The findings of this survey make clear the impact of the increase in cost of living on NHS staff and the patients and communities they support. To  respond to this evolving situation, trusts need:

  • Nationally coordinated support to underpin trusts' local responses to the cost of living pressures on staff.

    While trusts are leading local efforts to coordinate support for staff and reduce turnover, they would welcome more coordinated national guidance from NHS England on best practice, alongside support for the logistics of managing cost of living support for NHS staff and patients, to reduce duplication of effort. This needs to be accompanied by a long-term, fully funded workforce plan to ensure the NHS can recruit and retain the staff it needs.

Ultimately there needs to be a baseline set at national level so that all staff have access to a fundamental level of support, otherwise there is too much variance on the ground across providers and systems.

Acute trust, Midlands    
  • Realism from government and national NHS leaders about the direct effects of the cost of living on the performance and capacity of the health and care sector.

    Trusts need to be able to respond to the needs of their local communities while maintaining crucial services and retaining staff. They would like to see realism from government and the national NHS bodies about how cost of living pressures and inflation may affect workforce capacity and the delivery of key financial and operational targets, as well as recognition of the scale of the issue across acute, ambulance, community and mental health services.

This isn't something we can overcome simply by ignoring it, or working harder, or being more resilient. The workforce risks are getting harder to navigate and this is already having a negative impact on service users and their lives; the impact will extend across staff too in the months to come.

Mental health/Learning disability trust, Midlands    
  • Government action on the causes of the rise in cost of living, with measures to support the health of the most deprived communities.

    While trusts recognise the role they can play, there is a limit to how much change they can effect themselves. The most sustainable and effective solution will recognise that the impact falls unequally across society, with the most deprived and marginalised people suffering the most. The government needs to act on the drivers of rising costs over the short and medium term, to protect the public from the long-term impact of poverty on health. In this regard, government's recent intervention on energy costs for households, business and public sector for a six-month period is very welcome. With energy costs set to remain high for the foreseeable future, we welcome government's commitment to keep that policy under review and expect an extension to the existing measures to be required.

The cost of living situation is too vast and nationally driven to be giving it to local trusts to solve on top of everything else.

Mental health/Learning disability trust, North East and Yorkshire    
  • Cross-government commitment to address the wider determinants of health, to build resilience in communities and reduce poverty and its effects on health now and for the longer term.

    Preceding the current sharp rise in the cost of living was a prolonged period of widening health inequalities, a plateau in healthy life expectancy, and low investment in prevention and the wider determinants of health. The stark impact of these issues underscores the urgent need to commit to reducing health inequalities in the long term, with a focus on the most important building blocks of good health, including good work and fair pay, housing, the environment, and wider public services. While trusts step up wherever necessary to treat the health consequences of poverty, the only way to make services sustainable for the future is to ensure more people are supported to live in good health for longer.