Local auditor reporting in England 2018
The number of NHS and local government bodies with weaknesses in their arrangements for delivering value for money is increasing.
10 Jan 2019
As part of central government's decision to give more power to Councils and other local bodies (eg in healthcare), local organisations now decide how to spend hundreds of billion each year. Parliament and the public expect this spending to be efficient and effective and achieve the intended aims. Central government sets these aims, while local organisations decide how to spend the funding based on local needs and priorities. The public must be told how the money is spent and what outcomes have been achieved so that local electorates can be sure the money is spent well and can question decisions.
Central government must also be sure that the spending is achieving the desired outcomes and value for money. It is also responsible for protecting customers and making sure that where services fail, customers can get redress, including from local government and health Ombudsmen.
Key NAO publications:
The number of NHS and local government bodies with weaknesses in their arrangements for delivering value for money is increasing.
For combined authorities to deliver real progress they will need to demonstrate that they can drive economic growth and contribute to public sector reform.
The incentives on government Accounting Officers to prioritise value for money are weak compared to those associated with the day-to-day job of satisfying Ministers.
Over 10 million people who used public services (about 1 in 5) in the UK last year faced problems with the services. Detriment can and does occur. But users find the complaints and redress systems confusing.
The Department for Education is not meeting its objectives to improve the quality of care and the stability of placements for children in care.
The Better Care Fund is an innovative idea but the quality of early preparation and planning did not match the scale of the ambition. Current plans forecast £314m of savings for the NHS rather than the £1 billion in early planning assumptions.
The Department has increased local authorities’ flexibility over their funding, but as a result has less information on how funds are being spent.
Monitor has achieved value for money in regulating NHS foundation trusts, and has generally been effective in helping trusts in difficulty to improve.
The new policing oversight framework has been in place for a year but already there are gaps in the system with the potential to undermine accountability both to the Home Office and the public.
Although new organisations set up as part of the reformed health system were ready to start functioning on time, the transition to the system is not yet complete.