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NHS funding: New money for England is a start, but it must be spent wisely

by Matt Case | Analysis

18 June 2018

19 comments 19 comments

NHS hospital bicycle

The Prime Minister has announced that the NHS in England will receive an extra £20bn per year by 2023.

The announcement is welcome backing from the Government for the NHS, and represents a real cash injection. But is it enough? And, most importantly, what’s the money going to be used for?

The new money will see the NHS budget increase by an average of 3.4% each year until 2023, with slightly more funding available in 2019 and 2020. NHS England currently spends £114bn a year.

This is a real increase in the budget, as it goes above what would be expected by simply matching inflation. And with the average yearly increase in the NHS budget having been just above 1% since 2010, this is a big increase in the amount of money going into the NHS.

But over the next 10 years, as the population ages, pressure on the NHS will continue to build. We expect that by 2035, more than 500,000 people in the UK will be diagnosed with cancer every year. That’s an annual increase of over 150,000 people compared to the number diagnosed in 2015.

The NHS will need significantly more money to meet this demand, which the Government has recognised in its latest announcement. But independent analysis by the UK’s three biggest health policy research organisations – Nuffield Trust, the Health Foundation and the King’s Fund – estimates that the NHS needs funding increases of at least 4% per year both to meet demand and to make services fit for the future.

So, while the amount promised by the Government should do a lot to help the NHS meet demand in the short to medium-term, there are concerns that it isn’t enough to significantly improve services and outcomes.

And crucially, it’s only being provided to NHS England, which funds hospitals, GPs practices, and other healthcare services. The new cash boost won’t apply to the organisations providing our medical education, public health, social care, or vital government-funded medical research.

Without money across the board, it will be difficult for the NHS to match the growing need of patients. So, it will be important to understand what the Government plans for these other budget areas, details of which should come in the autumn.

How will the money be spent?

How the money will be spent is just as important as the amount. And as with any fresh government funding announcement, the details aren’t yet clear. But Theresa May has signalled that she wants cancer to be a focus. She has now asked the head of the NHS in England, Simon Stevens, to draw up a plan for the new funding.

The Prime Minister said today that she wants the new plan to improve cancer survival. We believe the UK should be aiming to be among the countries with the best cancer survival in the world. And to make this a reality, we need to double the pace of improvement in five-year survival over next 10 years.

Without the right staff working in the NHS, this won’t be achievable.

Earlier this month we launched our Shoulder to Shoulder campaign, highlighting how staff shortages are making it harder for the NHS to diagnose cancer earlier and treat it.

The earlier a cancer is diagnosed, the more likely it is to be treated successfully. But more than 1 in 10 NHS diagnostic jobs are vacant, and thousands more NHS staff will be needed in the future.

122 MPs have signed our letter to the Prime Minister, urging her to prioritise training and employing more NHS staff to diagnose and treat cancer in any new plan for the NHS.

That’s why we were pleased to hear Theresa May say today that workforce is a top priority for the new NHS plan. The Prime Minister is right to say that our NHS staff are the lifeblood of the NHS.

“Our ten year plan for the NHS must include a comprehensive plan for its workforce to ensure we have the right staff, in the right settings, and with the right skills to deliver world class care,” she said.

We will work with the Government and the NHS to help make sure that the NHS has the staff it needs in the future to diagnose and treat cancer earlier.

“Whilst we are concerned that the NHS will still struggle within this financial settlement, there is still much to be gained from how we choose to spend this money. It is essential that there is now a clear plan to train and employ more staff – starting now – so that this NHS investment isn’t a missed opportunity,” says our Chief Executive, Sir Harpal Kumar.

What else is needed?

It’s not just staff that the NHS needs if we are to double the pace of improvement in five-year cancer survival over the next 10 years. The new spending plan is the opportunity to make the changes needed to achieve this.

As well as workforce, we want the new plan to prioritise:

  • A health system focussed on prevention and early diagnosis
  • The UK becoming a world-leading innovator.

Having the right staff in the right numbers should be the number one priority if the Government is serious about diagnosing more cancers earlier. But the NHS will also need to adopt news ways to diagnose patients that help them access the health system quicker, such as the new multi-disciplinary diagnostic centres currently being trialled.

With the number of people diagnosed with cancer set to increase over the coming decades, more needs to be done to prevent as many cases of cancer as possible too. Around 4 in 10 cancers are preventable. And without a sustainable funding solution for public health, the NHS won’t be able to cope with the damage caused by smoking and obesity, the biggest preventable causes of cancer.

