Delivering The Cancer Reform Strategy
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Delivering The Cancer Reform Strategy
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Author : Great Britain: National Audit Office
language : en
Publisher: The Stationery Office
Release Date : 2010-11-18
Delivering The Cancer Reform Strategy written by Great Britain: National Audit Office and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-11-18 with Medical categories.
Improvements and efficiencies have been made in key areas of cancer care since the Cancer Reform Strategy was published in 2007. The NAO estimates that cancer cost the NHS approximately £6.3 billion in 2008-09, but it is not clear if the implementation of the Strategy is achieving value for money. Reported spending on cancer care varies between PCTs - in 2008-09 varying from £55 to £154 per head - and there is unexplained variation from year to year. Significant reductions have been made in the number of days cancer patients spend in hospital - largely as a result of increasingly treating patients as day cases. The Strategy aimed to minimise emergency admissions for cancer patients, but these are still increasing, with wide variations between PCTs and poor understanding of the reasons for those variations. There are opportunities to achieve better outcomes and free up resources. Reducing the average length of stay in hospital to the level of the best performing PCTs, efficiencies worth some £113 million a year could be achieved. If the number of inpatient admissions per new cancer diagnosis was reduced to the level of the best performing PCT, bed days equivalent to around £106 million each year could be saved. Radiotherapy machines could be used more productively to help the NHS meet increasing demand. High quality information is essential to be able to commission services successfully and to monitor performance. Some information on cancer has improved, but significant gaps still remain.
Delivering The Cancer Reform Strategy
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-03
Delivering The Cancer Reform Strategy written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-03 with Medical categories.
This report examines the Department of Health's and the NHS's performance in delivering cancer services; improving information on activity, cost and outcomes of cancer services; and how the Department intends to deliver cost-effective cancer services in the new NHS. The NHS spent £6.3 billion on cancer services in 2008-09. Tackling Cancer has been a priority for the Department since its ten year NHS Cancer Plan was published in 2000. In 2007 the Department published its five year Cancer Reform Strategy (the Strategy) to deliver improved patient outcomes. The NHS has made significant progress in delivering important aspects of cancer services, with falling mortality rates and consistent achievement of the cancer waiting times targets. However, early diagnosis does not happen often enough. And the gap in survival rates between England and the best European countries has not been closed. There remain wide, unexplained variations in the performance of cancer services and in the types of treatment available across the country; and significant gaps in information about important aspects of cancer services, in particular information on chemotherapy, on follow-up treatment, and on the stage that a patient's cancer has reached at the time of diagnosis. The Department cannot yet measure the impact of the Strategy on key outcomes, such as survival rates, and does not know if cancer services are being commissioned cost-effectively, due to poor data on costs and because outcomes data are not sufficiently timely. The Department must ensure the collection of high quality, comprehensive and timely data.
The National Programme For It In The Nhs
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-08-03
The National Programme For It In The Nhs written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-08-03 with Medical categories.
The National Programme for IT in the NHS is an ambitious £11.4 billion programme of investment. This report is concerned with a central part of the Programme, where the aim was to create a fully integrated electronic care records system, which is expected to cost around £7 billion in total The Department has failed to demonstrate the benefits achieved for the £2.7 billion spent to date on care records systems and has accepted it is unable to deliver its original vision. It is now relying on individual NHS trusts to develop systems compatible with those in the Programme. Furthermore the Department could not explain how potential inconsistencies would be dealt with or what it will cost local NHS organisations to connect up. The Department has not got the best out of its suppliers, despite having paid them some £1.8 billion so far. One supplier, CSC, has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap. The Department has been in negotiations with CSC for over a year, but conceded that it may be more expensive to terminate the contract than to complete it. The Department has also revised its contract with BT reducing the number of systems and increasing the price for each system delivered. This has resulted in BT being paid £9 million to implement systems at each NHS site, even though the same systems have been purchased for under £2 million by NHS organisations outside the Programme. The Committee is further concerned about the problems in getting timely and reliable information from the Department. Information provided has frequently been late, has contained inconsistencies and has contradicted other evidence.
Whole Of Government Accounts 2009 10
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2012-02-07
Whole Of Government Accounts 2009 10 written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-02-07 with Business & Economics categories.
