Funding failures created crisis in social care: government must act now to protect NHS from similar fate

06 October 2020

The chief executive of NHS Providers has warned that worrying gaps in health spending must urgently be addressed in the forthcoming comprehensive spending review (CSR).

In a speech to mark the launch of NHS Providers annual conference and exhibition, Chris Hopson said he despaired over the way politicians had treated social care, and was worried that the NHS could face a similar fate, where funding failing to keep up with demand had pushed social care into crisis.

He said the government’s current five year funding commitment for the NHS had left important gaps on money for buildings, equipment and staff training. He also warned that since the funding announcement, in June 2018, the NHS now had to deliver major new commitments from last December’s Conservative party election manifesto as well as meeting significant extra costs from COVID-19.

Speaking to hundreds of trust leaders from across England, Chris Hopson warned the government against pretending that the health service could cope with these pressures. He said it was impossible to see how the NHS could deliver what was now expected of it on the current funding settlement.

He called on the government to revisit all three elements of NHS funding in the forthcoming CSR:


He said the most pressing problem of all was the reform of social care – and that COVID-19 had clearly shown the cost of that neglect.

“We elect our politicians to tackle the difficult issues. For two decades they have failed us deeply, consistently and unacceptably by promising to sort the crisis in social care and then failing to do so” he said.

“Having driven social care into crisis by failing to fund it properly and sustainably, we must avoid driving the NHS into a similar fate. And we obviously need to rescue social care from its current state of crisis.”

The speech also paid powerful tribute to health service staff who, he said, were at the heart of the past, present and future of the NHS.

He praised the extraordinary response the health service had mounted to tackling the COVID-19 pandemic:

“The last nine months have been the most challenging in the NHS’s history and we all are in debt to the service that has achieved some incredible things.

“They created 33,000 beds for coronavirus patients and set up Nightingale hospitals across the country in under a month.

“24 hour mental health crisis services were also set up and ambulance and 111 call centre capacities were rapidly expanded.

“Community services were increased to ensure the safe discharges of large numbers of hospital patients and a new discharge to assess model was rolled out in three weeks.

“But none of this could have been achieved without the NHS workforce. And all parts of the workforce have contributed. Porters and pharmacists, psychiatrists and paramedics, podiatrists and physiotherapists. Procurement, estates, finance and HR teams.

“A collective team effort unprecedented in the NHS’s 70 year history and the nation as a whole owes a huge debt of thanks to frontline NHS staff”.

Mr Hopson made clear in his speech that the best way to repay that debt is to create and fund a sustainable NHS workforce model which fills current vacancies and stops asking staff “to go the extra mile and a half every single shift, every single working day”.

Looking ahead to winter, Mr Hopson warned of a potential “perfect storm” caused by a full second spike of COVID-19, winter pressures, the need to work at “full pelt” to recover services, tired staff in danger of burnout and the loss of up to 30% capacity in some trusts due to the need to separate COVID and non-COVID patients to keep them safe.

He set out what trusts need from the Government and NHS England and Improvement to prevent this perfect storm:

  1. A robust and effective testing regime that delivers for patients, the public and the NHS.
  2. Security of supply and distribution of personal protection equipment.
  3. Current gaps in second half finances and the extra costs resulting from any unexpectedly large second COVID spikes need to be fully covered.
  4. Realism about what can be achieved to ensure that an impossible burden is not placed on staff.
  5. Trusts being empowered to deliver, without needless top down oversight.
  6. Appropriately tough local lockdown measures wherever the virus is spreading in a way that could jeopardise the NHS’s ability to cope over its busy winter period.


In conclusion, Mr Hopson said the health and care system had been through the most astonishing nine months in its history, meeting challenges head on. But he cautioned that there were clearly more trials, and possibly the most difficult days, ahead.

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