MPs have raised questions over the accountability of local health bodies as they warn against short-term fixes to shore up the struggling health system.

A new report from the Public Accounts Committee (PAC) warned the financial position of the NHS remains in a ‘perilous state’ despite a rescue fund in 2016–17 worth £1.8bn.

It found trusts were forecasting a deficit of over £900m in 2017-18.

The PAC report also criticised the Department of Health and Social Care for being too focused on ‘propping up the system’ and ‘balancing the books in the short term’.

The MPs called on health secretary Jeremy Hunt, as well as NHS England and NHS Improvement, to focus more on transforming and improving patient services in the long term.

The committee welcomed the moves over the last two years towards setting up new integrated care systems through sustainability and transformation partnerships between healthcare commissioners, trusts and local authorities.

However, it said it was ‘concerned’ about how accountability within these systems will work in practice or how they will improve the care that patients receive.

‘As the new integrated care systems will seek to bring together the budgets, functions and care offered by the organisations involved in the interests of the patient, it is worrying that NHS England and NHS Improvement could not clearly explain how this will sit alongside each organisation’s existing responsibilities,’ reads the report.

‘For example, they provided no reassurance to our concerns about how they will ensure that patients’ complaints are effectively heard and addressed if care services are delivered jointly by different organisations.’

The PAC report also found that local organisations which should be working together were receiving ‘mixed and confusing messages’ because NHS England and NHS Improvement had not coordinated their approaches to regulating partnerships and integrated care systems.

They also warned the patient’s voice was at risk of being lost because the pace and scale of change brought about by sustainability and transformation partnerships has varied from place to place. This has undermined effective engagement.

‘Our committee has repeatedly called for a long-term plan for the NHS and by July we expect the Department for Health and Social Care to explain in detail exactly how it is approaching this task,’ said committee chair Meg Hillier MP.

‘Key to this will be securing a funding settlement from the Treasury that properly reflects current and anticipated demand for NHS services.

‘But there is work to do on the ground now. It is a basic point but new initiatives devised with the best of intentions are no use if they don’t work in practice.

‘It remains unclear how local partnerships, set up to develop strategy and help to transform services, will be held to account for their performance. This must be addressed.’