earliest possible opportunity. Despite having spent £168 million on the Progr...

It is not acceptable that the Department has spent £168 million on the Programme, and is about to commit to a further £2 billion for the Functional Assessment Service, without being transparent to Parliament about whether it is meeting Accounting …

▤ View document · ↗ GOV.UK
29 Nov 2023 | Committee report linked

Despite the lack of an accounting officer assessment for the programme, the Department told us that it had “sought to be transparent throughout” and had published information on the Programme as part of the Department’s annual report. It noted that the Infrastructure and Projects Authority also published an annual review of the GMPP, which included the Programme. The Department therefore considered that it had been “as transparent as possible”.64 The NAO report found, however, that the Depart...

Despite the lack of an accounting officer assessment for the programme, the Department told us that it had “sought to be transparent throughout” and had published information on the Programme as part of the Department’s annual report. It noted that …

▤ View document · ↗ GOV.UK
17 Nov 2023 | Committee report linked

DHSC is at risk of locking in a standard design that will result in future hospitals being too small, which could lead to significantly greater expenditure and disruption in the long run. The version of Hospital 2.0 that DHSC used in its business case for NHP, and the basis on which HM Treasury has provided indicative future funding, is founded on unrealistic assumptions. It assumes that increasing demand for hospital care from a growing and ageing population can be mitigated by a very high l...

DHSC is at risk of locking in a standard design that will result in future hospitals being too small, which could lead to significantly greater expenditure and disruption in the long run. The version of Hospital 2.0 that DHSC used …

▤ View document · ↗ GOV.UK
17 Nov 2023 | Committee report linked

We have previously expressed concern about a lack of evidence and transparency to justify scheme selection in other parts of government.67 In our 2020 report on the Towns Fund, we found that the Ministry of Housing, Communities and Local Government was not open about the process it followed and did not disclose reasons for selecting or excluding particular towns. This lack of transparency fuelled accusations of political bias in the selection process.68 In our 2022 report on local economic gr...

We have previously expressed concern about a lack of evidence and transparency to justify scheme selection in other parts of government.67 In our 2020 report on the Towns Fund, we found that the Ministry of Housing, Communities and Local Government …

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17 Nov 2023 | Committee report linked

We highlighted to DHSC that there seemed to be a black hole in the funding allocated compared with what would be required to get all the hospitals in the programme built, and asked whether it was discussing the issue with HM Treasury. DHSC told us that it had frequent discussions with HM Treasury and considered the funding was sufficient and 71 C&AG’s Report, paras 8 and 19 72 Committee of Public Accounts, Lessons from major projects and programmes, Thirty-Ninth Report of Session 2019–21, HC ...

We highlighted to DHSC that there seemed to be a black hole in the funding allocated compared with what would be required to get all the hospitals in the programme built, and asked whether it was discussing the issue with …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

UKHSA had a fundamental weakness in financial controls and processes which resulted in it being unable to prepare auditable accounts. On 1 October 2021, the day that it became operational, UKHSA implemented a new IT accounting system and transferred the operations of its three predecessors onto this new system. At the same time, it was responding to the COVID-19 pandemic and managing rapid large-scale changes in spending and headcount. Implementing a new IT system is always a challenge, but t...

UKHSA had a fundamental weakness in financial controls and processes which resulted in it being unable to prepare auditable accounts. On 1 October 2021, the day that it became operational, UKHSA implemented a new IT accounting system and transferred the …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

The Department has not yet developed a clear plan to remove the audit qualifications and deliver its accounts to a pre-summer recess timetable. The Department has prepared its accounts in exceptional circumstances for the past two years. It laid its 2021–22 Annual Report and Accounts on 26 January 2022, five days ahead of the statutory deadline, and as in 2020–21, they were heavily qualified by the C&AG. For 2022–23, it plans to bring forward its laying of its Annual Report and Accounts in Pa...

The Department has not yet developed a clear plan to remove the audit qualifications and deliver its accounts to a pre-summer recess timetable. The Department has prepared its accounts in exceptional circumstances for the past two years. It laid its …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

There have been repeated and unacceptable governance and accounting failures within the Departmental Group which has led to poor financial control, undermined Parliamentary accountability, and money being spent without Parliamentary approval. The Department has failed to implement adequate financial control across the Group which has resulted in numerous qualifications of both ‘true and fair’ and ‘regularity’ opinions. The Department’s own Core and/ or Group accounts have had multiple qualifi...

