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Report cover showing a nurse at work

Improving the use of temporary nursing staff in NHS acute and foundation trusts

“Trusts have been successful at reducing expenditure on agency nursing staff but there is scope to obtain greater value for money by improving the procurement and management of all temporary nursing staff. It is very important that trusts further develop their understanding of their demand for all nursing staff as the ability to be able to manage the workforce effectively will play a major part in determining whether trusts remain in financial balance under Payment by Results.”

12 Jul 2006
Report cover showing hospital with ambulances

Financial management in the NHS – NHS Summarised Accounts 2004-2005

‘There is no single cause of the deficits at NHS bodies and no single answer either. There are some systemic issues that have contributed to the deterioration in financial performance, but there are also local failings. The Commission is exploring this in more depth in two forthcoming reports – the review of the NHS financial management and accounting regime requested by the Secretary of State and Learning the Lessons from Financial Failure. Both of these reports will make recommendations to help put the NHS back onto a firmer financial footing.

‘One thing is clearer than ever: financial balance can only be achieved with commitment from finance staff, managers, clinicians and Board members. However the requirement for high quality, timely accounts must not be overlooked. There have been acknowledged weaknesses in the accounts of the NHS bodies and in 2004-05 there was evidence of inappropriate adjustments or omissions in more than a fifth of the accounts submitted for audit by NHS bodies. We have worked with NHS bodies, the Department of Health and NAO to address the weaknesses and hope to see an improvement in the quality of the 2005-06 accounts.’

Sir John Bourn, head of the NAO, said:

‘Many NHS bodies are managing their finances well, but it is worrying that a significant number are in deficit. All parts of the NHS and staff throughout the organisation must act together and take responsibility for improving financial management.

‘It is especially vital that financial control is not weakened as NHS bodies prepare for the impact of mergers and restructuring, as well as implementing Payment by Results and other national initiatives. It is also imperative that NHS bodies improve the quality of information underpinning both management and annual accounts. As well as supporting NHS Boards in informed decision-making, this will also allow local and national NHS accounts to be prepared, audited and published sooner.’

7 Jun 2006
Report cover showing a model of The Paddington Health Campus scheme

Department of Health – The Paddington Health Campus scheme

“A hospital development of this scale and ambition was always going to be a challenge but the original business case was inadequate, the lack of a single sponsor was a fatal flaw and the final scheme was not deliverable. The cancellation of the Paddington scheme at a cost of £15 million has left patients, staff and visitors to the hospitals with outdated facilities.

“The Department of Health should draw on my report’s conclusions and recommendations when deciding how best to initiate and manage its £7 billion to 9 billion capital investment programme in order to provide value for money to taxpayers, patients and staff.”

19 May 2006
Report cover showing a doctor checking a childs heartbeat with a Stethoscope

The Provision of Out-of-Hours Care in England

“The Department of Health is now on track towards providing high-quality out-of-hours services. I am glad to see signs that Primary Care Trusts are getting better at managing their providers.

“However, it is disappointing that there were so many problems in starting the new arrangements and I am concerned that so few providers are meeting their targets for the time it takes respond to patients. And the continuing confusion over whether out-of-hours is supposed to be an urgent or unscheduled care service should be dispelled without delay.”

5 May 2006
Report cover showing medication and a glass of water

The Management of Staff Sickness Absence in the National Probation Service

“Managing sickness absence more effectively will lead to better value for money in the Probation Service. Reducing current sickness absence rates of 12.3 days per person to the Service’s target of 9 days would save £11 million, equivalent to 66,420 working days or some 300 full time employees. Tackling the problem will require investment in better information, robust and proactive management, and consistent application locally of policies that have been agreed nationally, particularly to tackle stress and improve work/life balance. “

26 Apr 2006
Report cover showing a prisoner carrying a plate of food

Serving Time: Prisoner Diet and Exercise

“Prison catering has improved since we last examined it in 1997 and the Prison Service is more responsive to prisoner needs. The challenge now is for the Service to provide prisoners with food and opportunities to exercise which meet the government’s recommendations on healthy eating and exercise, whilst keeping costs firmly under control.”

9 Mar 2006
Report cover showing a man looking at the devastation of the Tsunami

Department for International Development Tsunami: Provision of Financial Support for Humanitarian Assistance

“The speed of DFID’s response after the tsunami was impressive and demonstrates the importance of planning for disasters. The scaling back of expenditure against the £75 million of immediate humanitarian assistance promised was justified, given the generosity of other governments and people from around the world. But it remains important to keep control over the £50 million paid in grants to other organisations and to know how it is spent.”

1 Mar 2006
Report cover showing school children holding apples in a bid for healthy eating

Tackling Child Obesity – First Steps

“Childhood obesity is a serious health problem that can follow people much later into life. It is a causal factor in a number of chronic diseases and conditions including high blood pressure, heart disease and type 2 diabetes. If we are serious about tackling childhood obesity then all government agencies and organisations must work together more effectively. Those of us involved in inspection and assessment must ensure that this partnership working really takes place nationally and locally.”

Audit Commission Chief Executive, Steve Bundred, said:

“The Government is facing a significant challenge on a serious social problem, but it is tackling it head on. To succeed, children must be engaged in the home, at school and when being treated by the NHS. It is no surprise that it is very complicated to address because the various government agencies involved are trying to bring about changes to the lifestyles of children and families. The recommendations in this report must be embraced urgently to give the Government the best chance of achieving its target.”

Sir John Bourn, head of the National Audit Office, said:

“Central Government must set a clear direction if we are to tackle obesity in children. Given that the target was established in 2004, the three Government Departments could have been quicker in co-ordinating their own actions and in making sure that those on the frontline were fully informed and supported in their efforts. There is now a need for the three Departments to work closely together to provide the leadership and direction that the whole delivery chain requires.”

28 Feb 2006
Report cover

NHS Direct 2004-2005: Qualification of Audit Opinion

“I have qualified the accounts of NHS Direct because of a lack of evidence that correct payments have been made to staff.

“NHS Direct has taken steps in year to centralize its accounting and payroll systems. It is vital that it continues to strengthen internal controls and ensures that proper accounting records are maintained in the future.”

8 Feb 2006