There has been a mixed response to new Chancellor, Jeremy Hunt’s announcement of a £3.3billion cash injection into NHS services, following his Autumn Budget speech last week.
In his first Budget as Chancellor, Hunt announced that healthcare spending will increase by £3.3billion in cash terms over the next two years.
And social care funding will also rocket by £2.8billion next year and £4.7billion the following year – representing a combined increase of £8.1billion across health and social care by 2025.
However, this will be paid for by delaying the social care reform announced last year and increasing direct central government funding by £1billion next year and £1.7billion the year after, as well as through increased council tax.
In other developments Hunt announced that capital spending across the NHS will increase slightly from what was planned last October and the New Hospital Programme will continue as proposed.
In return for the extra funding, the Government is expecting the NHS to make widespread efficiencies, as well as delivering improved performance on ambulance response times, A&E waiting times, and primary care access times.
In a further, important, development, the Chancellor also said the Department of Health and Social Care (DHSC) will next year deliver an independent assessment of workforce needs in five, 10, and 15 years, helping to ensure there are enough staff to deliver services in the future.
When the Government – and the country – face such a daunting set of challenges, we welcome the Chancellor’s decision to prioritise the NHS with funding to address rising cost pressures and help staff deliver the best-possible care for patients
And Patricia Hewitt, chairman of NHS Norfolk and Waveney Integrated Care Board, will lead a review into the role and powers of integrated care boards, with a view to seeing how local systems can be granted more autonomy with the right level of accountability in return.
Commenting on the announcement, Amanda Pritchard, chief executive of NHS England, said: “When the Government – and the country – face such a daunting set of challenges, we welcome the Chancellor’s decision to prioritise the NHS with funding to address rising cost pressures and help staff deliver the best-possible care for patients.
A serious commitment
“This shows the Government has been serious about its commitment to prioritise the NHS.
“The NHS is already one of the most-efficient health services in the world and we are committed to delivering further efficiencies, with over £5billion already freed up for reinvestment in patient care this year.
“NHS staff are delivering a huge amount in the face of record demand, with 10% more GP appointments than before COVID – an extra 35 million in a year – more support than ever for people’s mental health, and the highest level of cancer checks, while transforming people’s lives with innovative treatments such as laser therapy for epilepsy and genetic testing for sick babies and children.
“While I am under no illusions that NHS staff face very-testing times ahead, particularly over winter, this settlement should provide sufficient funding for the NHS to fulfil its key priorities.
“As ever, we will act with determination to ensure every penny of investment delivers for patients.”
On a knife’s edge
But Richard Murray, chief executive of health think tank, The King’s Fund, said the money may not be enough to keep services going and drive the efficiencies the Government is looking for.
He said: “The additional £3.3billion funding for the NHS budget is important recognition from the Government that the health service is on its knees trying to meet demand and keep patients safe.
The additional £3.3billion funding for the NHS budget is important recognition from the Government that the health service is on its knees trying to meet demand and keep patients safe
“However, with NHS funding on a knife edge, it will force the service to focus solely on its top priorities and go further on an already-ambitious efficiency programme.
“We warmly welcome the Chancellor’s commitment to a workforce plan, with independently-verified projections for staff numbers over the next 15 years, which means that health and care services can plan to train, recruit, and retain the staff they need in future and we hope the necessary resources will also be put in place to meet these needs.
“But, while it appears capital funding is protected in cash terms with inflation – at 11.1% - the Government will not be able meet its plans to maintain and improve NHS buildings, equipment, and IT and will need to cut back its ambitions.”
The budget demands NHS trusts make widespread efficiencies to protect services and improve access for patients
The budget demands NHS trusts make widespread efficiencies to protect services and improve access for patients
Industry leaders respond to the budget
Saffron Cordery, interim chief executive, NHS Providers
“Today’s announcement of £3.3billion for the NHS over each of the next two years is a welcome sign that the Treasury has heeded warnings from frontline NHS leaders.