There have been repeated and unacceptable governance and accounting failures within the Departmental Group which has led to poor financial control, undermined Parliamentary accountability, and money being spent without Parliamentary approval. The Department has failed to implement adequate financial

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

On the basis of a report by the Comptroller and Auditor General (C&AG), we took evidence from the Department of Health and Social Care (the Department) and the UK Health Security Agency (UKHSA) on the Department’s Annual Report and Accounts for 2021–22.1

On the basis of a report by the Comptroller and Auditor General (C&AG), we took evidence from the Department of Health and Social Care (the Department) and the UK Health Security Agency (UKHSA) on the Department’s Annual Report and Accounts …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

The C&AG’s audit of UKHSA’s first set of accounts resulted in him disclaiming his opinions.34 This means that he was unable to give an opinion on whether the accounts were ‘true and fair’ or on whether the transactions recorded in the accounts were applied to the purposes intended by Parliament (‘regularity’).

The C&AG’s audit of UKHSA’s first set of accounts resulted in him disclaiming his opinions.34 This means that he was unable to give an opinion on whether the accounts were ‘true and fair’ or on whether the transactions recorded in …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

The UKHSA accounts were ‘disclaimed’ as: the inventory transferred from Public Health England (£254 million) and the Department (£794 million) to UKHSA on 1 October 2021 was not subject to stock counts, £3.3 billion of consumption of Test and Trace inventory was not supported by records and the inventory held as at 31 March 2022 was not subject to stock counts until several months after the year end; UKHSA was unable to provide sufficient evidence to support the £1.9 billion accruals balance ...

The UKHSA accounts were ‘disclaimed’ as: the inventory transferred from Public Health England (£254 million) and the Department (£794 million) to UKHSA on 1 October 2021 was not subject to stock counts, £3.3 billion of consumption of Test and Trace …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

It is very unusual for an auditor to disclaim their opinion. No C&AG has disclaimed an audit opinion since January 2006, concerning the Home Office resource accounts 2004–05.36 UKHSA confirmed that they do not anticipate being able to produce accounts which will be unqualified until 2023–24 at the earliest.37

It is very unusual for an auditor to disclaim their opinion. No C&AG has disclaimed an audit opinion since January 2006, concerning the Home Office resource accounts 2004–05.36 UKHSA confirmed that they do not anticipate being able to produce accounts …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

There were multiple root causes of UKHSA’s inability to produce auditable accounts. One of the key causes was the accounting system that UKHSA implemented on 1 October

There were multiple root causes of UKHSA’s inability to produce auditable accounts. One of the key causes was the accounting system that UKHSA implemented on 1 October Type: conclusion | Number: 20 | Response status: accepted Government response: 4.1 The …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

We asked UKHSA whether it would have been better to use one of the systems used by its predecessor entities rather than implementing the new system on the day it became operational. UKHSA said that it had inherited the decision to implement the new system from Public Health England and acknowledged that, in hindsight, it may have been preferable to run existing systems side by side.40

We asked UKHSA whether it would have been better to use one of the systems used by its predecessor entities rather than implementing the new system on the day it became operational. UKHSA said that it had inherited the decision …

▤ View document · ↗ GOV.UK
5 Jul 2023 | Committee report linked

UKHSA also experienced significant difficulties with staffing which compromised its ability to provide evidence and explanations to support the figures reflected in the accounts. The C&AG reported that one barrier to his ability to obtain evidence to allow him to give an audit opinion was the transitory nature of UKHSA’s workforce. This meant that officials who had prepared figures for the financial statements had left the organisation by the time of the audit and were not able to provide exp...