Finally, the new plan must set out how the NHS will become a leader in introducing innovative practice and technology, such as more advanced imaging technology, or blood-based biopsies. To provide truly world-class cancer care it’s essential that the NHS can quickly adopt the latest evidence-based technologies.

What next?

In the autumn the Chancellor, Philip Hammond, will confirm exactly how the Government will raise the money to pay for the plan. At the same time, he will confirm whether public health, medical education and other important areas will receive any additional funding. We will be arguing strongly that they should.

Over the coming months, Simon Stevens and other NHS leaders will be putting their heads together to develop the new 10-year plan, which will determine how this new money is used to improve the NHS. We will continue to call for improving cancer outcomes to be a key part of this plan, based on the priorities outlined above. And we will ensure that what matters to patients is central to thinking.

At the moment, this plan and funding settlement is just for the NHS in England. But the governments in Scotland, Wales and Northern Ireland will also receive additional funding, which the Prime Minister urged them to use for their own long-term plans for the NHS. We would like to see these plans used to reset their aspirations for cancer care across the UK.

Matt Case is a policy advisor at Cancer Research UK

    Comments

  • Terence Neaster
    13 August 2018

    We need to govern “health tourism “
    The rest of Europe abuse our great system! British Armed Forces should have priority over most!

  • Terence Neaster
    13 August 2018

    We need to govern “health tourism “
    The rest of Europe abuse our great system!

  • Audrey Beckett
    17 July 2018

    Prevention is always better than cure!

  • Kathy
    15 July 2018

    I agree with Carol Gray.I was trained in 1971 as a nurse .I waa paid to do my training- It was not a lot, but enough to live and I still managed to support my family in another country.I am retired now but still do bank shifts as a scrub practioner in breast oncology surgery.
    I think it is essential to start paying nurses again to do their training .Let’s all get together to lobby the government to restart the programme so nursing students do not have to rely on parents to support their training! In fact more young people in the UK may decide to do nurse training if they were being paid ..

  • Philippa Fricker
    14 July 2018

    I was stunned after reading others’ comments: how we all basically feel the same frustration. Yes its great the Government are increasing NHS budget but it is so true that this must be handled with great care. I am not convinced that politicians know best in this regard. There is a responsibility on the ‘consumer’ to wake-up as well as ‘management’ – how can each contribute in a proactive way to make our ‘sick’ NHS proud and well.

  • Cora Cumming
    12 July 2018

    If extra money was invested in social care it would go a long way to cutting waiting lists a+e waiting times and it would make caring for our elderly more cost affective……cost per night of a hospital bed huge in comparison to a care home

  • Jeff lee
    10 July 2018

    Nhs must first stop the huge wasting of money before they get anymore to waste.
    PFI costs are horrendous, a £4m project costs the tax payers £850000 a year for nearly 20 years, check out Ruthbury hospital.
    A tv monitor costs £42000 to buy and install.
    Massive fees paid to agencies .

    It’s obvious the nhs needs to get its act together first before they are given more money .
    Maybe the nhs should pay their staff the same wages as Carr jones are forced to and have the sane incrediy ridiculous funding .

  • David Johnston
    10 July 2018

    What about Scotland , Wales and N Ireland? Not fair

  • Ian Boundy
    10 July 2018

    I think the NHS is a wonderful institution. It seems to have lost its way in the respect of trying to be all things to everyone ie. cosmetic surgery, health tourists,drug rehab, alcohol abuse etc.,as well as treatment for the ill. Which was it’s primary purpose.
    There seems to be an imbalance between “management” and the angels that actually get their hands dirty.I can guess which of the aforementioned groups will receive the bulk of the promised increase.
    I don’t like to be cynical,but there you go.
    And the latest wheeze is the use of robots, god knows how much they cost,and then there would be an army of programmers, tech guys ,service engineers,and more. All to be paid out of the NHS budget. You couldn’t make it up.

  • Linda Hill
    10 July 2018

    In all honesty I think they need to ask the nurses and doctors what is needed. They work in the NHS and know what is needed.

  • NHS worker
    10 July 2018

    The NHS does not need more money. It needs less incompetent managers and a better standard of workers. I work for the NHS and the amount of waste is ridiculous. The abuse of the NHS by overseas patients needs to be stopped. The abuse by British patients also needs to stop. People need to be more responsible for their own health. The NHS needs to be run like a business. Cut all the waste or the NHS will not last much longer.

  • Mrs Caroline Costantino
    10 July 2018

    Please draft a letter regarding the above and let’s us all lobby our local
    MPs to apply pressure on behalf of CRUK and the amazing work .

