The Government has come under fire after failing to announce any new increases in funding for health services in the Spring Spending Review.
While there was no promise of extra cash, Chancellor, Rishi Sunak, did reveal that the NHS efficiency target will double from 1.1% to 2.2% and that the controversial new 1.25% Health and Care Levy will go ahead on 1 April.
This levy will affect everyone paying National Insurance contributions and will be ringfenced so that every penny raised will go towards bolstering health and social care budgets.
But the measures were criticised for not going far enough to support NHS organisations in tackling the COVID-19 backlog and attracting and retaining employees.
A spokesman for the NHS Confederation, which represents frontline healthcare workers, said: “The statement failed to address several of our ongoing policy concerns: Workforce, ongoing COVID-19 costs, inflationary pressures for the NHS, and those most vulnerable in society remain unaddressed.”
He added: “While there is always scope for increased efficiency savings, providers up and down the country are operating with reduced capacity due to the need to separate out the care provided to COVID-19 patients and those without.
To reach these levels we’ll need to see real change in the way service works such as investment in more remote and digital technology, changing how clinicians work, and rolling back or adapting work around COVID-19 measures
“This continues to leave the NHS with less capacity to treat non-COVID-19 patients and therefore to improve efficiencies.
“And many providers are already having to deliver efficiency savings of beyond 2.2%.”
The Spring Statement follows the multi-year Spending Review unveiled in October, which set out an increase in NHS service and departmental capital funding to 2024/25.
Since then, however, inflation has continued to increase to levels not seen in decades and energy costs have doubled for many NHS trusts.
As a result, the Institute for Fiscal Studies estimates the NHS England budget is now expected to grow by 3.6% per year in real terms, compared with 4.1% in October.
And these costs will likely increase further owing to the war in Ukraine, making the job of reducing the elective backlog and meeting other areas of rapidly rising demand even harder.
The NHS Confederation also hit out at the lack of clarity over who will pay for COVID-19 testing in the future, a commitment that could cost NHS organisations, or staff themselves, millions of pounds if not centrally funded.
The spokesman said: “While there is always room for improvement and scope for increased efficiency savings, the NHS is still facing an uncertain period, with the threat from COVID-19 far from over.
For over a decade the health services has been trying to uncover more and more savings while carrying out more procedures, but this has never happened to the speed at which the government hoped
“Pressure is now on the Chancellor to increase spending at the Autumn Budget. By then, the impact of inflation on the cash increase in NHS spending will be clearer, as will the ongoing impact of COVID-19 on services and a potential rise in the energy price cap in October.”
These concerns were echoed by Nigel Edwards, chief executive of the Nuffield Trust.
He said: “Despite a boost from the levy, the NHS will still face tight budget constraints.
“Funding increases to the NHS’s core budget become less generous in each of the next three years, which is why the Chancellor has doubled the annual efficiency target to 2.2%.
“In reality, however, NHS trusts will need to find even more room for efficiency than that, as at the same time there will be steep reduction in COVID support, despite the fact this cost pressure is likely to remain in place for some time yet.
“For over a decade the health services has been trying to uncover more and more savings while carrying out more procedures, but this has never happened to the speed at which the government hoped.
“Banging the well-beaten drum for more savings will not help meet yet another target.
“To reach these levels we’ll need to see real change in the way service works such as investment in more remote and digital technology, changing how clinicians work, and rolling back or adapting work around COVID-19 measures.”
And Jonathan Murphy, chief executive of Assura said the announcement offered ‘little in terms of a long-term vision for the primary care sector’, particularly around capital budgets for improvements to the estate.
The pandemic, rising cost of living, and the economic impacts of war in Ukraine are mounting pressure on government funds, and it has never been more important to be creating a long-term, sustainable strategy for investment in the space that the NHS needs
He told BBH: “The reality is we are no closer to a clear national strategy for investment in primary care infrastructure – a crucial bedrock for primary and community healthcare of the future ‒ five years on from the Naylor Review of NHS premises and more than two years since the Health Infrastructure Plan.
“General practice premises are bursting at the seams when a key NHS policy is to recruit social prescribers, clinical pharmacists, physiotherapists, and additional healthcare roles in primary care.
“All of these people need places to work, and the BMA was among the organisations calling for the Chancellor to ringfence investment today to improve and modernise the NHS estate.
“This will be increasingly important if the NHS is to successfully blend face-to-face and remote care, and its spaces must evolve to accommodate the technology and different ways of working that involves.
“The pandemic, rising cost of living, and the economic impacts of war in Ukraine are mounting pressure on government funds, and it has never been more important to be creating a long-term, sustainable strategy for investment in the space that the NHS needs.” /