In November 2011, HM Treasury published the first audited Whole of Government Accounts (WGA), covering the year 1 April 2009 to 31 March 2010 (HC 1601, ISBN 9780102975192). The Committee welcomes this major step forward in improving transparency and accountability and highlights some of the information it contains: at 31 March 2010 the government's public service pensions liability was around £1,132 billion; the present value of its future commitments under PFI schemes was £131.5 billion; the government wrote off £10.9 billion in unpaid taxes and expected to have to pay £15.7 billion for outstanding clinical negligence claims; cost of future nuclear decommissioning (£56.7 billion); the need for stronger accountability systems to secure effective responsibility for cost and value for money at local levels - academies, Free Schools, Foundation Trusts and GP consortia. But the WGA will only serve its purpose- showing what the government owns, owes, spends and receives - if it is timely and robust. The figures in the first audited WGA are too dated because Treasury took 20 months to prepare and publish the report. Treasury must address the issues that led the Comptroller and Auditor General to qualify his audit opinion on the WGA 2009-10. A key issue is Treasury's decision to deviate from accounting standards, by omitting Network Rail, the publicly owned banks, and various other government-controlled or owned bodies from the WGA. The Committee sets out a set of principles that future accounts should follow.
The Impact Of The 2007 08 Changes To Public Service Pensions
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-05-26
The Impact Of The 2007 08 Changes To Public Service Pensions written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-05-26 with categories.
In 2007-08, new pension schemes were introduced for civil servants, NHS staff and teachers, designed to make public service pensions affordable. The changes are likely to reduce costs to taxpayers of the pension schemes by £67 billion over 50 years, with costs stabilising at around 1% of Gross Domestic Product (GDP) or 2% of public expenditure. The Committee is concerned that the Treasury did not test the potential impact of changes in some of the key assumptions underpinning the long-term cost projections. In addition, the Treasury has not tested whether reducing the value of pensions would affect the public sector's ability to recruit and retain high quality staff. Three-fifths of the savings to the taxpayer were expected to come from the cost sharing and capping mechanism - a transfer, from employers to employees, of extra costs that arise if pensioners live longer than previously expected. Employees would potentially pay 70% more for their pensions over the next 50 years if life expectancy continues to increase more than expected. Implementation remains on hold while the Government decides how to respond to the Independent Public Service Pensions Commission (the Hutton Commission). Public service employees do not have a clear understanding of the value of their pensions because they are not provided with clear and intelligible information to enable them to make rational decisions. Further changes to public service pensions are expected as Hutton's recommendations are implemented, but this should bring a period of stability and certainty for long-term public service pensions policy.
National Health Service Landscape Review
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-04-27
National Health Service Landscape Review written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-04-27 with Medical categories.
This report examines the value for money risks and implications of the Health and Social Care Bill. The Bill proposes a new model for the NHS focusing on patient outcomes. The proposals are intended to transform the NHS in England into a highly devolved, market-based model in which local commissioners and providers of health services are freed from central control, with an increased say for local authorities, patients and the public. Whilst the reforms could complement the imperative of achieving £20 billion efficiency gains by 2014/15, the reorganisation presents an additional challenge for the NHS. The health reforms are still at an early stage and key questions have yet to be addressed. It is vital that the Department creates robust accountability structures so that Parliament and the public can properly follow the taxpayers' pound and hold those responsible to account. The Committee is concerned that the Department has not yet developed a high quality risk management protocol for either the commissioning or providing bodies. The Department acknowledges that some health trusts and some GP practices have some way to go to achieve foundation trust status or become commissioning consortia. The Department must have effective systems in place to deal with failure so that whatever happens, the interests of both patients and taxpayers are protected. This report provides an overview of aspects of the reforms where Parliament requires clarification and draws out a number of risks associated with the transition to the new model that need to be managed.
Spending Reduction In The Foreign And Commonwealth Office
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-09-30
Spending Reduction In The Foreign And Commonwealth Office written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-09-30 with Political Science categories.
Around half of the Foreign and Commonwealth Office's budget is spent in foreign currencies. In 2008, the Treasury removed the protection it had previously provided to the Department against exchange rate fluctuations. The FCO did not have the expertise or experience to effectively manage the risk of a fall in exchange rates, and that the Treasury imposed poor value for money conditions on forward purchasing foreign currency. As a result of a decline in the value of sterling, in September 2009 the FCO faced an overspend of £91 million on its 2009-10 budget (£72 million centrally and £18.8 million overseas), out of its total budget of £1.6 billion. It made drastic cuts to reduce this overspend. The FCO did well to reduce spending so quickly, which enabled it to live within its budget. However, many of the spending cuts made were short term in nature, and involved simply delaying or stopping some activities, rather than making lasting efficiency improvements. Not enough was done to monitor and measure the impact of the cuts and there is a risk that such short term cuts can lead to increased spending in the future. The FCO needs to achieve sustainable reductions in running costs of £100 million over the next four years, and sees the overseas estate as a potential source of these efficiencies and income. But in the past, high charges have had the unintended consequence of discouraging other government departments from sharing premises.
