All eyes in the health and care system will be on the new chancellor tomorrow when he is expected to unveil details of the much-anticipated "mini budget".
Amid soaring inflation and huge strain on household and business budgets, the nation's health and care system is heading into winter under immense operational and financial pressure too. NHS trusts are working hard to make efficiency savings while also needing to increase capacity to deliver the plan to manage winter and get waiting lists down.
The new health and social care secretary has also set out her "A, B, C and D" of NHS challenges to be tackled. This week's announcements bring into sharp focus the potential impact on frontline services should financial trade-offs be made. Extra demands have been made already this year and health services need every penny they have. There is not the financial wriggle room to stretch the budget even further.
Last October's spending review gave the NHS a multi-year settlement to help to reduce care backlogs and to meet soaring demand. Today inflation is eating into that cash. The Institute for Fiscal Studies estimates the Department of Health and Social Care will face a real-terms budget cut between 2022/23 and 2023/24.
NHS England diverted £1.5bn to frontline services in May to offset inflationary pressures and had to find another £2bn from national budgets to cover the pay awards for NHS staff agreed but not fully funded by the government — leading to cuts in planned community diagnostic services and digital improvements.
The health and care levy was designed to deal with the backlog created by the pandemic and to bolster capacity in social care. Trust leaders, therefore, are looking to the government to confirm that the planned reversal of national insurance contributions will not mean a cut to vital funding for services and that money will not be taken from the core NHS budget.
Trusts, many facing exorbitant increases in energy costs, also seek reassurances about support measures and what the promised six-month energy price guarantee will mean for public services. Many trusts are on fixed contracts that are coming up for renewal, meaning they risk exposure to a significant rise in costs in 2023/24.
Critically, however, we need a well-funded social care system with enough capacity to help people live independently and to be able to recover at or closer to home after hospital treatment to free much-needed beds for others. This will help the NHS to tackle care backlogs and improve the flow of patients to ease knock-on problems in A&E and handover times for ambulance services.
What we don't want to see tomorrow is any suggestion that money will be redirected from the NHS into social care or NHS budgets being stretched to cover this expenditure too. That is a core concern. Social care must be boosted but to do so at the expense of the NHS would mean fewer beds for patients as we go into the very busy winter months. Taking money from already squeezed NHS budgets risks pitting it against social care when they share the same aim — providing high-quality care to those who need it.
People need and want a well-functioning, well-funded social care system just as they do a first-class NHS.
As the chancellor prepares to deliver the detail, the government faces a significant challenge to ensure that there is adequate financial support to allow the NHS and social care to deliver the services which taxpayers and patients expect and deserve.
This blog was first published by The Times Red Box.
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