In all my 30 years as a leader in the NHS I've seen first-hand the extraordinary dedication and resilience of staff, particularly during the pandemic. But relentless pressure on the healthcare system means that without sustained support and long-term investment to match, the future of the NHS is increasingly at risk. At the Spring Budget next month, the government has a crucial chance to set in motion what's needed and pave the way for an NHS fit for today, tomorrow and beyond.
Chancellor Jeremy Hunt has highlighted the need to boost public sector productivity and "deliver more for less". Indeed, the productivity review he has commissioned aims to be "the most ambitious review ever undertaken by a government". But when it comes to the NHS, disagreements on how this productivity push should be achieved could be the very thing holding it back. Beyond increasing activity and reducing costs, being more productive is about improving value for money by enhancing health outcomes and quality of care.
Trusts are already playing their part. They are spending less on temporary staff, exploring new care models like virtual wards, collaborating more with local providers to improve patient discharge and introducing staff wellbeing initiatives to combat low morale.
The Spring Budget is therefore a timely opportunity for the government to set the right course for the long-term investment and support needed.
Chief Executive
What's more, trusts are making important strides to reduce waiting times and unplanned hospital admissions, and bridging the gap between acute, ambulance, community, and social care services to offer more suitable care packages for patients. Positive work cultures that encourage staff to support each other and share ideas on how to improve patient care also pave the way for better health outcomes.
Yet external pressures persist. Over the last year, inflation rates exceeded the projections on which NHS financial plans were based, exacerbated by the disruptive impact of industrial action costing trusts an estimated £3bn. This has stretched trusts' budgets up to, and in many cases beyond, their limits, hampering the delivery of high-quality care. The failure to fully address these unfunded costs undermines the sustainability of the NHS.
The Spring Budget is therefore a timely opportunity for the government to set the right course for the long-term investment and support needed. We need the chancellor to prioritise funding for capital investment, digital infrastructure, and social care reform, as well as for wider public services that impact our wellbeing – such as education, transportation, and housing. Adequate public health spending is also key to tackling health inequalities and promoting preventive measures, which would yield significant returns in terms of improved health outcomes.
Capital funding is vital for laying the foundations for better health outcomes and economic productivity. The UK's spending on health capital has lagged behind comparable countries for the last decade, leading to older equipment and fewer beds per person. Likewise, better funding for innovation and technology could unlock the potential for digital advancements to streamline processes and enhance patient care. But we need to invest in the basics – core digital and IT infrastructure – before channelling the bulk of resources into newer technologies like artificial intelligence.
Expanding capacity in primary and community care is also crucial. Empowering services such as GPs, dentists, and pharmacies to provide a wider range of care could help with prevention, avoiding costly hospital admissions and ensuring patients receive timely care in appropriate settings.
Furthermore, urgent social care reform is needed to create a more integrated health and care system, reducing unnecessary hospital admissions and providing comprehensive support for those in need.
By prioritising the right investment, we can ensure the NHS is equipped to tackle current and future challenges, delivering the right care to all who need it.
Chief Executive
Any productivity improvement, however, hinges on solving workforce challenges. Staff are the lifeblood of health and care provision, but trusts are plagued with stubbornly high vacancy rates and burnout. Better investment in staff wellbeing, expanding training opportunities and resolving the damaging industrial disputes is therefore vital.
Beyond the NHS, a robust healthcare system contributes to a productive national workforce, reduces absenteeism and leads to cost savings in the long term by preventing ill health. The latest Office for National Statistics figures show 2.8 million economically active people are not in the workforce due to ill health – higher than previously thought. It also provides a valuable stimulus for local businesses and other services, delivering a vital win-win for investment.
Now more than ever, the government needs to provide tangible support to match the resilience and dedication of healthcare leaders and staff. By prioritising the right investment, we can ensure the NHS is equipped to tackle current and future challenges, delivering the right care to all who need it. The chancellor must seize this moment to secure the future of the NHS and demonstrate a collective commitment to a healthier, more resilient society for generations to come.
This opinion piece was first published by The New Statesman.
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