UKHSA also experienced significant difficulties with staffing which compromised its ability to provide evidence and explanations to support the figures reflected in the accounts. The C&AG reported that one barrier to his ability to obtain evidence to allow him to …

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5 Jul 2023 | Committee report linked

There were also operational decisions which UKHSA and the Department took which meant that some form of accounts qualification was always likely. The Department decided not to count the stockpile of emergency goods transferred from Public Health England to the UK Health Security Agency on 1 October 2022. The Department’s view was that counting these stocks on the date of transfer would have compromised the autumn 2021 vaccine roll-out because it would have required the closure of warehouses.4...

There were also operational decisions which UKHSA and the Department took which meant that some form of accounts qualification was always likely. The Department decided not to count the stockpile of emergency goods transferred from Public Health England to the …

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5 Jul 2023 | Committee report linked

The Department and bodies within its Group have had a number of financial governance and accounting failures in recent years. The Department Core and Group accounts have been qualified by the C&AG for the past two years. In both 2020–21 and 2021–22 there was a ‘true and fair’ qualification arising in respect of inventory, this arose as the Department was unable to perform stock takes to evidence the existence, completeness and valuation of inventory.55 The Department acknowledged that the inv...

The Department and bodies within its Group have had a number of financial governance and accounting failures in recent years. The Department Core and Group accounts have been qualified by the C&AG for the past two years. In both 2020–21 …

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5 Jul 2023 | Committee report linked

The C&AG also qualified the Groups ‘other accruals’ in 2020–21 as there was insufficient assurance in respect of existence and valuation of £17.3 billion, the Department accrues expenditure it has incurred but has not yet been invoiced for and therefore a liability which will need to be paid in future. In 2019–20 the C&AG qualified his ‘true and fair’ opinion on the Core Departments ‘other financial assets’ due to a disagreement in the application of financial reporting standard IFRS 9. The D...

The C&AG also qualified the Groups ‘other accruals’ in 2020–21 as there was insufficient assurance in respect of existence and valuation of £17.3 billion, the Department accrues expenditure it has incurred but has not yet been invoiced for and therefore …

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5 Jul 2023 | Committee report linked

Furthermore, the C&AG has qualified his ‘regularity’ opinion on the DHSC Group accounts for the past two years: the Department exceeded its budgetary limit for Resource Non-Budget Expenditure as authorised by Parliament in 2021–22 as a budget of £nil was authorised and the Department incurred an outturn of £2.457 billion; and in 2020–21, the Department spent £1.3 billion on projects they were required to but did not have the appropriate approval from Treasury for, and therefore was irregular,...

Furthermore, the C&AG has qualified his ‘regularity’ opinion on the DHSC Group accounts for the past two years: the Department exceeded its budgetary limit for Resource Non-Budget Expenditure as authorised by Parliament in 2021–22 as a budget of £nil was …

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5 Jul 2023 | Committee report linked

The C&AG being unable to provide an opinion on the UKHSA 2021–22 Annual Report and Accounts59 (see above) resulted in further ‘true and fair’ and ‘regularity’ qualifications on the Departmental Group accounts.60 . We questioned the Department on when it realised that the difficulties inherited by UKHSA would impact on the Group accounts. The Department said that ‘the precise issues’ and the amount of evidence not available to support the audit only became apparent to it in late 2022 and in Ja...

The C&AG being unable to provide an opinion on the UKHSA 2021–22 Annual Report and Accounts59 (see above) resulted in further ‘true and fair’ and ‘regularity’ qualifications on the Departmental Group accounts.60 . We questioned the Department on when it …

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5 Jul 2023 | Committee report linked

There have been other qualifications across the Departmental Group. The NHS Property Services (NHSPS) accounts were qualified in 2021–22 as NHSPS were unable to demonstrate compliance with the Financial Reporting Framework and account for the expenditure, assets and liabilities arising from certain contracts in accordance with IFRS16 Leases. There were 182 rental arrangements with approximate annual payments of £7.7 million, and NHSPS was unable to provide documentation to determine the subst...

There have been other qualifications across the Departmental Group. The NHS Property Services (NHSPS) accounts were qualified in 2021–22 as NHSPS were unable to demonstrate compliance with the Financial Reporting Framework and account for the expenditure, assets and liabilities arising …

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8 Feb 2023 | Committee report linked

The NHS estate is in an increasingly decrepit condition, but the Department seems unable to make timely decisions to address these problems. The NAO report found that the cost of tackling outstanding maintenance work on the NHS estate has now reached £9 billion, up from £5 billion seven years ago. Alongside this, there are long delays in making decisions on capital programmes. For example, staff and patients at the Queen Elizabeth hospital in King’s Lynn have been waiting for years for a deci...

