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“These findings demonstrate the extent to which GPs choosing to prescribe cheaper but just as clinically effective generic medicines can lead to real savings for the NHS. This is all the more important as the NHS’s spending on medicines continues to rise year on year, as the UK’s population ages and more and better treatments become available. The almost £400 million saved in just one year is money available to improve the quality of patient care.”

“It was no mean feat transferring virtually all NHS staff on to a new pay system within a very constrained timeframe, and this element of Agenda for Change has been a success. On the other hand, the benefits that should have come with this new simpler system, such as more effective working, have not been wholly achieved. So the programme as a whole has further to go before it achieves the intended value for money for the taxpayer.”

“The surplus of £1.67 billion is equivalent to about one week’s funding for the whole NHS. The organisations in the NHS are performing better financially and this surplus has created an element of certainty for financial planning that has not existed in recent years. This is especially reassuring given current financial pressures throughout the economy.

“Auditors have found matters to be addressed, such as localised accounting issues, and there are long-standing financial problems affecting a minority of trusts. The significant challenges for the NHS next year are in meeting new International Financial Reporting Standards and tougher deadlines on closure of accounts, but it looks as though most NHS bodies are well placed to cope.”

Tim Burr, the head of the National Audit Office, said:

“Good financial management is not just about achieving a surplus. It is also about meeting delivery targets within the resources available. The surplus was generated through good financial management: NHS bodies delivered more cost savings than expected while still delivering against targets and improving the quality of healthcare. But better forecasting of the outcome could enable resources to be deployed more flexibly in-year.”

“Good end of life care should mean that people are treated with dignity and respect and, where possible, in their preferred place of care. Some people receive high standards of care in their final weeks, days and hours, but others do not. Organisations responsible for the care of people approaching the end of their life need to improve the planning and delivery of services, particularly support in the community. There is scope to make these improvements by using both existing and planned additional resources more efficiently and effectively.”