1/19 Media reports suggest Govt now finalising health & care part of spending review and we're heading for a potential £5 billion NHS funding gap next year. We've issued a new report today with @NHSConfed showing why frontline NHS needs £10bn extra next year. New thread follows.
2/19 Bit of background context first. The NHS budget for five years, including next year and the year after, was set in June 2018, before covid. Over the last two years the Government has suspended those plans and given the NHS the extra money it needed to deal with covid…
3/19 ...Last year NHS received £18bn extra on top of original plan. In 1st half of this year NHS received an extra £7bn with more to come for 2nd half of year. According to Monday's Times (thetimes.co.uk/article/nhs-bo…) Govt now wants to return to pre-covid budget plan next year...
4/19 ...with an extra £5 billion to cover next year’s covid costs and significant new costs of recovering care backlogs that have built up. Our report with @nhsconfed today - nhsproviders.org/resource-libra… - shows NHS needs £10 billion next year. Hence potential very worrying £5bn gap.
5/19 Quick run round 3 different elements of how we get to the extra £10bn needed by frontline NHS next year. Element 1. Our report looks at extra costs NHS trusts will incur next year to carry on delivering existing services and meet new covid demand (eg long covid patients)...
6/19 …We surveyed our members (who spend 2/3 NHS budget) looking at 15 different categories of higher cost they will incur next year. They estimate their underlying recurrent cost base will rise by £4.6bn next year vs 2019/20. Details can be found in our report.
7/19 Element 2. Cost of recovering care backlogs. Depends on assumptions. Assume 50% referral bounce back and 3 year backlog elimination target. Drawing on work of others (public and private) like @TheIFS, we estimate a £3.5-4.5bn cost for each of 3 years starting next year.
8/19 Element 3. Although the NHS is one of most efficient health systems in world, covid-19 has meant NHS trusts have been unable to realise the same level of efficiency savings assumed in original 5 year budget. See here, for example: nuffieldtrust.org.uk/news-item/nuff…
9/19 Adding all these elements together gives an extra frontline NHS funding requirement of c£10bn next year in 2022/23. Versus media report of £5bn on offer from Government. The resulting £5bn funding gap is unprecedented. In the past, the NHS has been left with c£1bn gap....
10/19 ...And we've then spent the rest of the year working incredibly hard to close that gap. The press release we issued today conveys how worried we, and frontline leaders, are. And the possible consequences for patients that might follow: nhsproviders.org/news-blogs/new…....
11/19 ...These concerns have been picked up widely in news reports today. On the BBC: bbc.co.uk/news/health-58…. In the Guardian: theguardian.com/society/2021/s… And in the Daily Telegraph: telegraph.co.uk/news/2021/09/0….
12/19 As I said to @BBCr4today this morning (bbc.co.uk/sounds/play/m0… 49m 10secs in), in the near decade I've been doing this role, we've never issued such a clear and stark warning. Genuine worry that patient safety & care quality are at risk with such a large funding gap...
13/19 ...Trust leaders cannot stand idly by if that funding gap forces them to cut services, putting patients at risk. This is a key decision for @BorisJohnson and @RishiSunak, one of the most important of this parliament, with serious consequences for millions of patients.
14/19 Frontline NHS funding above covers acute hospitals, mental health, ambulance and community services. But very important to understand this is just one element of the health and care spending review. Vital that three other elements are properly settled too.
15/19 A. Increased social care funding & wider reform, now critical and cannot be delayed any longer. B. NHS capital budget – vital to recover £10 billion maintenance backlog, deliver Government commitment on 40 new hospitals and support backlog recovery/transformation.
16/19 C. Department of Health and Social Care central budget that includes the vital NHS education and public health grant budgets. And also includes key central covid-19 costs like test and trace and the ongoing covid-19 vaccination campaign. Maybe lower cost but still there!
17/19 Absolutely recognise that Govt faces real difficulty finding the extra funding for all these different elements at once. But Covid-19 is a once in a generation, global, shock, the seismic impact of which is unlike anything the NHS has experienced in its 73-year history...
18/19 ...The Government has said that we must learn to ‘live with covid’. That means they must fully recognise the extent, length and cost of the impact of covid-19 on the NHS. We must not pretend that this impact doesn’t exist or is smaller than it really is.
19/19 We also know that this isn’t just about money. Many trust CEOs saying they’re equally worried about having the right workforce in place too. In words of @BWCHBoss earlier today: “We are on a knife edge in so many ways and money should not be one of them”.
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