The NHS in Wales has reached a tipping point: the cost of providing healthcare continues to rise at the same time as demand on, and expectations of, the service continue to increase. Based on the current outlook, it is increasingly likely that a number of NHS organisations in Wales will not break even this financial year.
With well-documented financial uncertainty across the UK, public finances have never been more prominent in the headlines. Consideration must be given to what this means for the NHS, as investment in health boosts job opportunities and economic activity.
The Welsh NHS Confederation’s latest paper* examines the funding priorities** NHS leaders in Wales believe should be considered in future UK and Welsh Government budgets, highlighting areas of scrutiny for the Senedd to improve patient outcomes, enhance the quality and safety of healthcare services and reduce inequalities.
NHS Wales organisations recognise the significant investment in the service during the pandemic and do not underestimate the challenges that governments across the UK have in public service budget-setting in these unprecedented times.
But without further NHS investment in areas such as capital, workforce and revenue, patient experience and quality of care will suffer. NHS organisations need additional revenue to cover the ongoing costs of COVID-19, recovery of care services, addressing the backlog in elective care and the maintenance of NHS estates. NHS estates and infrastructure need significant investment to make them more sustainable and fit for purpose in order to maximise public assets and reduce carbon emissions. Governments must prioritise investing in the NHS workforce if we want a continued increase in the number of students and trainees in the sector, with further support for education and training opportunities for existing staff essential to aid retention.
We are also calling on the Welsh Government to recognise the significant contribution the NHS makes to local economies when making budget decisions. Every pound invested in the NHS results in £4 back in wider economic activity – so as well as delivering for patients, the NHS must be seen as an essential building block for economic growth and recovery.
Director of the Welsh NHS Confederation, Darren Hughes, said:
“We recognise that public finances across the UK are extremely challenging. However, governments must not make promises to the public about what the NHS will do without sufficiently equipping the NHS to be able to deliver on them.
“We’ve seen real examples of the challenges faced in recent weeks, with some health boards facing enhanced measures in certain areas. Money must be found to pay social care workers properly or the health and care system will collapse. If further cuts are on the table, we really need the government to be transparent with the public about the services they can expect from the NHS in the months and years ahead.
“The NHS must continue to transform and to address the demand on the system, worsening health inequalities, performance against targets, workforce pressures and funding shortfalls. NHS leaders across Wales are committed to doing the very best they can to deliver high-quality, timely and safe care to the people of Wales and deliver outcomes that matter most to patients, however the NHS and social care services need the right financial support and investment now to make it more sustainable in the future.”
*Funding priorities NHS leaders in Wales believe should be considered in future UK and Welsh Government budgets, and areas of scrutiny for the Senedd should include:
- Revenue: Providing additional funding to cover ongoing COVID-19 costs, recovery of care services, addressing the backlog in elective care and supporting the maintenance of NHS estates and infrastructure.
- Capital: Developing a ten-year investment plan for service change to reshape NHS estates and infrastructure, making them more sustainable, reducing carbon emissions and maximising public assets.
- Digital: Increase investment in digital data, technology and opportunity across NHS Wales and benchmark the level of digital investment against other health systems.
- Workforce: Increasing investment in the NHS workforce so we continue to see an increase in the number of students and trainees across a range of professional groups, the development of new roles and support for education and training opportunities.
- Efficiencies: Recognising the significant efficiencies NHS Wales organisations have made and continue to make and introduce a three-to-five-year efficiency programme to positively incentivise efficiency improvements, grounded in quality improvement data, better outcomes for citizens and Value-Based Healthcare.
- Social care: Providing local authorities allocations that are ring-fenced for social care funding to support system-wide health and wellbeing sustainability and to meet the needs of their population.
- Prevention and early intervention: Setting a nominal proportion of health and social care funds which should be spent on preventative and early intervention activities and to hold spending bodies to account for the use of these monies.
- Inequalities: Publishing a delivery plan that outlines the action being taken across all government departments to tackle inequalities, how success will be measured and evaluated, and how individual organisations should collaborate across Wales to reduce inequalities and tackle the cost-of-living crisis.
- Climate and sustainability: Providing further investment to support public bodies to reach the net zero target by 2030.
- NHS and the economy: Recognising the significant contribution the NHS makes to wider economic and social recovery when allocating funding. NHS organisations are well positioned to use their spending power and resources to address the adverse social, economic, and environmental factors that widen inequalities and contribute to poor health outcomes, to help create an ‘economy of wellbeing’.
- Accessing Levelling Up Fund: Working with the UK Government to ensure that the strategic priorities for NHS organisations in Wales are considered as part of the Levelling Up Fund and investment.
We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.