Hospital Dr News

NHS Plan’s good intentions jeopardised by underfunding and rising demand

The ambitious vision of the NHS Long Term Plan will be extremely challenging to deliver without urgent government action on wider health funding, warn the Health Foundation and NHS Confederation.

With over-stretched, under-staffed services and poorly maintained facilities, the health service will continue to struggle in the face of rising demand, an analysis suggests.

It says success or failure will depend on whether the government commits to supporting investment in the workforce, capital infrastructure, the prevention agenda, and social care.

These areas of funding were excluded from the five-year NHS funding settlement, announced last year.

Under the new funding settlement, NHS England’s budget is set to increase by £20.6bn in real terms and NHS leaders have laid out a plan to allocate the additional funding towards necessary improvements in mental health, primary and community services.

But to meet growing patient demand, hospital activity will need to rise by at least 2.7% a year by 2023/24.

The Health Foundation’s analysis reveals that if NHS earnings are to keep pace with wage growth for other professions, the extra money will only enable hospital activity to grow by 2.3% over this period.

Managing demand to this extent would require a major change to recent trends – demand for hospital services has increased by 3% a year since 2010/11.

Front-line NHS leaders responding to the NHS Confederation survey say reducing demand for acute care through better integration and prevention is essential. But they are not confident of this being achieved – only one in four leaders believe their local health systems will be able to reduce the rate of growth in demand.

Funding cuts to social care and public health are undermining pioneering new service models designed to keep people well and out of hospital, and nine in 10 leaders are not confident the NHS will be able to deliver the reforms set out in the plan without a long-term financial settlement for social care.

The government has changed the planned phasing of the additional £20.6bn in funding which means there will be modest increases over the next couple of years with the largest injection in 2023/24.

The Health Foundation says that this runs contrary to the front-loaded settlement announced last summer and will make it hard to support a period of initial investment in care outside of hospitals. It highlights that if demand for hospital services can’t be reduced, we are likely to see increasing waiting times and the planned investment for improvements diverted to prop up struggling hospitals.

Dr Jennifer Dixon, Chief Executive at the Health Foundation, said: “The vision set out by NHS leaders in the long-term plan is the right one, and the extra funding announced by Theresa May last summer is welcome. But this is not job done.

“Policymakers need to face the fact that there is urgent unfinished business if the NHS is to deliver its vision to improve patient care. There are mounting workforce shortages, the social care system is starved of funding, capital investment is going backwards, and public health funds cut. This all piles demand on the NHS and risks swallowing up the extra money and leaving far less to modernise care, reduce waiting times, and prevent illness in the first place.”

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