Chancellor urged to end NHS budget uncertainty

NHS services will be put in a perilous position at the start of the “recovery phase” of the pandemic unless the Chancellor urgently provides financial certainty to NHS organisations this week.

With just 17 days to go before the start of the new financial year, the Government has yet to finalise the NHS budget for 2021/22. There is uncertainty over whether the Chancellor will follow through on his commitment to give the NHS "whatever resources it needs" to cover the extra direct costs resulting from COVID-19. These include additional costs to the NHS from PPE, testing, and infection control measures.

In a letter to the Chancellor, the NHS Confederation is warning that failure to confirm the NHS’s budget this week will have an impact on services and communities around the country. With the scale of the treatment backlog and additional demands for long COVID and mental health facing the NHS, the letter outlines how this would put many services in a perilous position – just as the NHS attempts to plot a way out of the pandemic.

The Confederation, which represents the whole health system in England, Wales and Northern Ireland, is calling on the Chancellor to conclude the Treasury’s budget negotiations with the NHS as soon as possible and enable NHS organisations to get on with planning services for their local communities.

Last week’s NHS performance figures were another reminder of the huge disruption to NHS services and patients caused by COVID-19. The good news is that 1.3 million patients received non-COVID care in January. Given the major surge of COVID-19 cases in January, this shows the enormous lengths NHS staff and their teams have gone to maintain care for patients. The NHS is not, and never has been, a COVID-only service, but the scale of the challenge ahead is huge. There are now 4.6 million patients waiting to start treatment, with more than 300,000 people now waiting more than a year, and a surge in demand for mental health support is widely anticipated.

NHS Confederation chief executive Danny Mortimer said: “We understand the impact the pandemic has had on public finances and the uncertainty this has caused. But it is simply not possible for the NHS to fully recover services, while still dealing with the pandemic, unless there is an agreed budget for next year. NHS leaders are struggling to comprehend why they are in this position and they desperately require certainty.

“The Chancellor promised to give the NHS ‘whatever resources’ it needed to meet the extra costs of responding to the pandemic. However, we are concerned that this commitment hasn’t translated into a finalised budget with just over two weeks to go. NHS organisations cannot be expected to absorb these ongoing costs in their current budgets.

“Should the Treasury’s budget discussions with the NHS fail to conclude this week, then we face the real prospect of some services having to be cut back. Tough decisions on priorities will be inevitable. No one wants to be put in this position but planning for service delivery in April and beyond is nigh on impossible without a confirmed budget in place. As we begin our path to recovery, we now need clarity from the Chancellor and the Government.”

The NHS Confederation also warns that NHS leaders need access to capital funding to order new equipment and make the necessary changes needed to buildings and infrastructure in order to remodel wards, GP surgeries, ambulance call centres and other health care settings to respond to the ongoing demands for enhanced infection control measures.