NHS England: difficult debate needed on services despite extra funds in budget

NHS England says it needs to discuss ‘what it is possible to deliver for patients with the money available’ after failing to get as much as it requested in the budget

The NHS England board is to discuss 'what it is possible to deliver for patients with the money available' after the health service in England failed to get all the funds it requested from the Treasury in the budget, officials have indicated.

Sir Malcolm Grant.

NHS England chair Sir Malcolm Grant said the money promised by chancellor Philip Hammond in Wednesday’s budget will go some way towards filling the widely accepted funding gap.

But he said the NHS can no longer avoid a difficult debate on what can be provided by the health service on the funds it is operating on.

In a statement, Sir Malcolm said: ‘The extra money the chancellor has found for the NHS is welcome and will go some way towards filling the widely accepted funding gap.

‘However, we can no longer avoid the difficult debate about what it is possible to deliver for patients with the money available.

‘The NHS England board will need to lead this discussion when we meet on 30 November.'

Longer waits for care

Meanwhile, NHS England national medical director Sir Bruce Keogh said the money promised by Mr Hammond will force a debate about what the public can and can't expect from the NHS.

He warned that longer waits for care seem ‘likely/unavoidable’.

The comments come after the Treasury pledged more money for the NHS in England, with the specific aim of helping the health service get back on track with regard to soaring waiting lists and emergency department targets.

Mr Hammond acknowledged that the NHS is under pressure and committed resource funding of £2.8 billion to the NHS in England.

This includes £350 million to cope with pressures over the coming winter, £1.6 billion in 2018-19 and the remainder the following year.

Rationing could spread

Earlier this month, NHS England chief executive Simon Stevens said that without more money for the NHS the number of patients waiting to be admitted to hospital in England for surgery will rocket to five million by 2021.

This means one in 10 adults will be on the waiting list, he said. Mr Stevens also indicated that controversial rationing policies adopted in some parts of the NHS could be rolled out nationally without more money and said expansion plans for mental health and improvements in cancer care could stall.

He drew on a new analysis by the Health Foundation, the King's Fund and the Nuffield Trust which calculated that the NHS needs £4 billion more next year to prevent a deterioration in patient care.

Tough choices and trade-offs

Chris Hopson, chief executive of NHS Providers, the trade body which represents NHS services, said: 'It is disappointing that the government has not been able to give the NHS all that it needed to deal with rising demand, fully recover performance targets, consistently maintain high-quality patient care and meet the NHS's capital requirements.

'Tough choices are now needed and trade-offs will have to be made.'

Concerns were also raised over a lack of funding for social care in the budget.

Association of Directors of Adult Social Services president Margaret Willcox said: 'We are extremely disappointed that the government has not addressed the need for extra funding for adult social care. This means that this winter and throughout next year we will continue to see more older and disabled people not getting the care and support that they desperately need now.'

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