Summary of our Comprehensive Spending Review submission

A summary of our submission to HM Treasury’s Comprehensive Spending Review 2020.

27 October 2020

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A summary of our submission to HM Treasury’s Comprehensive Spending Review 2020.

In light of the pressures presented by the COVID-19 pandemic, the government has announced that its planned multi-year Comprehensive Spending Review (CSR) will now be a one-year settlement, to be unveiled in late November. The government has, however, committed to fully fund what it describes as a multi-year resource settlement for the NHS.

Based on ongoing engagement with NHS leaders, our CSR submission to the Treasury, submitted in September 2020, outlines what the health and care system needs to get back on track and transform services. This briefing summarises the key points raised in our full submission.

Key points

  • Health and care, and reducing health inequality, should be at the heart of the Spending Review. The government must deliver on its commitment to a multi-year funding settlement for the NHS – both in terms of revenue and capital spending.
  • COVID-19 has meant that demand is up, capacity is down and waiting lists are increasing. The existing funding settlement for the NHS, though relatively generous compared to other public services, needs to be re-examined in light of the extra pressures caused by the pandemic.
  • The NHS needs additional investment to stabilise, improve resilience and deliver the ambitions outlined in the widely supported NHS Long Term Plan. Crucially, investment is required in areas that are outside the core NHS England and NHS Improvement budget that have not been dealt with – including a multi-year capital settlement, the public health grant, education and training budgets, and social care. These were always intended to be funded at the CSR.
  • The NHS workforce is overstretched and exhausted, and existing commitments to fill clinical vacancies are not being met. The NHS needs additional investment to increase staffing levels, including by extending training places across all professions.
  • The government must follow through on its commitment to reform social care by delivering a sustainable social care system, backed up by reform and a long-term funding settlement.