  • Alan jackson
    10 July 2018

    Should be spent on more cancer research and diabetes research

  • Nick Peel
    9 July 2018

    Hi K,
    Thanks for your comment and your generous support.
    You can find out more information about monthly donations on our website.
    Or, to update your monthly donation, please call us on 0300 123 1861.
    Best wishes,
    Nick, Cancer Research UK

  • K Vigneswaran
    8 July 2018

    I would like to increase my monthly contribution from £2 to £5. Please let me know how to proceed

  • Khadim Hussain
    8 July 2018

    How can I help? I run a comic & book shop in Middlesbrough, is there any way we can engage the Pakistani/Indian community?

  • Carol Gray
    8 July 2018

    I think the wisest thing in your article is when you say that ‘the extra funding needs to be spent wisely’….too often extra funding seems to generate yet another layer of unnecessary management when it SHOULD be spent onimproving FRONTLINE STAFF numbers…they are at the coal face and are doing the vital day to day work…without them nothing will improve..and start PAYING STUDENT NURSES TO DO THEIR TRAINING….it is RIDICULOUS that nursing is treated as a normal university degree course as it is anything but that…when I trained we received a wage…my son…who is now training received a £600 per month bursary for him and his wife to live on….he got on in the last bursary year…it is even worse now …if we didn’t pay the majority of their household expenses then he would not have even been able to start his paediatric degree course and what a loss to nursing that would have been as he is a born nurse…it is in his blood.Stop recruiting from abroad and sort out getting our own potential nurses trained and into permanent NHS jobs…stop TV campaigns to get more people to apply to do the nursing degree course until a fair and sustainable system of paying these students is put in place.They need to be able to eat…pay bills and live whilst doing their 3 year degree course NOT have to rely on parental support or getting a job…they work 12 hour shifts when on placement and STILL have assignments to complete ..when are they supposed to work elsewhere just to fund their training????…RIDICULOUS.

  • Roger Townsend
    6 July 2018

    I do not agree that this extra £20 bn should be poured into more staff: increasing the bloated NHS still further. This is what taxpayers are scared stiff of. It is already by far the biggest employer in Europe and there should be a reallocation of existing numbers. I also do not agree that early diagnosis is solely the result of extra staff. Individuals should also take more responsibility for their own health symptoms and I speak as a Bowel Cancer and my daughter as a very recent Ovarian Cancer patient who has raised over £1700 with her 7 year old son in the Race for Life on Sunday.

  • Fiona tylecote
    6 July 2018

    When will there be any concentration and research in childhood cancers. Fit and active young children are falling ill to this disease and having to use treatments for other cancers and hope they work.
    These children are having their whole lives stolen from them.
    Childhood cancers are different – rarer but with so much more impact on everyone.
    Please put more research in

    Comments

  • Terence Neaster
    13 August 2018

    We need to govern “health tourism “
    The rest of Europe abuse our great system! British Armed Forces should have priority over most!

  • Terence Neaster
    13 August 2018

    We need to govern “health tourism “
    The rest of Europe abuse our great system!

  • Audrey Beckett
    17 July 2018

    Prevention is always better than cure!

  • Kathy
    15 July 2018

    I agree with Carol Gray.I was trained in 1971 as a nurse .I waa paid to do my training- It was not a lot, but enough to live and I still managed to support my family in another country.I am retired now but still do bank shifts as a scrub practioner in breast oncology surgery.
    I think it is essential to start paying nurses again to do their training .Let’s all get together to lobby the government to restart the programme so nursing students do not have to rely on parents to support their training! In fact more young people in the UK may decide to do nurse training if they were being paid ..

  • Philippa Fricker
    14 July 2018

    I was stunned after reading others’ comments: how we all basically feel the same frustration. Yes its great the Government are increasing NHS budget but it is so true that this must be handled with great care. I am not convinced that politicians know best in this regard. There is a responsibility on the ‘consumer’ to wake-up as well as ‘management’ – how can each contribute in a proactive way to make our ‘sick’ NHS proud and well.

  • Cora Cumming
    12 July 2018

    If extra money was invested in social care it would go a long way to cutting waiting lists a+e waiting times and it would make caring for our elderly more cost affective……cost per night of a hospital bed huge in comparison to a care home

  • Jeff lee
    10 July 2018

    Nhs must first stop the huge wasting of money before they get anymore to waste.
    PFI costs are horrendous, a £4m project costs the tax payers £850000 a year for nearly 20 years, check out Ruthbury hospital.
    A tv monitor costs £42000 to buy and install.
    Massive fees paid to agencies .

