Public Accounts Committee: DHSC Annual Report and Accounts 2023-24 (14 May 2025)

Summary

The work of the Department of Health and Social Care (DHSC) and its organisations touches the lives of an average of 1.7 million patients per day and costs the UK taxpayer around £187.3 billion per year. This report presents the Public Accounts Committee’s analysis of the DHSC Accounts for 2023/24. The Public Accounts Committee is a Select Committee in the House of Commons that examines value for money of Government projects, programmes and service delivery.

Content

This report highlights a number of issues of concern, including the two areas highlighted below.

Abolition of NHS England

The Committee points to several issues where it believes further clarity is required from the Government in this respect:

• The lack of a clear plan for how DHSC and NHS England will achieve significant headcount reductions, and the costs involved.
• How the reductions fit in with the wider 10 Year Health Plan for the NHS.
• How savings made from reducing NHSE staff costs help frontline services.
• How the institutional knowledge of NHSE would be preserved following its abolition.
• The scale of headcount reductions in the DHSC, and the geographical spread of the planned 50% headcount reductions in NHSE and across local Integrated Care Boards.

Clinical negligence

The Committee has expressed disappointment in this area and stressed the need for significant improvements, stating that:

“Both patients and public money need to be better protected by the Department. Far too many patients still suffer clinical negligence which can cause devasting harm to those affected. It also results in large sums of public money being spent on legal fees and compensation, drawing resources from the wider health service.”

Concerns it highlights include:

• £58.2bn has been set aside to cover the potential cost of clinical negligence events in the latest accounts – the second largest liability across government after nuclear decommissioning.
• 19% of money awarded to claimants in 2023-24 goes to their lawyers (£536m of the total £2.8bn paid that year), on top of the fees payable for the Government Legal Team.

It recommends that within six months, DHSC should set out a plan with clear actions to:

• Reduce tragic incidences of patient harm to as low a level as possible
• Manage the costs of clinical negligence more effectively, including introducing a mechanism to reduce legal fees.
• Improve patient safety across the NHS and in particular in maternity services