“It will go some way towards making up the shortfall in NHS budgets caused by inflation and will allow the NHS to deliver on its key priorities.
“Trust leaders will also have heard the Chancellor’s call for efficiency savings and demands to weed out waste. And, while they will rise to the challenge, we must not forget that this announcement follows years of underinvestment in which health spending has fallen below that of comparable European countries.
“Similarly, the Chancellor’s commitment to publish an independent assessment of NHS workforce needs next year is welcome.
“This morning, over 100 health and care organisations – including NHS Providers – wrote to the chancellor asking for this and we are pleased our voices have been heard.
“As a next step, it is essential that this assessment is published in full with an explicit commitment to provide the necessary funding.
“But, while there is much trust leaders can welcome in today’s Autumn Statement, they are also keenly aware of the extremely-challenging state of wider public finances.
“The impact of double-digit inflation and deep budget cuts to other key public services will exacerbate the cost of living crisis and,
“And, while additional funding for social care is similarly welcome, delaying the charging reforms put forward by Sir Andrew Dilnot is a backwards step away from meaningful social care reform which will continue to leave many people facing unpredictable care costs.
“Trust leaders are seeing daily how years of under investment in social care has knock on effects for the NHS with thousands of people staying in hospital longer than needed. We need radical action – and fast.”
While it appears capital funding is protected in cash terms with inflation – at 11.1% - the Government will not be able meet its plans to maintain and improve NHS buildings, equipment, and IT and will need to cut back its ambitions
Mark England, chief executive of predictive health tech firm, HN
“It is positive to see the Government’s commitment to spending on NHS services and specifically targeting an approach to reduce the number of beds taken up by those unnecessarily in hospital.
“However, it is clear that restoring NHS services will require a commitment to fixing longer-term problems across the health and care system, and a more-preventative approach.
“We need to look at population health in terms of anticipatory care and focus on models and pathways which can prevent people from unplanned care whether in primary care or in hospital.
“These care models need to work for local places, not a one-size-fits-all approach.
“Data has a key role to play in being able to highlight those people with rising risks and to show which patients could benefit from more-proactive support. This is critical for redeploying very-finite resources for proactive care.
“The Government has rightly focused on workforce, but if we empower patients to take ownership of their own health, we can reduce the strain on the system.
“This boils down to delivering personalised health and care services to the right people, at the right time.
“It’s time to focus on prevention-based healthcare to ensure services are being used effectively and to empower patients to become effective self managers.
“If we do not act now and move to a more-predictive and preventative NHS then, in a similar way to climate change inaction, the future problems tomorrow will continue to grow ever more challenging.”
While additional funding for social care is similarly welcome, delaying the charging reforms put forward by Sir Andrew Dilnot is a backwards step away from meaningful social care reform which will continue to leave many people facing unpredictable care costs
Paul Landau, chief executive of health tech firm, Careology
“I’m pleased to see today’s commitment from the Government to spend more on the NHS and to focus specifically on the workforce.
“However, if it is going to achieve its ambition to improve outcomes for people living with cancer, we need a radical transformation of the critical role of digital.
“We specifically need digital funding: for not only patient-facing tech, but for the health technology infrastructure.
“The Chancellor mentioned the need to tackle waste and inefficiency in the NHS and we hope that the independent review he has commissioned will look at the role technology can play in this.
“If we are going to reduce the unprecedented backlog of people awaiting treatment for cancer, then care teams need more support to reduce the manual processes they undertake at the moment.
“By empowering patients to understand and manage parts of their treatment away from the hospital, there is the potential to free up thousands of hours of clinical time and increase survivorship.”
If we do not act now and move to a more-predictive and preventative NHS then, in a similar way to climate change inaction, the future problems tomorrow will continue to grow ever more challenging
Matt Honeyman, policy lead at software firm, Accurx
“The Chancellor’s £3.3billion package for the NHS to deliver better outcomes for citizens and drive efficiencies is welcomed.