Office Of Rail Regulation
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2011-07-12
Office Of Rail Regulation written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-07-12 with Business & Economics categories.
The Office of Rail Regulation (the Regulator) is the independent economic and safety regulator of the rail industry in England, Scotland and Wales. The Regulator's duties include promoting economy and efficiency in the rail industry with much of its work focusing on Network Rail, the owner and monopoly provider of the national rail network, including track, signalling and stations. Network Rail does not face normal commercial pressures from investors and lenders to improve efficiency as it is a not-for-dividend company without shareholders, financed by debt guaranteed by the Government. It is therefore the role of the Regulator to hold Network Rail to account for its performance and to incentivise it to become more efficient. The Regulator sets efficiency targets when it determines the limits on fees Network Rail can charge train operators for use of tracks, stations and depots. Sir Roy McNulty's recent review of the rail industry showed that the rail industry continued to fail to achieve effective value for money. The Committee states that the Regulator did not exert sufficient pressure on Network Rail to improve its efficiency, and that there is an absence of effective sanctions for under-performance in the system and should enforce a stronger link between performance and bonus payments to Network Rail's senior managers. The relationship between Network Rail, the Regulator and their advisors appears to the Committee to be too cosy. Network Rail should be more accountable for its use of public money, and more transparent in its operations. The Committee sets out 11 conclusions and recommendations.
Reorganising Central Government Bodies
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2012-04-24
Reorganising Central Government Bodies written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-04-24 with Political Science categories.
Under the Public Bodies Reform Programme the Government is reducing the number of its arm's length bodies from 904 to between 632 and 642 by the end of the current Spending Review period and will have a substantial and lasting impact. The Programme is intended to improve accountability for functions currently carried out at arm's length from Ministers. The Cabinet Office says it is on track to make £2.6 billion of administrative savings by 2015. However there are substantial reservations about the robustness of this claim. Key concerns are that: there is a risk departments are claiming savings which are actually cuts to services, when they should be including only genuine savings arising from administrative reorganisations; estimates of transition costs such as redundancy and pension costs are incomplete; the savings estimate does not fully take account of the ongoing costs to other parts of government of taking on functions being transferred from abolished bodies and some departments have wrongly included wider savings from bodies being retained, rather than just administrative savings from bodies being abolished or substantially reformed. The Cabinet Office has accepted that its savings estimate needs to be reassessed and has undertaken to 'rebase' it. Focus now needs to be on managing the Programme effectively. Departments have decided on the form of individual reorganisations themselves without clear direction from the centre, leading in some cases to inconsistent treatment of bodies with similar functions. Furthermore, departments may not be getting the best value for money from the sale or transfer of assets of bodies being abolished
Department For Business Innovation And Skills
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Author : Great Britain: Parliament: House of Commons: Committee of Public Accounts
language : en
Publisher: The Stationery Office
Release Date : 2012-03-23
Department For Business Innovation And Skills written by Great Britain: Parliament: House of Commons: Committee of Public Accounts and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-03-23 with Education categories.
The Department for Business, Innovation and Skills and the Skills Funding Agency provide funding for further education students aged 19-plus. The Department for Education and the Young People's Learning Agency fund further education for 16-to-18-year-olds. These two departments provided £7.7 billion in funding to the sector during the 2010/11 academic year. The various government bodies that interact with the sector have different funding, qualification and assurance systems. Differences in the information required and collected create an unnecessary burden for training providers and divert money away from learners. To provide value for money, the systems need to be appropriate, efficient, avoid unnecessary duplication, and balance the protections they provide for public money with the costs of the bureaucracy they impose. No one body is currently accountable for reducing bureaucracy in the further education sector. Instead, the two Departments and the two funding agencies maintain separate responsibilities based on their funding streams. BIS has a stated policy objective of reducing bureaucracy imposed on further education providers but would not accept overall responsibility for bringing together efforts to reduce bureaucracy in the sector. Both BIS and DfE, and their funding agencies, have launched separate initiatives designed to simplify the requirements they place on providers. However BIS does not manage the simplification as a programme with a clear and consistent goal. While BIS has required the Agency to reduce its own administrative costs by 33%, there is no rational view on the amount by which they would like to reduce bureaucracy in providers nor do they accept that measurement of progress is necessary.