This will be the third annual report by the NAO on the financial sustainability of the NHS, which continues to face very severe financial pressures while undergoing significant structural changes. In 2013-14 responsibility for commissioning services from NHS trusts and NHS foundation trusts transferred from Primary Care Trusts and Strategic Health Authorities to newly-created bodies: In 2013-14, the Department of Health allocated £95.2 billion to NHS England to pay for NHS services. The largest proportion was spent by 211 new clinical commissioning groups to buy services from 98 NHS trusts, NHS Direct and 147 NHS foundation trusts. NHS England directly commissioned £13.4 billion of specialised treatment, such as organ transplants and new drug therapies. Monitor continues to regulate NHS foundation trusts, and another new body, the NHS Trust Development Authority, supports NHS trusts that have yet to achieve foundation status. In 2013-14, NHS bodies achieved a net surplus of £722 million, made up of an £813 million underspend by NHS England and clinical commissioning groups, and a £91 million net deficit in NHS trusts and foundation trusts. This is a third of the £2.1 billion net surplus achieved in 2012-13. This inquiry will examine how the Department of Health, working with NHS England, Monitor and the NHS Trust Development Authority, will relieve financial pressure in the NHS, challenge oversight arrangements and work on achieving strategic change.
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