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NHS financial sustainability

Inquiry

The scale of the challenge facing the NHS is unprecedented. Local NHS systems in England ended 2023/24 with a collective deficit of £1.4bn. NHS England (NHSE) received more than £4.5bn in extra funding in 2023/24, and reduced planned spending against its central budget by £1.7bn – but these actions did not prevent NHS systems’ deficits significantly increasing beyond what was planned at the start of the year.

The NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness and accessibility, according to the National Audit Office’s (NAO) July 2024 report. The NAO has warned that, with an ageing and increasingly sick population, either much future demand for healthcare must be avoided, or the NHS will need a great deal more funding, or service levels will continue to be unacceptable and may even deteriorate further.

The Committee found in 2020 that the pandemic had highlighted the need for the NHS to fundamentally transform services to ensure that it could meet rising demand in the future while maintaining vital service standards. Committee reports on NHS bodies since 2011 have highlighted a range of challenges, including rising demand, lack of capital investment, trust deficits and workforce issues.

Based on the NAO report, the Committee will hear from senior Department of Health & Social Care and NHSE officials, on subjects including:

- Operational improvements identified by the NAO to help the NHS do more with the resources it has;

- How NHSE supports NHS bodies that are struggling; and

- Longer-term challenges to the NHS’ financial sustainability.

Please note that the Committee is unable to consider or assist with individual cases. If you need help with an individual problem you are having, you may wish to contact your constituency MP.

Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere.

If you have evidence on these issues please submit it here by 23:59 on Thursday 14 November 2024.

This inquiry is no longer accepting evidence

The deadline for submissions was Thursday 14 November 2024.

Reports, special reports and government responses

View all reports and responses
5th Report - NHS financial sustainability
Inquiry NHS financial sustainability
HC 350
Report
Response to this report
Treasury minutes: Government response to the Committee of Public Accounts on the Fifth report from Session 2024-25
HC 350
Government Response
Letter from the Interim Permanent Secretary of the Department of Health and Social Care relating to the delay to publication of Treasury Minute 5 NHS financial sustainability, 03 April 2025
Inquiry NHS financial sustainability
Correspondence
Letter from the Interim Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to a follow up on questions raised in the oral evidence session held on 25 November 2025 on NHS Financial Sustainability, 18 March 2025
Inquiry NHS financial sustainability
Correspondence
Letter from the Chief Financial Officer and Deputy Chief Executive at NHS England relating to the oral evidence session held on 25 November 2024 on NHS Financial Sustainability, 05 March 2025
Inquiry NHS financial sustainability
Correspondence

Oral evidence transcripts

View all oral evidence transcripts
25 November 2024
Inquiry NHS financial sustainability
Witnesses Sir Chris Wormald KCB (Permanent Secretary at Department for Health and Social Care), Andy Brittain (Director General for Finance at Department for Health and Social Care), Amanda Pritchard (Chief Executive at NHS England), Julian Kelly (Chief Financial Officer at NHS England), and Antonia Williams (Director of Public Services at HM Treasury)
Oral Evidence
The Royal College of Radiologists (NFS0015)
The Medical Defence Union (NFS0001)
MR NIGEL D COOK (Expert Business Efficiency Identification, Management and Delivery at (retired)) (NFS0002)

Contact us

  • Email: pubaccom@parliament.uk
  • Phone: 020 7219 8480 (strictly media enquiries only – contact us via our email for general enquiries)
  • Address: Public Accounts Committee, House of Commons, London, SW1A 0AA