The Government is being urged to make more-long-term decisions on NHS funding and service delivery in an effort to avoid a crisis this winter.
Ahead of Chancellor, Jeremy Hunt’s Autumn Statement on 22 November, Richard Murray of health think tank, The King’s Fund, warned against the cycle of annual emergency funding for the NHS based on a series of short-term plans, saying it was ‘no way to run a health service, or social care system, efficiently’.
And he added: “We need to get back to a place where the health and care system does not face a meltdown every winter, but that requires long-term decisions that can bring demand, capacity, and efficiency back into better balance.”
The upcoming budget announcement comes at a perilous time for health and care services, with more and more NHS organisations slipping into financial deficit, progress on tackling waiting lists stalling, and industrial action continuing.
The risk to the NHS, to government, and most of all to patients, is that if no more money is forthcoming then the NHS may have no choice but to abandon some, or all, of its winter plans in order to reduce the potential deficit
And, as local authorities run into increasing financial difficulty, directors of adult social care services are warning that they will fail to meet their statutory duties and will have to cut back care services.
Murray said: “Estimates vary as to just how much money is needed to meet these unforeseen commitments, but by the end of August NHS England was already estimating a total system deficit north of £1billion, the majority of which it believes is due to the cost of strikes – and industrial action has continued since then.
“If this is correct, it would mean a full-year effect difficult for anyone to manage.”
And he added: “The risk to the NHS, to government, and most of all to patients, is that if no more money is forthcoming then the NHS may have no choice but to abandon some, or all, of its winter plans in order to reduce the potential deficit.
“Aside from the obvious risk of worsening any winter crisis in health and care, it is hard to see how the optics could be anything but dreadful.
“In this gloomy scenario, while it may be too late for the Government to make the coming winter any easier, it may still be able to make it a lot worse.
“It could also present the NHS with a difficult decision: deliberately overspend despite being ordered to stop, or follow orders and watch as services slide further into crisis and patients and users suffer the consequences.
“The former would maintain services, but potentially mean the NHS busts its budget, while the latter preserves financial discipline, but not patient care.
“The likely outcome is probably somewhere in between.”
The deplorable neglect has left an ever-growing number of people suffering as they wait for treatment and there is a chasm between the number of patients needing treatment and the number of nursing staff available
His calls for a more-long-term approach to funding services is supported by the NHS Confederation, which this week published five ‘key asks’ of the Chancellor in his speech.
They are:
- Significantly increase the country’s Capital Departmental Expenditure Limit (CDEL)
- Support a cross-government approach that creates the conditions for everyone to enjoy the best-possible health
- Support the NHS to make long-term financial planning decisions
- Fully support the NHS Workforce Plan with a clear long-term funding commitment
- Complete the Long-Term Workforce Plan with a social care equivalent
And the Royal College of Nursing (RCN) also wants to see a workforce funding commitment.
RCN director for England, Patricia Marquis, said: “Ministers will try to use strikes as an excuse for their failure to cut waiting times, but the very reason nursing staff took action is because of the rapid deterioration we witnessed in recent years.
“The bottom line is that this was a crisis that started over a decade ago with serious underinvestment in the NHS and its workforce.
“The deplorable neglect has left an ever-growing number of people suffering as they wait for treatment and there is a chasm between the number of patients needing treatment and the number of nursing staff available.
“If the Prime Minister wants to stand by his word, we need to see investment in the nursing workforce in the Autumn Statement.”
- Companies:
- NHS England
- King's Fund
- The NHS Confederation and NHS Employers
- Royal College of Nursing
