Spending Review must provide certainty and early investment

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The NHS Confederation has called on HM Treasury to outline a multi-year funding plan for the NHS in the upcoming Spending Review, to provide much-needed certainty on healthcare funding over the next five years.

In its representation to the Treasury, which aims to influence the Spending Review, the organisation also called for social care to be appropriately resourced, cuts to the public health grant reversed, and for limited pay flexibilities to be allowed.

Financial settlement

Submitted on 4 September, the Confederation's submission also stresses the need for the £8 billion of additional funding pledged by the Chancellor in July to be delivered in full as a real-terms increase of all health spending. This includes capital investment, public health and running costs for the whole system. 

Issued on behalf of members, the 12-page document seeks assurance that at least £4 billion of additional funding will be available to the NHS by 2017/18. This would enable organisations to better plan for, invest in and deliver the transformation set out in the Five Year Forward View.

“[The Spending Review] can establish the financial settlement needed and conditions necessary to enable our members to focus on developing the models described in the Five Year Forward View,” the submission says. 

Confed calls

In July, HM Treasury published Spending Review 2015: A country that lives within its means, outlining the government’s priorities for the Spending Review and the principles that will guide its decisions.

In the foreword Chancellor George Osborne wrote: "The Spending Review will prioritise our investment in the NHS and in our national security."

The document kicked off an engagement process which sought representations from "representative bodies, interest groups and individuals" to inform the review.

The Confederation's submission puts forward ten proposals for how the government can support the NHS in this Parliament. All are based on detailed engagement with Confed members and a wide range of health and care organisations.

The central message is the importance of clarity and stability in funding. The document calls on the Treasury to:

  1. Outline a multi-year plan across the whole of this Parliament for increasing health spending by at least £8 billion a year by 2020/21.
  2. Confirm that additional funding applies to the total department budget to protect all NHS spending.
  3. Confirm that at least £4 billion of additional funding will reach the NHS budget by 2017/18.
  4. Outline a multi-year plan across the whole of this Parliament for addressing the social care funding gap by 2020/21.
  5. Confirm a clear plan for retaining the Better Care Fund at the current level of funding and how it will operate in practice.
  6. Provide certainty and support for individuals who are planning and funding their own social care.
  7. Increase the Five Year Forward View transformation fund to at least £1 billion in 2016/17 and establishing a wider focus on transformation.
  8. Reverse the cuts to the public health grant and protect spending on public health and prevention across this Parliament.
  9. Reaffirm commitment to increase funding for child and adult mental health in this Parliament.
  10. Agree to limited flexibilities to allow employers to operate outside of 1 per cent public sector pay constraint cap.

Spending Review 2015 timetable

Find out more 

Download the full version of the submission to the Treasury or access the speed-read summary.

NHS Clinical Commissioners' (NHSCC) submission sits alongside that of the Confed. Head to the NHSCC website to download a copy.

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