Commenting on the potential implications of the UK/US trade deal on new branded medicines, Sally Gainsbury, Senior Policy Analyst, said:
“The deal appears to come with a major trade-off for the NHS. By committing a larger share of national income to new branded medicines, the health service will be forced to divert spending from its existing services. In a labour-intensive service, this is likely to translate into less funding for staff.
“Even a conservative estimate suggests that higher spending on medicines could leave the UK with 10,000 fewer NHS staff by 2028 than it might otherwise be able to afford to employ that year. That doesn’t necessarily mean the workforce will shrink from its level today, but it does mean the NHS will be constrained in its ability to expand staffing to fill current workforce gaps and keep pace with rising demand for health care.
“Ultimately, however, it’s very difficult to properly assess the overall impact on the NHS, as the government has refused to publish its impact assessment on the deal. Until we get genuine transparency over what the trade deal will mean for the public finances – and therefore for the NHS – we will be unable to fully appraise how much health care will be impacted.
Notes
- Sally Gainsbury's remarks on the impact on staffing were made at the Labour Party Conference fringe and in an interview with Channel 4 News.
- The money needed to cover higher spend on new medicines is calculated based on the agreement’s commitment to increase the share of GDP spent on these products. This difference, UK wide, is a £1.6bn higher spend in 2028 (when the committed target share in the deal is 0.35% of GDP). This figure is based on the Office for Budget Responsibility’s baseline scenario for real GDP growth.
- In calculating the effect on staffing numbers, we assume that 59% of the higher spend on new medicines committed to in the deal is paid for by diverting funds that would otherwise have been spent on the workforce. This 59% is a conservative estimate, based on the proportion of NHS spend which goes on staff employed and contracted by the health service today. It excludes staffing in outsourced services.
- As the estimate assumes only 59% of the higher cost of new medicines would be funded from the workforce budget, a further £660m of the committed higher spend would still need to be found from other areas of health service spending.
- As a result, we estimate the NHS across the UK will employ in the region of 13,500 fewer staff in 2028 than without the deal. This estimate is based on dividing the workforce proportion of the funding required by the average salaries of full-time equivalent employees in the English NHS in March 2026, adjusted for national insurance costs and pensions and also for the current distribution of staff roles (for example doctors, nurses and administrators).
Nuffield Trust
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