Funding settlement a big step forward but PM's world-class NHS difficult to achieve

Nigel Edwards comments on the multi-year funding settlement announced by the Prime Minister.

Press release

Published: 17/06/2018

Commenting on the Prime Minister’s remarks on the Andrew Marr show about the NHS funding settlement, Nuffield Trust Chief Executive Nigel Edwards said:

“The Government has recognised that the NHS cannot adequately care for a sicker, older population if it is lurching from budget to spending review with funding persistently lagging behind what’s needed. 

“So the Prime Minister’s commitment to a multi-year funding settlement and real terms increases of 3.4% for the NHS in England is a big step forward. This should mean the NHS can finally make some longer-term plans about staffing and services and ends the decade of austerity affecting the health service that has left the NHS with substantial deficits, long waiting times and staffing shortages.

“But this increase is not quite all it seems. Because it doesn’t apply to the whole Department for Health and Social Care Budget, it leaves out spending on things like training staff, building hospitals and public health. It appears that the real figure for all spending on healthcare will be lower, closer to 3% [1].

“Leaving out these crucial areas will make it much harder for the NHS to realise its plans to tackle the growing crisis facing the NHS workforce and to shift towards a focus on preventing ill health. While there are reports this will be addressed at the Budget, firm assurances are needed well before then.

“What’s more, this settlement is significantly lower than the 4% we, and many others, said was needed as a minimum to prevent deterioration in patient care. While a welcome respite, it will not equip the NHS to make much-needed changes to services, adopt new technologies, or expand the workforce. The Prime Minister’s ambition to create a world-class health service will be difficult to achieve with spending increases of less than the historic average.

“Today’s announcement marks real progress in getting the NHS back on its feet. But the health service and its patients should not yet breathe a sigh of relief.”

Notes to editors

  1. The Nuffield Trust understands that the 3.4% increase applies to the NHS England revenue budget. When applied to the entire Department for Health and Social Care Budget (TDEL), our calculations suggest these increases are likely to be equivalent to around 3%.
  2. Nigel Edwards has set out nine lessons from previous reforms that policymakers can learn when investing in the NHS, as well as nine things to watch out for in the funding settlement.