Written evidence submitted to the Public Accounts Committee on Financial Sustainability of the NHS

We welcome this opportunity to submit written evidence to the Public Accounts Committee on the Financial Sustainability of the NHS. This reply draws on recent published academic work, senior level personal experience of public service management and accounting practices, and response to the House of Lords Select Committee on Long-Term Sustainability of the NHS (Ferry and Gebreiter, 2016). The National Audit Office (NAO) (2016a) has recently repeated its view that financial problems are endemic in the NHS and the situation is not sustainable, and that while there has been effort to stabilise the system by the Department of Health, NHS England and NHS Improvement they have not demonstrated balanced resources and value for money. We concur with the view of the NAO on the current financial situation and so rather than repeat any of these messages the main focus of our response concerns whether accountability arrangements for sustainability of the NHS are 'fit for purpose', especially given ongoing resource pressures (Ham et al., 2015) and structural fragmentation (NAO, 2014, 2015a, 2016b, 2016c)