“This funding needs to be primarily spent on recruiting and retaining NHS staff, but the role of simple tech that enables those hard-working staff to save time and deliver better care cannot continue to be overlooked.
“Staff and patients need to see some of the support package being dedicated to technology that saves time and enables better communication.
“This will be absolutely critical to sustaining and improving the NHS – just like it was during the pandemic.
“This kind of technology needs to be seen as a priority and will help stretched NHS staff do more with their time.”
The Chancellor mentioned the need to tackle waste and inefficiency in the NHS and we hope that the independent review he has commissioned will look at the role technology can play in this
Shaun Gomm, commercial director at Nexer Digital
“With the eventual digitisation of all public services inevitable, it’s crucial that any transformation is carried out with inclusion and accessibility at its core.
“The very nature of public services is that they are fair and equally accessible to all so in the drive to ‘turbo-charge’ digitisation, public services must ensure they are not creating accessibility barriers, and that the needs of those with disabilities are being taken into account when designing and implementing them.
“The Government Service Standard and the Technology Code of Practice (TCoP) must remain front and centre when designing, buying, or building technology that is going to be used to deliver or supplement public services.
“Yet, there have been noises coming from some corners of government indicating a decline in the influence of the Government Digital Service (GDS) and the Central Digital and Data Office (CDDO), which created and govern these standards.
“It is vital, therefore, especially in light of the recent statement and plans to digitise, that these institutions remain empowered and at the heart of digital government.
“Without these adequately-funded, resourced, and supported bodies, public services could quickly become not fit-for-purpose.
“It’s also worth noting that, in creating inclusive user experiences, the Government needs to consider funding and support for members of society that are not IT literate, or those that cannot afford or access technology.”
Reforms to planning laws that help expedite the building of integrated retirement communities would do more to drive change than anything from the Treasury coffers
Nick Sanderson, chief executive of care provider, Audley Group
“An £8billion funding injection for the NHS and social care sector will be warmly welcomed by the industry.
“But, while it will help in the short term, we must look at other ways to tackle, over the long term, the fundamental issue of how we care for people as they get older.
“A commitment to supporting specialist retirement housing which prioritises health and wellness would bring a wealth of benefits, including helping to unplug the housing market as older people will be motivated to downsize and it will alleviate pressure on stretched care services.
“And, importantly at a time of financial strain, it doesn’t need Treasury money to happen.
“Reforms to planning laws that help expedite the building of these integrated retirement communities would do more to drive change than anything from the Treasury coffers.
“The cross-party housing for older people taskforce was announced early in 2022 and this initiative was, and still is, a big step towards solving the overarching problem this country faces in terms of health, social care, and housing and now it must be advanced.”
Neil Griffiths, managing director of TeleTracking UK and former deputy chief executive of UCLH NHS Foundation Trust
“The Chancellor’s announcement of extra funding to support the NHS over the next two years is to be greatly welcomed, particularly in the face of so many broader austerity measures.
“However, as the Chancellor also stated, now is indeed the time ‘to ask challenging questions about how to reform public services for the better’, particularly with a view to reducing waste and increasing efficiency.
“Now, more than ever, new approaches to care delivery and reform are needed – approaches that embrace digital solutions at the most-strategic, system-wide level; that challenge known blocks to progress; and that encourage and support NHS staff through one the most-challenging times in the NHS’s history.
“If we are to make the most of our existing resources, enable more capacity, and more effective management of that capacity, then digital solutions, such as operational platforms, will play a critical role in acting as the foundation and enabler to achieve measurable and sustainable improvements.
“Operational platforms provide visibility across critical workflows, increasing bed capacity, improving patient flow and resource allocation and they are proven to improve co-ordination and control across a hospital or health system, so are fundamental in giving clinical staff time back to care.”
