The Spring Budget delivered by Chancellor Jeremy Hunt last week contained little for the NHS, and what was given is largely dependent on huge productivity increases being achieved.
Money for Tech and Digital
The main funding pledge was £3.4 billion of capital investment primarily for technology and digital transformation, which the Chancellor claimed doubles the digital transformation budget. The spending will be spread over three years.
In return, the Chancellor said that NHS England chief executive Amanda Pritchard has agreed to annual productivity growth of 1.9% by the end of the next parliament. This level of productivity gain is almost double the historic trend of about 1%. The increase in productivity is supposed to be achieved due to the transformation in technology, use of AI and improvements in digital technology
It is unclear yet whether the £3.4 billion is entirely ‘new money’ or how much will have to be found from other capital budgets, which have not been set beyond 2024-25, according to an analysis by HSJ.
The Treasury told HSJ the £3.4 billion “will be fully additional to NHS’s existing tech and digital capital investment”, with £2.2 billion of the costs allocated in today’s Budget. The remaining £1.2 billion “will be earmarked from the wider capital envelope”, but whether it will be taken from future NHS budgets, or elsewhere, is unclear.
The Kings Fund notes that the £3.4 billion is ‘mostly’ new money with other money from reallocating funding from other government departments.
The £3.4bn additional funding for technology will be divided across the following three areas: to ‘transform access and services for patients, giving them more choice and the ability to manage and attend appointments virtually’ including improvements to the NHS app; the use of data to reduce time spent on ‘unproductive’ administrative tasks by NHS staff (this includes AI pilots automating the writing and clinical coding of notes and an acceleration of the Federated Data Platform, being developed by Palantir, to bring together data currently stored on separate systems); and updating IT systems across the NHS, including all NHS trusts to have Electronic Patient Records by March 2026, and to update over 100 MRI scanners with AI and to digitalise transfers of care.
More specific areas to be funded by the £3.2 billion long-term capital investment include: £35 million over three years (2024/25–2026/27) to improve maternity safety through specialist training, more midwives and engagement with mothers; and £45 million of additional funding for medical research charities in the life sciences sector. There will also be tighter controls on how much the NHS spends on temporary (agency) staff, including the ending of ‘off-framework’ agency staffing from July 2024.
Commenting on the money for digital, Nuffield Trust Chief Executive Thea Stein noted:
“The additional investment in AI and technology to improve patient care and speed up test results are welcome, but the conversation about productivity needs a rethink. New technology will take time, patience and working together with NHS leaders and staff to yield results. In addition, the NHS budget hasn’t kept up with cost pressures which has forced the NHS to regularly raid capital budgets, near to £1 billion this year alone. There is no guarantee we won’t see this again.”
Dr Jennifer Dixon, Chief Executive of the Health Foundation, said:
“An extra £3.4bn in capital spending to boost NHS technology is a welcome and significant investment in the health service, though it won’t kick in until 2025/26, after the general election. NHS history is littered with promises to spend more on capital and technology, budgets that have then been raided to pay for short-term pressures, so it’s essential that this money is spent as intended.”
It should be noted that when he was health secretary Mr Hunt had previously said the NHS should go paperless by 2018.
Day-to-Day Funding increase
The Chancellor announced a £2.5 billion increase to the Department of Health and Social Care’s planned day-to-day spending budget for next year, 2024-25, which will partially cover the ongoing cost for the NHS of pay deals settled last year. But NHS England’s day-to-day spending will barely continue to rise in real terms (ie, accounting for inflation) between 2023/24 and 2024/25.
Thea Stein of the Nuffield Trust noted that this increase “represents the bare minimum needed to reflect current costs and will do little to put the NHS’s finances in a healthier position, leaving it with significantly lower funding levels than needed to fund the government’s workforce plan.”
Jennifer Dixon, Chief Executive of the Health Foundation, noted that although the £2.5 billion is welcome “no-one should be under any illusion that this will significantly reduce the long waiting times currently being experienced by patients.”
What was missing from the budget
What was perhaps most striking about the budget for health and social care was what was missing – social care, GPs, and public health.
Some financial support was given to the children’s care sector – £165 million for new homes – but any money for the adult social care sector is to be spent on digital technology, rather than tackling the crisis in the sector.
Professor Martin Green OBE, Chief Executive Officer of Care England, said:
“This year’s Spring Budget made it clear that the government has no intention to make good on its 5-year-old promise to ‘fix social care’. While financial support was given to the child social care system which was recognised as broken, no such lifeline was given to adult social care. Our sector continues to move ever closer to a cliff edge. We all want good quality care for our loved ones – now we need those in Government to care.”
Nuffield Trust CEO Thea Stein noted:
“If this is the final fiscal event before an election, then the government’s achievements on social care remain thin. While the confirmation of the extra £500 million for councils and commitment to improving data and AI in social care are welcome, the harsh reality is that thousands of people go without the care they need as the sector struggles across the board. With council finances as precarious as they are and no additional funding to cover growing costs forthcoming in today’s budget, they will likely struggle to sustain day-to-day delivery of social care services let alone improve access to care or bring about much-needed comprehensive reform.”
Organisations in the mental health sector were also disappointed, although the NHS funding might alleviate some of the pressure placed on services, it’s unclear whether any of this funding will be allocated to mental health services.
The mental health charity MIND is concerned that there is no new funding for the Right Care Right Person initiative, whereby individuals in mental health crisis are seen by the right professional. A move primarily aimed to reduce the time spent by police officers in dealing with those in mental health crisis. As MIND noted:
“It is simply impossible to take a million hours of support out of the system without replacing it with investment. Failing to properly fund NHS mental health crisis services while instructing police forces to step back from mental health calls is an unsafe and frankly irresponsible decision.”
“Given the lack of funding for mental health services announced in today’s budget, it is even more critical that the UK government slows down the roll-out of Right Care Right Person and puts the needs of people with mental health problems and the public first.”
There was nothing in the budget for GPs and general practice, either. Dr Steve Taylor, a Doctors Association (DAUK) GP spokesperson, noted that there was nothing to reverse the massive funding cuts to general practice in the past decade.
Dr Taylor noted that despite more demand than ever, practices are closing, GPs are leaving and some are without work, describing it as a ‘catastrophe for patients’, adding:
“As representatives of GPs working in the NHS, the budget has failed to provide what is needed for safe and effective patient care in the community.”
Finally, despite the number of people out of work due to ill health, there was nothing in the budget targeted at prevention of illness and public health. The one small public health measure was the increase in duty on vaping products in an effort to deter people who don’t smoke from vaping.
The Health Foundation noted:
‘Good health and a thriving economy are inexorably intertwined, as shown by persistently higher levels of economic inactivity driven by worse working-age health. As the OBR has pointed out, economic inactivity is currently weighing down on economic growth, with labour force participation projected to fall over the parliament. This underlines the importance of keeping people well in addition to treating those who are sick.’
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
Comments are closed.