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DH&SC: Annual Report and Accounts 2017-18 Department of Health and Social Care Annual Report and Accounts 2017-18 (For the period ended 31 March 2018) Accounts presented to the House of Commons pursuant to Section 6(4) of the Government Resources and Accounts Act 2000 Secretary of State’s annual report presented to Parliament pursuant to Section 247(D) of the National Health Service Act 2006 Annual Report presented to the House of Commons by Command of Her Majesty Annual Report and Accounts presented to the House of Lords by Command of Her Majesty Ordered by the House of Commons to be printed on 12 July 2018 HC1205 This is part of a series of departmental publications which - along with the Main Estimates 2017-18 and the document Public Expenditure: Statistical Analyses 2017 - present the Government’s outturn for 2017-18 and planned expenditure for 2018-19. © Crown copyright 2018 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government- licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU or email [email protected]. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is also available on our website at: www.gov.uk/government/publications Any enquiries regarding this publication should be sent to us via our Customer Service Centre using the web contact form at: https://contactus.dh.gov.uk/?openform ISBN 978-1-5286-0334-8 CCS0318289748 Printed on paper containing 75% recycled fibre content minimum Printed in the UK by the APS Group on behalf of the Controller of Her Majesty’s Stationery Office Contents Performance Report ............................................................................................................................... 1 Permanent Secretary’s Overview ................................................................................................... 1 Our 2017-18 Achievements - At a glance ....................................................................................... 4 Delivering a Financially Sustainable System ................................................................................. 31 Secretary of State for Health and Social Care Annual Report 2017-18 ........................................ 46 Accountability Report ........................................................................................................................... 60 Lead Non-Executive Board Member’s Report .............................................................................. 60 Corporate Governance Report ...................................................................................................... 61 Directors’ Report ........................................................................................................................... 61 Statement of Principal Accounting Officer’s Responsibilities ....................................................... 68 Governance Statement ................................................................................................................. 70 Remuneration and Staff Report .................................................................................................... 88 Parliamentary Accountability and Audit Report ......................................................................... 107 The Certificate and Report of the Comptroller and Auditor General to the House of Commons .............................................................................................................. 118 Financial Statements ........................................................................................................................... 122 Consolidated Statement of Comprehensive Net Expenditure .................................................... 122 Consolidated Statement of Financial Position ............................................................................ 123 Consolidated Statement of Cash Flows ...................................................................................... 124 Consolidated Statement of Changes in Taxpayers’ Equity ......................................................... 125 Notes to the Department’s Annual Report and Accounts .......................................................... 127 Annexes – Not subject to audit ....................................................................................................... 191 Annex A – Regulatory Reporting – Government Core Tables ......................................................... 191 Annex B – Financial Performance Detail ......................................................................................... 193 Annex C – NHS Operational Performance ...................................................................................... 206 Annex D – Other Departmental Information .................................................................................. 213 Annex E – Department of Health and Social Care Official Development Assistance ..................... 217 Annex F – Our Arm’s Length Bodies and Delivery Partners ............................................................ 220 Performance Report Performance Report Permanent Secretary’s Overview The Department of Health and Social Care supports its Ministers in setting the strategic direction for the health and care system. Our objectives are delivered in conjunction with our Arm’s Length Bodies, and are to help people lead healthier lives, creating a safe, high quality health and care system that is financially sustainable. This year has again been challenging for the health and care system, treating a record number of patients, with the system working to strike the right balance across performance, transformation, quality and safety and living within its financial means. The health and care system, despite the challenge, has once again delivered financial balance by building on the financial rigour and efficiency measures set in 2016-17, with the majority of NHS provider organisations meeting their control totals in 2017-18. Despite the endeavours of those working in the NHS many of the key waiting time and performance targets have not been achieved in 2017-18. Focus on measures to recover performance has begun, with additional funding to support urgent and emergency care secured in the spring. Long-term sustainable improvements, maximising resources, minimising waste to improve services will be essential to balance the health and care needs over the coming years whilst maintaining financial balance. As the NHS reaches its 70th birthday, additional funding has been secured, with the NHS receiving an average of 3.4 per cent real terms funding increase over the next five years, helping to secure the long term future of the health service. 2017-18 has seen the Department of Health become the Department of Health and Social Care, with the move of long-term social care strategy back to the Department. We have made good progress towards our vision for the Department’s future, enhancing our role as a great Department of State leading the health and care system effectively. I would like to take this opportunity to extend my personal thanks to all the staff both within the Department and across the health and care system for their continued and dedicated hard work, passion and commitment to support the Department and the wider health and care system. Sir Chris Wormald KCB Permanent Secretary of the Department of Health and Social Care Department of Health and Social Care Annual Report and Accounts 2017-18 1 Performance Report Our Role and Purpose 1. The Department of Health and Social Care (DHSC) supports the Government’s Health Ministers in leading the nation’s health and care to help people live healthier lives for longer ensuring that people have the support, care and treatment they need, with the compassion, respect and dignity they deserve. 2. As a Great Department of State, we support the NHS to ensure efficient, productive, safe, timely and high quality hospital care; whilst transforming out of hospital care to keep people living better for longer in their community. Additionally, we stay at the cutting edge of medicine and support the outstanding work of over 1.2 million staff within the health and care system, whilst training the workforce of tomorrow. In doing this, we remain accountable for the health and care system to Parliament and the taxpayer, getting the most out of every taxpayer pound spent. 3. We support and advise our Ministers to shape policy, set direction and to lead key strategic debates, while remaining accountable for delivering our commitments, acting as guardians of the health and care framework and as trouble-shooters (to take action when necessary to solve complex issues). In doing all this, we work closely with our partners in the health and care system, our Arm’s Length Bodies (ALBs) and agencies, local authorities, across government, and with both patients and the public, ensuring that we are all working with one focus – the people who use our services. 4. The Department works through a number of ALBs, whom we support and hold to account in carrying out their responsibilities. These are set out in further detail in The Accountability Report and include: NHS England (NHSE) and NHS Improvement (NHSI) who collectively lead the NHS in England; ensuring patients receive high quality care in local
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