    It’s obvious the nhs needs to get its act together first before they are given more money .
    Maybe the nhs should pay their staff the same wages as Carr jones are forced to and have the sane incrediy ridiculous funding .

  • David Johnston
    10 July 2018

    What about Scotland , Wales and N Ireland? Not fair

  • Ian Boundy
    10 July 2018

    I think the NHS is a wonderful institution. It seems to have lost its way in the respect of trying to be all things to everyone ie. cosmetic surgery, health tourists,drug rehab, alcohol abuse etc.,as well as treatment for the ill. Which was it’s primary purpose.
    There seems to be an imbalance between “management” and the angels that actually get their hands dirty.I can guess which of the aforementioned groups will receive the bulk of the promised increase.
    I don’t like to be cynical,but there you go.
    And the latest wheeze is the use of robots, god knows how much they cost,and then there would be an army of programmers, tech guys ,service engineers,and more. All to be paid out of the NHS budget. You couldn’t make it up.

  • Linda Hill
    10 July 2018

    In all honesty I think they need to ask the nurses and doctors what is needed. They work in the NHS and know what is needed.

  • NHS worker
    10 July 2018

    The NHS does not need more money. It needs less incompetent managers and a better standard of workers. I work for the NHS and the amount of waste is ridiculous. The abuse of the NHS by overseas patients needs to be stopped. The abuse by British patients also needs to stop. People need to be more responsible for their own health. The NHS needs to be run like a business. Cut all the waste or the NHS will not last much longer.

  • Mrs Caroline Costantino
    10 July 2018

    Please draft a letter regarding the above and let’s us all lobby our local
    MPs to apply pressure on behalf of CRUK and the amazing work .

  • Alan jackson
    10 July 2018

    Should be spent on more cancer research and diabetes research

  • Nick Peel
    9 July 2018

    Hi K,
    Thanks for your comment and your generous support.
    You can find out more information about monthly donations on our website.
    Or, to update your monthly donation, please call us on 0300 123 1861.
    Best wishes,
    Nick, Cancer Research UK

  • K Vigneswaran
    8 July 2018

    I would like to increase my monthly contribution from £2 to £5. Please let me know how to proceed

  • Khadim Hussain
    8 July 2018

    How can I help? I run a comic & book shop in Middlesbrough, is there any way we can engage the Pakistani/Indian community?

  • Carol Gray
    8 July 2018

    I think the wisest thing in your article is when you say that ‘the extra funding needs to be spent wisely’….too often extra funding seems to generate yet another layer of unnecessary management when it SHOULD be spent onimproving FRONTLINE STAFF numbers…they are at the coal face and are doing the vital day to day work…without them nothing will improve..and start PAYING STUDENT NURSES TO DO THEIR TRAINING….it is RIDICULOUS that nursing is treated as a normal university degree course as it is anything but that…when I trained we received a wage…my son…who is now training received a £600 per month bursary for him and his wife to live on….he got on in the last bursary year…it is even worse now …if we didn’t pay the majority of their household expenses then he would not have even been able to start his paediatric degree course and what a loss to nursing that would have been as he is a born nurse…it is in his blood.Stop recruiting from abroad and sort out getting our own potential nurses trained and into permanent NHS jobs…stop TV campaigns to get more people to apply to do the nursing degree course until a fair and sustainable system of paying these students is put in place.They need to be able to eat…pay bills and live whilst doing their 3 year degree course NOT have to rely on parental support or getting a job…they work 12 hour shifts when on placement and STILL have assignments to complete ..when are they supposed to work elsewhere just to fund their training????…RIDICULOUS.

  • Roger Townsend
    6 July 2018

    I do not agree that this extra £20 bn should be poured into more staff: increasing the bloated NHS still further. This is what taxpayers are scared stiff of. It is already by far the biggest employer in Europe and there should be a reallocation of existing numbers. I also do not agree that early diagnosis is solely the result of extra staff. Individuals should also take more responsibility for their own health symptoms and I speak as a Bowel Cancer and my daughter as a very recent Ovarian Cancer patient who has raised over £1700 with her 7 year old son in the Race for Life on Sunday.

  • Fiona tylecote
    6 July 2018

    When will there be any concentration and research in childhood cancers. Fit and active young children are falling ill to this disease and having to use treatments for other cancers and hope they work.
    These children are having their whole lives stolen from them.
    Childhood cancers are different – rarer but with so much more impact on everyone.
    Please put more research in