The injection of funds into the NHS will go some way to mitigate the impact of inflation, but the larger spend in social care should have more impact and create an opportunity for more-meaningful investment in digital
Steve Sawyer, managing director, Access Health, Support and Care (HSC)
“The increase in funding, particularly in social care, is long overdue but very much welcomed.
“The injection of funds into the NHS will go some way to mitigate the impact of inflation, but the larger spend in social care should have more impact and create an opportunity for more-meaningful investment in digital.
“Likewise, it’s reassuring to see further money being put towards delayed discharge, as this could pave the way for investment in solutions that support the integration between the NHS and step-down services into the community.
“Confirmation that the social care cap will be delayed after weeks of speculation will give some comfort to service providers, and the reallocation of funding from the reforms to other care packages will further help address service challenges in the short term.
“However, it’s disappointing that the announcement means the time, effort, and money spent by councils and their technology partners in preparing for the changes could have been allocated elsewhere over the last few years.
“And the open-ended nature of the delay makes it difficult to plan accordingly; what happens to the arrangements already in place and what should be prioritised next?
“In order to overcome this uncertainty and ensure councils make the most of the increased spending plan – including investing in digital –it’s vital that Government sets out clear guidance on the delay in the coming months.”
Now, more than ever, new approaches to care delivery and reform are needed – approaches that embrace digital solutions at the most-strategic, system-wide level; that challenge known blocks to progress; and that encourage and support NHS staff through one the most-challenging times in the NHS’s history
Paula Ridd, general manager, Altera Digital Health UK
“The financial, workforce, and efficiency challenges that the care system faces are not confined to the NHS, so I was pleased to see in the Autumn Statement the money also allocated to social care.
“Chancellor Hunt referenced the 13,500 hospital beds that are taken up by people who should be cared for at home, and while additional funding for social care will help provide additional care packages for these people, to achieve the system-wide efficiencies also referenced requires investment in other areas, too.
“Currently too many health and care teams work in silo, resulting in unnecessary duplication of effort and a disjointed patient journey.
“This is often because they don't have access to the important data that exists elsewhere in the system.
“I would encourage Patricia Hewitt and her review team to consider engaging with trusts and ICSs that are leading successful digital transformation initiatives, having invested in the technology and infrastructure to enable the sharing of information to support patient better flow.
“Doing this will help more care teams drive efficiencies and provide a better of quality of care.
“In terms of funding, it is pleasing to see such a large amount of funding being allocated to health and social care, but only time will tell if it is allocated correctly and with transparency, enabling it to reach less-digitally-mature organisations who need it most.”
In terms of funding, it is pleasing to see such a large amount of funding being allocated to health and social care, but only time will tell if it is allocated correctly and with transparency, enabling it to reach less-digitally-mature organisations who need it most
Craig Oates, managing director, Doctrin
“While it’s always encouraging to hear about increased investment in the NHS, the money needs to be targeted to areas where it will have the biggest impact, ensuring it enables the NHS to overhaul the longstanding challenges facing the health system today.
“GPs, and healthcare staff across the board, are still incredibly overworked as they deal with rising demand.
“There needs to be continued investment in effective digital health and clinical tools that support providers to manage their workload, while improving access to services and giving patients more control over their care.
“Adopting new digital tools doesn’t have to be an arduous process, as demonstrated by the work we’ve carried out at GP practice group, Lakeside Healthcare.
“The practices have increased access to care with our care navigation and digital triage platform, while significantly reducing GP workload by making the most of the wider team of healthcare professionals, such as practice nurses.
There needs to be continued investment in effective digital health and clinical tools that support providers to manage their workload, while improving access to services and giving patients more control over their care
“Digital primary care is often overlooked in government funding announcements. However, as proven by the wider private healthcare sector, digital tools have a transformative impact – and we hope key decision makers will bear this in mind when allocating the increased NHS spending.
“Digital health is not an extra, it is the key enabler to helping our NHS teams address key challenges and it is as vital today as antibiotics and diagnostic imaging has been in the last century.”