1/10 We’re going to be hearing a lot about NHS funding today so thought it might be worth doing a twitter thread to provide some context. Money isn’t everything...but it’s central to the success of the NHS as it underpins and pays for NHS capacity, workforce, infrastructure etc.
2/10 The NHS has just been through the longest and deepest financial squeeze in its history. Average real terms annual growth rate for NHS funding 1948 to 2018 has been 3.6% per year. Average annual real terms funding rises for NHS 2010-2018 have been less than 2% a year.
3/10 So the Government’s proposal to increase frontline NHS funding by 3.4% a year from 2019/20 to 2023/24 and put this into legislation is welcome. A lot more than the NHS has been receiving over the last nine years. It’s also a lot more than other public services will receive.
4/10 But a 3.4% annual real terms increase in NHS funding is only just (in fact not quite) a return to long term trend NHS funding growth. It’s also important to match up the funding increase with the actual NHS need. Thanks to @HealthFdn and @TheIFS there’s a simple formula....
5/10 Succession of NHS 3.5% real terms annual funding increases needed to keep up with rising cost and demand; 4% increases needed to recover performance gap that has opened up over last nine years; 5% needed to transform the NHS and, by implication, deliver the Long Term Plan.
6/10 There’s also another potential benchmark. Many compare the scale of current NHS challenges to those in the late nineties / early noughties. Between 1996-97 and 2009-10 the Government increased NHS funding by an average of 6.0% a year in real terms.
7/10 One further way of looking at this. Widespread agreement that many of today’s NHS challenges are due to a significant demand/capacity mismatch. Demand is growing rapidly but longest & deepest ever NHS funding squeeze means NHS capacity has been nowhere near keeping up...
8/10 If DHSC budget had increased in line with NHS trend funding growth over last 10 years, it would now be £35bn bigger. So whilst this first year’s extra frontline £5.5bn & 2023/24’s extra £30.5bn are very welcome, we must also think of £35bn capacity growth NHS has lost out on
9/10 Today’s Government commitment to increase NHS funding is therefore welcome but we need to properly contextualise it. Demand is growing rapidly, there’s a very large performance gap to recover and investment is needed to transform NHS to deliver excellent Long Term Plan...
10/10 We must therefore be realistic about how far the extra investment will actually go and what it buy. NHS ready to deliver but if rhetoric and expectations massively exceed reality we risk setting NHS & its staff up to fail and we risk letting patients and the public down.