The NHS estate is in an increasingly decrepit condition, but the Department seems unable to make timely decisions to address these problems. The NAO report found that the cost of tackling outstanding maintenance work on the NHS estate has now …

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2022

23 events
14 Oct 2022 | Committee report linked

Throughout the course of the 2019–20 accounts preparation process, the Treasury repeatedly underestimated how long it would take to produce the WGA; missing both 11 Public Accounts Committee, Report of session: Whole of Government Accounts 2018–19, 22 January 2021 12 HM Treasury, The Whole of Government Accounts (Specified Dates) Order 2010, 2010 No. 570, 31 March 2010 13 WGA 2019–20, para 9, p 211 14 WGA 2019–20, title page 3 15 HM Treasury, Whole of Government Accounts: year ended 31 March ...

Throughout the course of the 2019–20 accounts preparation process, the Treasury repeatedly underestimated how long it would take to produce the WGA; missing both 11 Public Accounts Committee, Report of session: Whole of Government Accounts 2018–19, 22 January 2021 12 …

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14 Oct 2022 | Committee report linked

In July 2020 the Treasury launched its new financial IT system, OSCAR II, for use in preparing the WGA. OSCAR II replaced the previous, obsolete system and was designed to support, amongst other functions: the collection and consolidation of data from component bodies into the WGA; holding, storing and updating information with easy and immediate access to data; and the production of reports with use of intuitive reporting tools. According to the Treasury, the update was expected to bring sig...

In July 2020 the Treasury launched its new financial IT system, OSCAR II, for use in preparing the WGA. OSCAR II replaced the previous, obsolete system and was designed to support, amongst other functions: the collection and consolidation of data …

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14 Oct 2022 | Committee report linked

The Treasury has told us that that all known issues with OSCAR II have now been resolved as they move onto the production of the 2020–21 WGA. However, the Treasury informed us that it anticipates that there are likely to be some new issues that will yet arise. The system is supported by a service desk and the Treasury hopes that any new issues can be dealt with in the usual course of businesses without adding to the production delay; whether this will be the case is yet to be seen.35 The Trea...

The Treasury has told us that that all known issues with OSCAR II have now been resolved as they move onto the production of the 2020–21 WGA. However, the Treasury informed us that it anticipates that there are likely to …

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14 Oct 2022 | Committee report linked

Another factor to consider in elevating the usability of the WGA is the way in which current Government policies and economic context are reflected in its reporting; currently such context is lacking. The Treasury has invited our thoughts on how value could be added to the WGA and the Performance Report could be greatly improved by developing the commentary to reflect developments in the public sector and financial landscapes since the reporting date.49 50 This is especially relevant given th...

Another factor to consider in elevating the usability of the WGA is the way in which current Government policies and economic context are reflected in its reporting; currently such context is lacking. The Treasury has invited our thoughts on how …

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14 Oct 2022 | Committee report linked

The Treasury expressed its understanding of how the issues that are of greatest interest to users of the WGA, including the Committee, evolve over time. The Treasury told us that where users of the WGA continue to rely on the document as a key source of information on an issue, then it will continue to highlight that area. However, it contended that committing to a particular timeframe for reporting on a given issue is not in the interest of this ambition to deliver adaptable reporting which ...

The Treasury expressed its understanding of how the issues that are of greatest interest to users of the WGA, including the Committee, evolve over time. The Treasury told us that where users of the WGA continue to rely on the …

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14 Oct 2022 | Committee report linked

The Treasury currently uses the NAO’s COVID-19 Cost Tracker to provide data for its reporting on COVID-19 in the WGA. However, the NAO is set to cease publishing this information in the near future and it is therefore important that the Treasury should not depend solely on the NAO but instead develop and use its own assessment of these costs. The Treasury has confirmed to us its public commitment to continuing this work for the next two years.66 The Treasury said that it would consider how it...

