Daily Insight: Under pressure and overspending | Expert Briefing


The Department of Health and Social Care decided that Monday afternoon, when the eyes of the country turned to the chamber of the House of Commons, was the perfect time to publish its 2020-21 annual report and accounts.

They appeared 10 months after the end of the year, although still on schedule, with some pretty startling details.

The pages contain details of an £8.7billion impairment loss on the £12.1billion of personal protective equipment purchased in 2020-21, largely due to the significant fall in the value of the kit currently, compared to its purchase. , at a time of endless demand and high prices.

It includes details of how DHSC’s inventory management systems “were unable to cope with the large and rapid increase in purchases”, how they “did not keep adequate records of location or condition of £3.6 billion of inventory”.

And it details how £1.3billion of DHSC spending was “irregular because it spent the funds without the necessary UK Treasury approvals or in express breach of terms set by the UK Treasury. “. This included a consultancy contract extension, which pushed the contract to over £150million – the threshold at which the department should have sought approval.

The accounts state that HMT also “declined to retrospectively approve the contract, after reviewing the relevant facts.”

The DHSC, NHS and the government as a whole were operating in incredibly difficult circumstances – under ‘extraordinary pressure’, as the auditor put it – so we can’t be too surprised when departments take greater risks , operate beyond their normal processes and procedures.

Unfortunately, the DHSC “was unable to adequately manage some of the high risks”, according to the auditor, meaning there were “significant losses to the taxpayer”.

The underserved get poorer

New HSJ An analysis found that several areas that already had low numbers of GPs in 2015 have seen some of the biggest declines in the past six years.

The new analysis – which looks at the full-time equivalent workforce – suggests wide variation between local systems in their efforts to increase the number of GPs in their areas and comes against an intense policy backdrop focused on the general medicine, with Health and Social Care Secretary Sajid Javid planning a national review of the workforce and funding and employment models.

Some systems, including West Yorkshire, Birmingham and Solihull, have managed to increase their numbers significantly, while those starting with lower numbers have tended to recruit or retain more GPs.

However, the systems covering Kent and Medway, Bedfordshire, Luton and Milton Keynes, Mid and South Essex, and Cambridgeshire and Peterborough have all seen relatively steep declines, despite already having some of the lowest numbers of GPs per capita. .

Clinical commissioning groups covering these areas said HSJ difficulties in attracting GPs and the steps they have taken to try to obtain and retain more GPs; including working on new ‘attraction packages’ which include ‘financial incentives’, running ‘scale programmes’ to increase the number of GP trainees, ‘target support’ to newly qualified GPs and offering a occupational health support for practices.

Whether these efforts will succeed remains to be seen. Meanwhile, a promise made by the Conservative government to increase the number of GPs in 2015 was missed as numbers fell in subsequent years, and a renewed promise in 2019 (6,000 by 2024-25) is expected to also be missed.


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