Spring Budget will not ‘fix’ the problems facing the NHS, say BMA

Health leaders have welcomed the new funding announced for the NHS in the Chancellor’s Spring Budget, but warn the investment will not solve all the problems facing the health service.

On Wednesday (6 March), Jeremy Hunt announced a £3.4 billion fully funded NHS productivity plan focused on digital transformation. This funding will expand the use of AI, improve the NHS app for patients, create a new app for staff and ensure all hospitals are using electronic patient records.

The NHS will also receive a further £2.5 billion in additional funding to reduce waiting times, while capital funding remains unchanged. However, the NHS Confederation says this revenue is unlikely to account for either the costs of the ongoing financial impact of industrial action nor the ever-increasing backlog of care.

NHS leaders therefore predict that trusts will have to top up funding throughout the year, as was the case in 2023/24. The NHS Confederation says this is an “unacceptable and counterproductive” way to run health planning and spending.

The government says it will also:

• Reduce the cost of agency staffing from July 2024, including ending the use of expensive ‘off-framework’ agency staffing.
• Invest £35 million over three years to improve maternity safety across England. This includes specialist training for staff and additional midwives.
• Introduce new productivity measures at a national, ICB and trust level from the second half of 2024/25, with further details announced in the summer.
• Introduce a new vape tax and increase tobacco levies, raising £500 million from October 2026.

Another ‘incredible tough year’ for the health service

Matthew Taylor, chief executive of the NHS Confederation, says the additional investment in technology has the potential to improve patient care and staff productivity, and extending the use of Electronic Patient Records will help to support joined up care across services.

However, he has criticised the investment as falling “flat” against a backdrop of “significant deficits and universal pressures across the health service.”

He said more funding is needed to fix ‘crumbling’ infrastructure in hospitals and other clinical settings, warning that the £2.5bn boost for NHS budgets next year will “scarcely touch the sides.”

“2024/25 is going to be another incredibly tough year for the health service and for patients,” he said.

“Given the Chancellor’s health background, NHS leaders had hoped to see more recognition for the situation they are up against with full funding of the workforce plan and greater investment in primary and community care so that they can carry out the important prevention work that will mean so much to the NHS in years to come.

“In previous years unrealistically tight revenue settlements like this have been followed by in-year emergency top ups that are overly prescriptive and inefficient, this is not the way to plan for the future or improve productivity. NHS leaders hoped that the Chancellor would have stopped this from happening today,” he added.

Adult social care plans absent from Spring Budget

The British Medical Association has made similar criticisms and Dr Emma Runswick, BMA council deputy chair, says the Spring Budget “far from fixes all of the problems facing the NHS, its staff and the nation’s health.”

Dr Runswick says the government has ignored the number of staff vacancies in NHS hospitals, and the absence of any commitments on public sector pay will do nothing to bring an end to pay disputes or keep doctors working in the NHS.

Nursing associations are also concerned about the soaring vacancies in their profession, and Professor Pat Cullen, RCN General Secretary and Chief Executive says the government has laid the ground for the nursing crisis to worsen.

“Nursing staff urgently need more people to join their ranks and they want to be fairly rewarded for their work. After a decade of real-terms pay cuts, an above inflation pay rise and additional salary top-up worth several thousand pounds is what our profession is demanding from government this year,” she said.

Notably, the Chancellor made no mention of adult social care during his speech, and Nuffield Trust Chief Executive Thea Stein says this omission raises “serious concerns amid a bleak financial outlook for local government.”

“The government has said it will deliver reforms to the costs people pay for their care by October 2025 but, so far, no funding has been made available to ready the sector, which raises questions about delays to the current timetable,” she said.

Meeting the demands of an ageing population

Ultimately, with the total funding pledge for the health service rising by just 0.2% in real terms, health leaders are concerned that the NHS will soon struggle to meet the demands of an ageing population.

While the extra funding is a welcome improvement, healthcare professionals are concerned that the funding will not go far enough to reduce waiting times, cut down on the number of staff vacancies, and ultimately, improve patient care.

With more people than ever out of the workforce due to ill health, Dr Jennifer Dixon, Chief Executive of the Health Foundation says it is time for a “new approach that prioritises the long-term health and prosperity of the nation.”

Featured image: © UK Parliament