NHS Providers says the chancellor must seize the opportunity in the budget to help the health service escape from an impossible trap, as it struggles to meet soaring demand in the midst of an unprecedented financial squeeze.

In its budget submission to the Treasury, published today, the membership organisation for NHS mental health, community, ambulance and hospital trusts says the government has a clear choice between increasing NHS funding to a level that allows recovery of the key performance standards for the public, or accepting they will fall further behind under current funding plans.

The government has a clear choice between increasing NHS funding to a level that allows recovery of the key performance standards for the public, or accepting they will fall further behind under current funding plans.

It points out that despite best efforts from front-line staff all four key NHS performance targets for A&E, planned operations, ambulance response times and cancer were missed last year for the first time ever. The elective surgery list is now nearing a length last seen in 2007; and trusts are warning they will struggle to recover the 95 per A & E four hour target.

In calling for a realistic, prioritised plan for the rest of the parliament, it emphasises that NHS trusts want to meet the constitutional standards placed on the NHS. It also points out that they have improved productivity and made significant savings in recent years, and continue to do so.

However, the paper also highlights the increasingly difficult environment faced by trusts:

• demand has increased far more quickly than was assumed in the 2015 Comprehensive Spending Review
• pressures have been exacerbated by wider challenges in other parts of the public sector, in particular social care
• growing demand and staff shortages are making workplace pressures intolerable – a problem compounded by seven years of pay restraint
• cuts to capital spending have resulted in a rapidly rising bill for urgent repairs
• the need to modernise care to meet growing and changing demand will require additional spending on infrastructure

NHS Providers calls on the chancellor to:

• recognise that recovering NHS constitutional standards will require new money
• make sure that NHS trusts are properly engaged in setting delivery commitments to avoid development of an impossible plan
• ensure NHS funding for this parliament is frontloaded over the next two years
• follow through on commitments for capital funding, focussing on backlog maintenance and funding to transform services
• fully fund additional costs resulting from the likely end to pay restraint – this should not be funded within existing budgets.

The chief executive of NHS Providers, Chris Hopson said: 

“The Budget is an important opportunity, at the beginning of this Parliament, to protect care quality for patients and service users and help the NHS break out of the downward spiral in which it is currently trapped.

There isn’t enough funding to cope with rising demand and meet performance targets but it’s yet to be widely accepted that the targets are undeliverable without the extra funding.

“There isn’t enough funding to cope with rising demand and meet performance targets but it’s yet to be widely accepted that the targets are undeliverable without the extra funding.

“This risks eroding public confidence in the NHS but also putting trusts and frontline staff in a position of inevitably failing, however hard they try.

“National leaders will come under enormous pressure to recover the 18 week referral-to-treatment and A & E performance standards – and much else besides – in return for any extra funding.

“Any commitments must be properly costed, fully assured and agreed with the frontline leaders who will be accountable for delivering what is promised.”