Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 January (HL3972), what the total value is of the five special severance payments currently pending approval by the Treasury; and whether any of these payments have already been disbursed or remain withheld pending approval.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
All five cases are pending retrospective approval. The National Audit Office, as disclosed on page 47 of the consolidated provider accounts, put a value to these cases of £180,688. Final values may change subject to the approval process.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many GP practices achieved an overall Quality and Outcomes Framework score of 95 percent or higher in the most recent financial year; what proportion of all GP practices this represents; and what was the total value of payments made to these practices.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In the 2023/24 reporting year, 2,867 general practices (GPs) had an overall achievement greater than or equal to 95%. This equates to 45.7% of GPs included in the published Quality and Outcomes Framework (QOF) dataset, or 6,267 GPs. The total estimated value of payments calculated based on these achievement figures was £413,953,264.95.
While the QOF remains an important mechanism for understanding performance and incentivising quality care, it is not the only measure of GP standards. We are committed to reducing administrative burdens and outdated performance targets. To shift care from sickness to prevention, subject to consultation, in the 2025-2026 GP contract we are proposing renewed focus of the QOF. This will offer financial incentives to reward GPs who go above and beyond to prevent the most common killers like heart disease.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 January (HL3973), what was the total cumulative impairment of public dividend capital for each NHS provider listed in that answer in each of the past 10 financial years, broken down by financial year.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The attached table shows the cumulative Public Dividend Capital impairment for each of the listed NHS Providers in HL3973, per year, for the past seven financial years.
Please note that as detailed on page 187 of the document, Department of Health and Social Care Annual Report and Accounts 2019-20, Public Dividend Capital impairments have only been recognised on an individual provider basis by the Department since the 2019/20 Annual Report and Accounts, which included a prior period adjustment to apply the same across 2017/18 and 2018/19. Due to the size of the document, a copy has been placed in the Library.
For this reason, the Department has been unable to provide data for the past 10 financial years, although the Department has provided the full information held.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 16 January (HL3971), what are the names and total revenue allocations for each of the 38 National Health Service NHS providers that failed to meet the audit completion deadline of 28 June 2024 for the financial year ending 31 March 2024.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department set a deadline of 28 June 2024 for the completion of National Health Service provider audits, for the year that ended 31 March 2024. 38 NHS providers did not meet the deadline. NHS providers do not receive revenue allocations, and instead revenue is earned through the provision of services. A table showing the 38 NHS providers and their total operating income is attached.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what proportion of GP practices in the top 20 percent of achievement scores in the Quality and Outcomes Framework had an exception reporting rate above the national average in the most recent financial year for which data are available.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Personalised care adjustments (PCAs) replaced exception reporting in 2019. PCAs operate in the same way as exceptions, but PCA specification follows a consistent hierarchy which supports better attribution of the reason for care being personalised.
The national PCA rate in 2023/24 was 8.2%. 1,253 general practices’ Quality and Outcomes Framework (QOF) achievement rates fell in the top 20% of achievement rates, and of these, 418, or 33.6%, had PCA rates greater than 8.2%. This information is taken from the published QOF statistics, and is available in an online only format on the NHS.UK website.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government which NHS providers accounted for the largest proportion of the £7.5 billion impairment in its Public Dividend Capital investments in 2023–24 outlined on page 240 of the Department of Health and Social Care’s Annual Report and Accounts 2023–24, published on 17 December 2024; and what were the individual values of those impairments.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Public Dividend Capital (PDC) is impaired, on an individual National Health Service provider basis, where the net assets of those NHS providers fall below the level of PDC issued to that trust or foundation trust, irrespective of whether subsequent PDC write-offs are likely to occur. The following table shows the NHS providers that accounted for the largest proportion of the £7.5 billion impairment in 2023/24, along with their respective values:
NHS provider name | Impairment value |
Barts Health NHS Trust | £621,000,000 |
Barking, Havering and Redbridge University Hospitals NHS Trust | £298,000,000 |
Manchester University NHS Foundation Trust | £289,000,000 |
University Hospitals of Derby and Burton NHS Foundation Trust | £282,000,000 |
University Hospitals Coventry and Warwickshire NHS Trust | £260,000,000 |
University Hospitals Birmingham NHS Foundation Trust | £248,000,000 |
Norfolk and Norwich University Hospitals NHS Foundation Trust | £238,000,000 |
University Hospitals of North Midlands NHS Trust | £234,000,000 |
King's College Hospital NHS Foundation Trust | £216,000,000 |
Mersey and West Lancashire Teaching Hospitals NHS Trust | £212,000,000 |
University Hospitals Sussex NHS Foundation Trust | £203,000,000 |
South Tees Hospitals NHS Foundation Trust | £201,000,000 |
North West Anglia NHS Foundation Trust | £196,000,000 |
Mid Yorkshire Teaching NHS Trust | £187,000,000 |
St George's University Hospitals NHS Foundation Trust | £180,000,000 |
North Bristol NHS Trust | £176,000,000 |
East Lancashire Hospitals NHS Trust | £175,000,000 |
Worcestershire Acute Hospitals NHS Trust | £172,000,000 |
Portsmouth Hospitals University NHS Trust | £158,000,000 |
East Kent Hospitals University NHS Foundation Trust | £145,000,000 |
Sherwood Forest Hospitals NHS Foundation Trust | £131,000,000 |
Maidstone and Tunbridge Wells NHS Trust | £129,000,000 |
Leeds Teaching Hospitals NHS Trust | £126,000,000 |
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust | £105,000,000 |
A change in the accounting treatment for measuring Private Finance Initiative lease liabilities under International Financial Reporting Standards 16 Leases has partly contributed to the increase in the value of the impairments reported in the Department’s 2023/24 accounts.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, with reference to pages 239 and 240 of the Department of Health and Social Care Annual Report and Accounts 2023–24, published on 17 December 2024, how many cases of retrospective approval for expenditure outside delegated limits have been identified in the Consolidated NHS Provider Accounts for 2023–24; and whether the Treasury has granted retrospective approval for all these cases to date.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS England has requested retrospective approval of five cases from HM Treasury relating to National Health Service trusts and NHS foundation trusts’ special severance payments in the 2023/24 financial year, all five of which are still pending approval. The retrospective approval process is as set out in HM Treasury’s guidance on managing public money, Guidance on Public Sector Exit Payments: Use of Special Severance Payments.
Asked by: Lord Agnew of Oulton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what proportion of NHS providers failed to complete audited financial results in line with the Department of Health and Social Care's reporting timetable in the past financial year.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department set a deadline of 28 June 2024 for the completion of National Health Service provider audits for the year that ended on 31 March 2024. 38 of the 211 NHS providers, representing 18%, did not meet the deadline.