Author: Great Britain: National Audit Office Publisher: The Stationery Office ISBN: 9780102969467 Category : Medical Languages : en Pages : 40
Book Description
A combination of inadequate information and fragmented purchasing means that NHS hospitals' procurement of consumables is poor value for money. The NAO estimates that at least £500 million a year could be saved by the NHS on its spending on consumables, and potentially much more for some products. With no central control over Foundation Trusts, the Department of Health cannot mandate more efficient procurement practices. Responsibility to demonstrate value for money in procurement falls upon the management of individual trusts. The price that trusts pay for the same items varies widely. The average variation between the highest and lowest unit price paid was 10 per cent. Some trusts are not getting value for money because they are buying many different types of the same product. For example, trusts bought 21 different types of A4 paper, 652 types of medical gloves and 1,751 different cannulas. There is also a large variation between trusts: one bought 13 different types of glove, whilst another bought 177 different types. There are unnecessary administrative costs because many trusts make multiple small purchase orders. Hospital trusts have complete freedom in purchasing decisions and can use regional procurement hubs, the NHS Supply Chain or they can buy direct from suppliers. Evidence suggests that new contracts are being established which overlap and duplicate each other. There is no national performance framework for hubs which would enable comparisons to be drawn between them or to allow an assessment of their potential optimal performance.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215559609 Category : Medical Languages : en Pages : 48
Book Description
The 165 NHS acute and Foundation hospital trusts in England spend over £4.6 billion a year on the procurement of medical supplies and other types of consumable goods. Each trust controls its own purchasing and can purchase consumables in various ways: dealing direct with suppliers; through the national supplies organisation, NHS Supply Chain; or via the regional Collaborative Procurement Hubs. They can also choose to join other trusts in collaborative purchasing arrangements for particular localities or types of supplies. The Department sees the future for NHS procurement as a 'pyramid' structure with national, regional and local procurement of different types of goods, as appropriate to the products and the supplier markets. However, this theoretical model does not reflect the current complex reality, with a profusion of bodies involved in the procurement process. Its effectiveness is open to question in the emerging landscape where Foundation Trusts act independently with no explicit incentive to co-operate. The fragmented system of procurement has produced a great deal of waste, with trusts being charged different prices for the same goods, ordering in inefficient ways and failing to control the range of products which they purchase. The NAO has estimated that trusts could save around £500 million annually, 10% of their consumables expenditure, by amalgamating small orders into larger, less frequent ones, rationalising and standardising product choices and striking committed volume deals across multiple trusts. A lack of data has limited progress towards more efficient procurement and there has not been sufficient control over procurement practices.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215561329 Category : Medical Languages : en Pages : 52
Book Description
In 2009-10 the eleven regional ambulance services in England handled 7.9 million emergency calls and spent 1.5 billion pounds on urgent and emergency services. They are expected to make 4 percent efficiency savings year on year in a time when public demand for services continues to rise. Performance was measured against three response time targets until 1 April 2011, but the incentive to meet these targets has led to some inefficiency, such as when more than one team is sent to incidents. The Committee welcomes the decision to introduce a wider suite of health quality indicators to create a broader performance regime in which response times remain one indicator. There is wide variation in the cost of responding to an incident across the services, and there is a need for more consistent performance data in order to benchmark and share best practice. Under the NHS reforms there is vagueness around who will be responsible for what: who commissions ambulance services; who is responsible for improving efficiency in ambulance services or who will intervene if a service has financial trouble or seriously under performs? There is need for greater clarity on the roles and responsibilities of the Department, commissioners and ambulance trusts with appropriate structures for accountability. Other parts of the Health service affect ambulance services and a more integrated emergency care system is needed to ensure that ambulances are utilised in the most efficient manner. Levels of collaboration between ambulance, fire and police services could be strengthened.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215561664 Category : Business & Economics Languages : en Pages : 52
Book Description
The Efficiency and Reform Group (the Group) was established within the Cabinet Office in May 2010 to lead efforts to cut government spending by £6 billion in 2010-11. Its long term aim is to improve value for money across government by strengthening the central coordination of measures to improve efficiency. The imperative to make savings in the short term has involved the Group imposing new controls on departments, such as moratoria on certain expenditure. Sustained efficiency improvements, though, will need a much deeper change to both the culture and institutional structure of government. The Group also needs to clear up confusion over who is accountable for what in terms of improving value for money, especially in defining its responsibilities and those of the Treasury and individual departments. The Group's actions have resulted in efficiency savings of £3.75 billion across departments in 2010-11. It should continue to describe any future spending reductions accurately and explain any impact on services. The scale of the challenge to deliver efficiencies is huge: the Government intends that half of the £81 billion reduction in spending planned over the next three years should come from efficiencies rather than through cuts to services or delays to important projects. Many of the efficiencies must be achieved in areas where the Group currently has a limited influence, or by local bodies, where it has none. The Group should set out how it will operate to ensure that its approach can be replicated across the wider public sector.
