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Financial and service sustainability

Local services make a huge difference to people's health, wellbeing and quality of life. Yet there are indications that local services are not sustainable – economically, socially or environmentally.

In the NHS, organisations are allowed to spend more, or less, than the money they have been given if needed to ensure patient care. As a result, an increasing proportion of Trusts are rated at "high risk of financial failure". Local councils, by contrast, are legally required to both keep within budget and deliver certain services. With a 37% cut in central funding over the five years since 2010, councils have had to cut back other services, and longer-term investment and innovation.

Whether budget cuts put pressure on services or on finances, radical change in the way services are delivered is needed to make them more effective and cheaper. Some solutions being tried include joining up the delivery of different services, delivering services across bigger regions, and delivering services digitally.

Key NAO publications:

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Managing business operations – senior leaders guide

This guide will help senior leaders in government departments to manage and improve the way public services are delivered.

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Published:
30 Mar 2021

Local government finance in the pandemic

This report examines whether the government secured financial sustainability across the local authority sector during COVID-19.

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Published:
10 Mar 2021
£50 notes

Managing PFI assets and services as contracts end

This report provides information on managing PFI contracts when they end and considers whether government is preparing for expiry appropriately.

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Published:
5 Jun 2020