The Spring Budget offered little additional support for the NHS or social care, as the government leaned on existing commitments around workforce, technology upgrades, and efficiency drives. What will be the impact?
No New Funding to Boost NHS Capacity
Sally Gainsbury, Senior Policy Analyst of the Nuffield Trust, confirmed that the day-to-day health budget is set to grow by less than 2% in real terms next year—well below the historical average of around 3%, which is typically required to maintain current service levels. Although the budget restates NHS England’s funding uplift to £192 billion by 2025/26, this was not a new commitment.
She is among the growing critics who accuse the government of not investing enough to address record waiting lists, an overstretched workforce, and depleted buildings and equipment.
“Over the last decade and a half, successive governments have repeated the same mistake of underestimating the level of funding growth required to keep up with growing patient needs and expectations, resulting in chaotic last minute top ups to the budget. This has already happened for the budget for the current financial year, which had to be supplemented with an extra £800m for the NHS just four months after the Chancellor’s autumn statement.
Progress with preventing sickness?
Preventing illness is a major priority for the government. It helps people live longer and with better quality of life. Importantly, it also raises equity and potentially reduces the cost burden on the NHS.
The Chancellor’s address did not specifically mention public health objectives. However, in February, the government announced a £200 million increase to the public health grant for the fiscal year 2025/26, raising the total to £3.9 billion. This increase represents a 3% real-term rise after adjusting for inflation, but the amount spent per person is still lower than 10 years ago.
There are fears that cuts across the public sector will negatively impact the level of disease and the NHS’s ability to tackle it.
In its budget analysis the Kings Fund said:
‘The NHS is not an island. There are a range of public services that impact our health, such as the quality of housing, access to green space, and availability of transport. Similarly, the extent to which the NHS can prevent, diagnose and treat illnesses earlier can reduce pressures on other areas of public spending.
Diabetes UK expressed apprehension that cuts to the welfare budget could push more individuals into poverty, potentially exacerbating health inequalities and hindering efforts to prevent diseases such as diabetes.
The Local Government Association has highlighted that some services, such as sexual health clinics, are experiencing record demand along with staffing shortages.
“At a time when NHS and social care pressures are greater than ever, vital sexual health, drug, alcohol and health visiting services cannot keep living a hand to mouth existence with insufficient resources to meet this demand.”
Unprecedented pressure on ICSs
At a local level, many Integrated Care Systems (ICSs) are running significant deficits, with growing pressure to make deep cuts or reconfigure services. The budget did not provide dedicated support to ease these pressures, so boards are being asked to perform the impossible task of balancing the books and improving outcomes.
The government is requiring a 2% increase in productivity to help close the funding gap. However, critics argue that this demand is unrealistic, as it doubles the historic average rise of 1%.
Research by the Lowdown has found that ICBs are planning to make savings totalling £8bn, and topping the table is Lancashire and South Cumbria with a £530m savings target, but three-quarters of the 42 ICS are planning savings of over £100m
| ICB | Savings target (£m) |
| NHS Lancashire and South Cumbria ICB | 530 |
| NHS North East and North Cumbria ICB | 520 |
| NHS Greater Manchester ICB | 490 |
| NHS Cheshire and Merseyside ICB | 440 |
| NHS West Yorkshire ICB | 434 |
| NHS Kent and Medway ICB | 400 |
| NHS North East London ICB | 289 |
| NHS South West London ICB | 257 |
| NHS South Yorkshire ICB | 255 |
The Lowdown team will soon publish the results of its latest investigation into Integrated Care Systems (ICSs) and their plans for making savings over the next year. So far, our findings reveal that nearly all ICSs aim to limit their use of agency and bank staff, which cost the NHS over £10 billion last year. Some ICSs have taken further steps, such as implementing recruitment freezes in areas like Cornwall, Sussex, Cheshire, and Merseyside, or opting not to fill vacant positions. Integrated Care Board (ICB) leaders across all regions are setting targets to reduce the size of their workforce in order to address financial deficits and meet efficiency goals. This approach contrasts with the national plan, which aims for growth in the NHS workforce.
Adult Social Care Pressures Overlooked
There’s an estimated £2.8 billion gap in adult social care funding, driven by rising provider costs—particularly from increases to National Insurance and the minimum wage.
The Nuffield Trust estimates that the combined effect of the 1.2 percentage point increase in Employer NICs and the 6.7% rise in the NLW will result in additional costs of approximately £2.8 billion for independent adult social care providers in the next financial year. This escalation poses a risk of business failures among smaller providers, potentially disrupting care for vulnerable individuals.
Association of Directors of Adult Social Services (ADASS) projects that councils will incur up to £1.8 billion in extra costs due to these wage and tax increases, which could have severe consequences for their ability to meet statutory care obligations.
In response to the Spring Statement, Dame Jennifer Dixon, Chief Executive of the Health Foundation, said:
‘Social care was notable by its absence from the Chancellor’s speech….This will heap further pressure on a struggling sector and risks reducing people’s access to publicly funded care. The Social Care Commission’s work to develop a long term plan for reforming social care cannot come soon enough.’
Investment for tech but not crumbling hospitals
One of the most widely noted omissions was the lack of capital funding for hospitals and equipment. With a known £10.2 billion maintenance backlog, including unsafe and deteriorating buildings, the budget was a missed opportunity to invest in the NHS estate—something both NHS leaders and cross-party MPs have consistently called for.
The Health Foundation commented in March 2025 after the announcement:
‘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… 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.’
Existing Workforce Investment Still Not Addressing Immediate Shortfalls
The government reaffirmed its £2.4 billion over five years for the NHS Long-Term Workforce Plan. While this remains a positive long-term signal, no additional funding was announced, and it does little to ease short-term staffing gaps, pay pressures, or recruitment struggles facing many frontline services.
Critics, including the Health Foundation and Public Accounts Committee (PAC), argue the workforce plan announced in June 2023 is not fully costed beyond the initial phase. Future workforce costs (salaries, placement capacity, supervision, infrastructure) are not yet funded or budgeted for. PAC (Nov 2023) said it had “serious doubts” about deliverability without sustained, long-term funding commitments. In January 2025, NHS England said the PAC’s report contained “basic factual inaccuracies and a flawed understanding of how the NHS and the government’s financial processes work.”
However, the Royal College of Physicians and other health leaders have called for the Public Accounts Committee to re-open inquiry into NHS England’s Long Term Workforce Plan.
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