Author: Great Britain. Parliament. House of Commons. Committee of Public Accounts Publisher: The Stationery Office ISBN: 0215085779 Category : Political Science Languages : en Pages : 41
Book Description
This report summarises the key areas of the Committee's work over the past five years. It draws out the areas where progress has been made and where their successors might wish to press in future. The Committee has assiduously followed the taxpayer's pound wherever it was spent. Since 2010 they held 276 evidence sessions and published 244 unanimous reports to hold government to account for its performance. 88% of their recommendations were accepted by departments. In many cases they successfully secured substantial changes, for example with the once secret tax avoidance industry. They secured consensus from government and from industry that private providers of public services do have a duty of care to the taxpayer, and in pushing the protection of whistleblowers further up the agenda of all government departments. By drawing attention to mistakes in the Department for Transport's procurement of the West Coast Mainline, more recent procurements for Crossrail, Thameslink and Intercity Express have all benefited from more expert advice and a more appropriate level of challenge from senior staff. After discovery in 2012-13 that 63% of calls to government call centres were to higher rate telephone numbers, the Government accepted our recommendation that telephone lines serving vulnerable and low income groups never be charged above the geographic rate and that 03 numbers should be available for all government telephone lines. They also secured a commitment to close large mental health hospitals.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215043764 Category : Political Science Languages : en Pages : 44
Book Description
Under the Public Bodies Reform Programme the Government is reducing the number of its arm's length bodies from 904 to between 632 and 642 by the end of the current Spending Review period and will have a substantial and lasting impact. The Programme is intended to improve accountability for functions currently carried out at arm's length from Ministers. The Cabinet Office says it is on track to make £2.6 billion of administrative savings by 2015. However there are substantial reservations about the robustness of this claim. Key concerns are that: there is a risk departments are claiming savings which are actually cuts to services, when they should be including only genuine savings arising from administrative reorganisations; estimates of transition costs such as redundancy and pension costs are incomplete; the savings estimate does not fully take account of the ongoing costs to other parts of government of taking on functions being transferred from abolished bodies and some departments have wrongly included wider savings from bodies being retained, rather than just administrative savings from bodies being abolished or substantially reformed. The Cabinet Office has accepted that its savings estimate needs to be reassessed and has undertaken to 'rebase' it. Focus now needs to be on managing the Programme effectively. Departments have decided on the form of individual reorganisations themselves without clear direction from the centre, leading in some cases to inconsistent treatment of bodies with similar functions. Furthermore, departments may not be getting the best value for money from the sale or transfer of assets of bodies being abolished
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215043382 Category : Education Languages : en Pages : 44
Book Description
The Department for Business, Innovation and Skills and the Skills Funding Agency provide funding for further education students aged 19-plus. The Department for Education and the Young People's Learning Agency fund further education for 16-to-18-year-olds. These two departments provided £7.7 billion in funding to the sector during the 2010/11 academic year. The various government bodies that interact with the sector have different funding, qualification and assurance systems. Differences in the information required and collected create an unnecessary burden for training providers and divert money away from learners. To provide value for money, the systems need to be appropriate, efficient, avoid unnecessary duplication, and balance the protections they provide for public money with the costs of the bureaucracy they impose. No one body is currently accountable for reducing bureaucracy in the further education sector. Instead, the two Departments and the two funding agencies maintain separate responsibilities based on their funding streams. BIS has a stated policy objective of reducing bureaucracy imposed on further education providers but would not accept overall responsibility for bringing together efforts to reduce bureaucracy in the sector. Both BIS and DfE, and their funding agencies, have launched separate initiatives designed to simplify the requirements they place on providers. However BIS does not manage the simplification as a programme with a clear and consistent goal. While BIS has required the Agency to reduce its own administrative costs by 33%, there is no rational view on the amount by which they would like to reduce bureaucracy in providers nor do they accept that measurement of progress is necessary.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215040480 Category : Business & Economics Languages : en Pages : 68
Book Description
Under European Directives, all member states are required to install 'intelligent metering systems' - smart meters - to at least 80% of domestic electricity consumers by 2020. The UK Government has opted for a more challenging programme, with plans for energy suppliers to install smart electricity and gas meters in all homes and smaller non-domestic premises in Great Britain by 2019. The Department estimates that the smart meters programme will cost some £11.7 billion. This large complex programme requires replacing around 53 million gas and electricity meters, with significant uncertainties over the estimated costs and benefits involved. Installation costs will be borne by consumers through their energy bills, but many of the benefits accrue in the first instance to energy suppliers. No transparent mechanism presently exists for ensuring savings to the supplier are passed on to consumers, and the track record of energy companies to date does not inspire confidence that this will happen. There remain significant uncertainties in a number of key areas in the programme and the Department needs to address these by conducting proper trials to identify and manage the risks associated with an IT project involving such a substantial amount of money which is financed by individuals as consumers. The Department needs to ensure that the vulnerable, those on low incomes and those who use prepayment meters also benefit from smart meters. It would be unacceptable if these consumers bore the costs of smart meters through higher charges without getting a share of the potential benefits.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts Publisher: The Stationery Office ISBN: 9780215039910 Category : Business & Economics Languages : en Pages : 72
Book Description
HM Revenue & Customs faces a huge challenge to resolve long-standing problems with the administration of PAYE and tax credits while making substantial reductions to its running costs. The Department needs to stabilise its administration of PAYE following the problems encountered after a new processing system was introduced in 2009. It also needs to recover a significant amount of outstanding tax credit debt while minimising the amount of new debt being accumulated. While £900 million extra has been allocated to tackle tax avoidance, at the same time, following the 2010 Spending Review, the Department is required to reduce its running costs by £1.6 billion over the next four years. The Department has made progress in improving PAYE administration since the Committee's last examination of this area in 2010. However, as a consequence of the Department's handling of the 2009 transition to the new PAYE Service, it has had to forgo up to £1.2 billion of income tax underpaid from 2004-05 to 2009-10. Under current plans, it will take until 2013 before all processing backlogs are cleared and the new PAYE Service is operating as intended. The Department needs to focus on improving data quality in particular to sustain progress in PAYE administration. Without a clear plan for reducing tax credit debt, the level of uncollected debt will continue to rise to an estimated £7.4 billion by 2014-15. The Department has been forced to acknowledge that much of this debt will never be recovered from tax credit claimants, and recently wrote off some £1.1 billion of debt dating back to the introduction of the scheme.
Author: Great Britain: National Audit Office
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain. Parliament. House of Commons
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain. Parliament. House of Commons. Committee of Public Accounts
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts