Nuffield Trust response to the Spending Review

John Appleby responds to the Spending Review announced by the Chancellor on 25 November 2020.

Press release

Published: 25/11/2020

Responding to the Spending Review announced by the Chancellor, Nuffield Trust Director of Research and Chief Economist Professor John Appleby said:

“The £3bn "NHS recovery package" starting April next year is designed to help deal with the growing waiting list and support cancer and mental health services impacted by the pandemic. This additional funding comes as the NHS faces the most difficult time in its history. Although welcome it is not clear that this will be adequate to meet the enormous challenge ahead.

“Waiting lists will continue to grow as hospitals continue with time consuming infection prevention and control measures which significantly reduce the rate at which patients can be seen and treated. That will create real pressure, requiring extra staff and capacity which will need to be fully funded if the NHS isn’t going to spend the next decade running to catch up.

“While promised increases in NHS pay are welcome without a similar commitment for social care there is a real risk the vulnerable sector will see its much-needed workforce go elsewhere. There is an added risk that the sector also loses more senior staff as the gap closes between their pay and that of entry level roles damaging both the sustainability and quality of services.

“While the government has announced that councils will have access to over £1bn more in funding for social care, around 70% of this must be raised by local councils through tax. Given the economic backdrop, councils are likely to have a very hard time trying to raise the funds this way, with poorer areas hit harder.”

Notes to editors

  • The Nuffield Trust will be publishing further analysis of Covid-19 cost pressures shortly.
  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  • For more information or to arrange an interview, please contact Simon Keen on 07805 217935 or