The Treasury currently uses the NAO’s COVID-19 Cost Tracker to provide data for its reporting on COVID-19 in the WGA. However, the NAO is set to cease publishing this information in the near future and it is therefore important that …

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10 Jun 2022 | Committee report linked

The Department has regularly failed to follow public spending rules and across the Departmental Group there is a track record of failing to comply with the requirements of Managing Public Money. The Department is required to obtain approval from the Treasury before committing to expenditure where such authority is needed. The Treasury has confirmed that £1.3 billion of the Department’s spending in 2020–21 did not have HM Treasury consent and was therefore ‘irregular’. The Treasury has stated ...

The Department has regularly failed to follow public spending rules and across the Departmental Group there is a track record of failing to comply with the requirements of Managing Public Money. The Department is required to obtain approval from the …

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10 Jun 2022 | Committee report linked

The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how it identifies and manages declarations of interests. A considerable amount of taxpayers’ money was spent on products from new suppliers, including those with no previous experience of supplying certain Department of Health and Social Care 2020–21 Annual Report and Accounts 7 types of products, increasing the risk that the Department entered into contracts where conflicts of in...

The Department’s COVID-19 pandemic procurement highlighted the importance of achieving transparency in respect of how it identifies and manages declarations of interests. A considerable amount of taxpayers’ money was spent on products from new suppliers, including those with no previous …

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10 Jun 2022 | Committee report linked

There is no clear plan as to how the Department will bring forward the publication date of its annual report and accounts. The Department prepared its 2020–21 Annual Report and Accounts in exceptional circumstances. The Department’s 2020–21 Annual Report and Accounts, and those of NHS England and the Consolidated NHS Provider Accounts, were published on 31 January 2022—the day of the statutory deadline for all Departments. However, HM Treasury expects Departments to publish their Annual Repor...

There is no clear plan as to how the Department will bring forward the publication date of its annual report and accounts. The Department prepared its 2020–21 Annual Report and Accounts in exceptional circumstances. The Department’s 2020–21 Annual Report and …

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10 Jun 2022 | Committee report linked

We asked the Department for an update on the current position of contracts it had entered into in response to the COVID-19 pandemic. The Department has now identified 17 Q 43 18 Q 79 19 Q 88; DHSC 2020–21 ARA, page 123 20 C&AG’s Report, The supply of personal protective equipment (PPE) during the COVID-19 pandemic, Session 2019–21, HC 961, 25 November 2020 21 C&AG’s Report, The supply of personal protective equipment (PPE) during the COVID-19 pandemic, Session 2019–21, HC 961, 25 November 202...

We asked the Department for an update on the current position of contracts it had entered into in response to the COVID-19 pandemic. The Department has now identified 17 Q 43 18 Q 79 19 Q 88; DHSC 2020–21 ARA, …

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10 Jun 2022 | Committee report linked

The Department told us that in order to get money to where it thought it was needed during the COVID-19 pandemic it deliberately loosened controls and thereby took on a lot of additional risk spending money without prior approval.35 It acknowledged that its controls and processes were inadequate for the post-pandemic environment and need to be reset. We questioned the Department on what changes it had made to its processes so that this does not happen again. The Department told us that it had...

The Department told us that in order to get money to where it thought it was needed during the COVID-19 pandemic it deliberately loosened controls and thereby took on a lot of additional risk spending money without prior approval.35 It …

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10 Jun 2022 | Committee report linked

The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not best support the current operating environment” and that “necessary adjustments are required to the framework of risk control and governance arrangements for them to be considered effective in what is a new operating environment”. The Head of Internal Audit also reported that “lines of accountability, interfaces, interdependencies and escalation routes are not clear or fully integrated across the...

The Department’s Head of Internal Audit concluded that “the existing arrangements in place do not best support the current operating environment” and that “necessary adjustments are required to the framework of risk control and governance arrangements for them to be …

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10 Jun 2022 | Committee report linked

There has been considerable public and political interest in the Department’s COVID-19 pandemic procurement including how significant amounts of taxpayers’ money had been spent- especially where products had been sourced from new suppliers including from companies with no previous experience in these types of products. Such procurement- undertaken at pace- increased the risk that the Department entered into 34 C&AG’s Report, paras 16, 17 35 Q126 36 Qq 11–13 37 Report by the Comptroller and Au...

