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

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