Releasing resources to the frontline: the Department of Health's review of its arm's length bodies
Arm's Length Bodies (ALBs) are stand-alone, national organisations that are sponsored by the Department of Health to deliver specialised services and functions. ALBs range in size, but normally have boards, employ staff and publish accounts, and receive substantial funding from the Department. This National Audit Office report examines the allocation of resources and potential efficiencies that such bodies require. There are four categories of ALB: (i) Regulation of the healthcare system, e.g. Healthcare Commission; (ii) Establishing of national standards for healthcare, e.g. National Institute for Health and Clinical Excellence; (iii) Safety and public welfare, e.g. Health Protection Agency; (iv) Provision of central services to the NHS, e.g. NHS Litigation Authority. In 2003-04, there were 38 ALBs, employing some 25,000 staff and receiving £1.2 billion grant-in-aid funding. The NAO has set out a number of recommendations, including: to deliver efficiencies in ALBs, targets should focus on value for money defined in terms of total resources; Departments must be clear about what targets mean in practice and that any decisions to merge or reconfigure such bodies should be based on an Impact Assessment, identifying the costs and benefits of the change; Departments intending to deliver efficiencies through their ALBs, should map out their ALB sector and understand the individual circumstances of the particular ALB; Departments should also establish baseline performance and financial metrics; sponsors or other parts of the Department should not commission new work from ALBs without prior discussion with the central ALB finance team; after the conclusion of the ALB Review in 2008-09, good practice governance arrangements should be maintained, with appropriate assessment of the purpose and value for money of any new ALBs established.
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This report has been prepared under Section 6 PART
Angie MacArthur Alex Scharaschkin PART
The Department needs to provide more 23 APPENDICES
National Audit Office 2008
achieved ALB BSU ALB Review ALB sector ALBs felt Arm's Length Bodies Assessment Audit Office analysis Authority NHS balanced scorecards Blood and Transplant budgets Business Services Authority cash releasing savings Clinical Excellence Commission for Patient Commission for Social Contracts Procurement programme costs associated counterfactual Department of Health Department's efficiency savings Embryology Authority ensure example expenditure Fertilisation and Embryology frontline headcount reductions Health Act Commission Health Protection Agency Healthcare Commission Human Fertilisation Human Tissue Authority implementing the Review Involvement in Health Mental Health Act Merged into NHS National Audit Office National Contracts Procurement NHS Blood NHS Business Services NHS Direct NHS Institute NHS Litigation Authority NHS Modernisation Agency NHS PASA NHS Professionals NHS Purchasing NHS Trusts number of ALBs number of bodies organisations Patient and Public Postgraduate Medical Education procurement savings Purchasing and Supply ring fenced savings and headcount Social Care Council Social Care Inspection sponsors staff transferred value for money