There has been considerable public and political interest in the Department’s COVID-19 pandemic procurement including how significant amounts of taxpayers’ money had been spent- especially where products had been sourced from new suppliers including from companies with no previous experience …

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10 Jun 2022 | Committee report linked

We asked the Department how with such a large number of potential and potentially significant conflicts of interest, within staff, non-executive directors or Ministers at the Department, they make sure that conflicts are identified and dealt with properly. The Department told us that this is particularly challenging for them, because health and care makes up about 10% of the economy, as a result for any relative you have there is a one in 10 chance of them either being an employee of the NHS ...

We asked the Department how with such a large number of potential and potentially significant conflicts of interest, within staff, non-executive directors or Ministers at the Department, they make sure that conflicts are identified and dealt with properly. The Department …

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10 Jun 2022 | Committee report linked

The Department set out in its Governance Statement that during the audit of the Department’s accounts, it became apparent the Department’s process for collating and assessing potential related parties and related party transactions did not provide the necessary completeness assurance over the interests held by senior individuals. Consequently, the Department undertook further work to strengthen its processes, including obtaining direct written confirmation of related parties from Ministers, n...

The Department set out in its Governance Statement that during the audit of the Department’s accounts, it became apparent the Department’s process for collating and assessing potential related parties and related party transactions did not provide the necessary completeness assurance …

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10 Jun 2022 | Committee report linked

To provide proper timely accountability on how public funds have been spent, the administrative deadline set by Treasury for Departments to publish their Annual Report and Accounts is 30 June, where possible, and no later than the parliamentary summer recess in July. An extension must be agreed for publication beyond this date. The Department published its 2020–21 Annual Report and Accounts on 31 January 2022, the day of the statutory deadline for all Departments. The Department told us it is...

To provide proper timely accountability on how public funds have been spent, the administrative deadline set by Treasury for Departments to publish their Annual Report and Accounts is 30 June, where possible, and no later than the parliamentary summer recess …

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10 Jun 2022 | Committee report linked

We asked the Department what it was doing to assure itself that the situation at UHL would be resolved and whether it was an isolated occurrence or indicative of similar issues that may surface elsewhere in the NHS in the future. The Department acknowledged the fact that annual report and accounts had not been published for 2019–20 or 2020–21 was a serious issue. It told us the Trust entered special measures in August 2020 and NHS Improvement is working intensively with UHL, with national and...

We asked the Department what it was doing to assure itself that the situation at UHL would be resolved and whether it was an isolated occurrence or indicative of similar issues that may surface elsewhere in the NHS in the …

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25 Mar 2022 | Committee report linked

The Department explained that the resolution of the qualified opinion on the WGA continues to be discussed between the Department and HM Treasury, albeit has been deprioritised while government focuses on its response to the COVID-19 pandemic. The Department told us that it envisaged that it may be particularly challenging to demonstrate the accuracy of the more complex valuations required for land and buildings and the pension assets and liabilities recognised within the SARA at a different ...

The Department explained that the resolution of the qualified opinion on the WGA continues to be discussed between the Department and HM Treasury, albeit has been deprioritised while government focuses on its response to the COVID-19 pandemic. The Department told …

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4 Feb 2022 | Committee report linked

We asked the Department that given the pharmacy scheme involved an unusual and novel use of public money and in relation to the entire episode with Greensill Capital whether HM Treasury’s initial scepticism about the use of supply chain finance in the NHS has been validated. The Department told us that knowing what it knows now, it would not embark on the scheme again. The Committee asked a broad question about the large percentage of suppliers to government—in the high 90%s—paid within 30 da...

We asked the Department that given the pharmacy scheme involved an unusual and novel use of public money and in relation to the entire episode with Greensill Capital whether HM Treasury’s initial scepticism about the use of supply chain finance …

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4 Feb 2022 | Committee report linked

The combined effect of the introduction of an even earlier reimbursement process for pharmacies and the failure of Greensill Capital placed the Department in a position 15 Q 59 16 Qq 65–66 17 Supply Chain Finance in Government: Boardman Review 18 C&AG’s Report, para 18 19 C&AG’s Report, paras 2.29–2.30 The pharmacy early payment and salary advance schemes in the NHS 13 of making payments in advance of need, which Managing Public Money states should be “exceptional, and should only be consider...

The combined effect of the introduction of an even earlier reimbursement process for pharmacies and the failure of Greensill Capital placed the Department in a position 15 Q 59 16 Qq 65–66 17 Supply Chain Finance in Government: Boardman Review …

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2021

4 events
24 Sep 2021 | Committee report linked

Framework agreements and Accounting Officer System Statements are important in clarifying relationships and accountabilities, both between departments and ALBs and across wider departmental groups.24 Framework agreements formalise the governing principles and the relationship between ALB and sponsor department, and Accounting Officer System Statements set out the accountability relationships and processes within a departmental group. Four out of the 10 framework agreements examined by the NAO...

Framework agreements and Accounting Officer System Statements are important in clarifying relationships and accountabilities, both between departments and ALBs and across wider departmental groups.24 Framework agreements formalise the governing principles and the relationship between ALB and sponsor

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22 Jan 2021 | Committee report linked

The Treasury has aspirations to standardise financial reporting across government but has not set out how this will make the WGA more useful or accessible. The Treasury faces difficulties when trying to categorise transactions and balances reported by over 9,000 organisations into robust categories that are useful to the user. The Government Finance Function within the Treasury is undertaking work to align finance processes across government such as expense claims. It is also planning to stan...

The Treasury has aspirations to standardise financial reporting across government but has not set out how this will make the WGA more useful or accessible. The Treasury faces difficulties when trying to categorise transactions and balances reported by over 9,000 …

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22 Jan 2021 | Committee report linked

Regarding the provision for clinical negligence, the WGA shows a levelling off of new cases and explains that in the second year of its new strategy to tackle clinical negligence laid out in April 2017, NHS Resolution mediated 380 cases, or 110% more than the previous year.20 We asked the Treasury what progress was being made to control the liability. The Treasury responded that clinical negligence had been picked up by the balance sheet review and that the lead for this area was the Departme...

Regarding the provision for clinical negligence, the WGA shows a levelling off of new cases and explains that in the second year of its new strategy to tackle clinical negligence laid out in April 2017, NHS Resolution mediated 380 cases, …

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22 Jan 2021 | Committee report linked

Previously the Treasury has expressed dissatisfaction at the level of expenditure across all types of government spending that is classified as miscellaneous or other by WGA bodies, as it prevents the WGA providing more granular information. The Treasury stated that the implementation of the new OSCAR II IT system should help improve the quality of the information disclosed.44 To further improve the quality of information about what costs Departments have incurred, the Treasury’s Government F...

Previously the Treasury has expressed dissatisfaction at the level of expenditure across all types of government spending that is classified as miscellaneous or other by WGA bodies, as it prevents the WGA providing more granular information. The Treasury stated that …

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2020

4 events
6 Nov 2020 | Committee report linked

NHSX is not a statutory body and does not prepare financial statements for audit. We asked how the Department was tracking the performance of NHSX and ensuring that money was being well used given that NHSX was not audited. The Department explained that NHSX’s funding came from the budgets of the Department and NHSE&I, and would therefore follow the normal funding allocations processes within each of these organisations. The Department accepted that the budgetary arrangements for digital tran...

NHSX is not a statutory body and does not prepare financial statements for audit. We asked how the Department was tracking the performance of NHSX and ensuring that money was being well used given that NHSX was not audited. The …

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28 Jul 2020 | Committee report linked

Departments with large projects should, from 2021, be able to demonstrate compliance with the recommendations of the 2019 Government financial reporting review, the revised Financial Reporting Manual and the forthcoming thematic review of project reporting review of accounts, which included publishing trends in project data. Project data published in departments’ annual reports should be easily reconciled to data published in the IPA annual report and should be consistent with announcements b...

Departments with large projects should, from 2021, be able to demonstrate compliance with the recommendations of the 2019 Government financial reporting review, the revised Financial Reporting Manual and the forthcoming thematic review of project reporting review of accounts, which included …

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