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Spending Round must invest in NHS workforce

Call comes from doctors and health leaders

Jo Carlowe

Wednesday, 04 September 2019

In the lead up to the chancellor’s Spending Round, health leaders are calling for investment in education and training to strengthen the NHS workforce.

The fast-track Spending Round, due to be delivered today, will set departmental budgets for 2020-21.


The NHS Confederation, which represents all organisations that plan, commission and provide NHS services, is urging chancellor Sajid Javid to tackle key areas of health expenditure not included in the £20.5 billion of NHS funding that kicked in from April this year.

In a briefing, published ahead of the chancellor’s announcement, the NHS Confederation calls for urgent government action in five key areas, warning that failure to act on these “will jeopardise the ambitions of the NHS Long Term Plan”.

The briefing sets out the following five funding priorities for the NHS:

  1. Investment in education and training budgets which is essential for recruiting, retaining and strengthening the NHS workforce: “The delivery of the forthcoming NHS People Plan will not be achieved without additional funding to attract applicants for clinical careers,” the Confederation warns. 
  2. While the £1.8 billion of additional capital investment recently announced by the prime minister is welcome, says the NHS Confederation, it adds “it is substantially short of the £6 billion maintenance backlog that has built up in recent years. The government should increase capital funding beyond the £1.8 billion to make sure all NHS organisations can access capital investment to renew buildings, equipment and IT.”
  3. Urgent funding is required in the short-term to plug the widening funding gap that has built up in social care. The Confederation states: “At a bare minimum, the chancellor should provide an extra £1.1 billion in 2020/21 – this is the level recommended by the Health Foundation for local councils just to maintain current levels of care and support. It is important that this is genuinely new money and not transferred from existing budgets, including the Better Care Fund.”
  4. The chancellor should look to reverse cuts to public health funding which has seen the public health grant reduced in real terms by £850 million since 2014/15. Without improved public health funding, the prevention agenda of the Long Term Plan will not be deliverable, warns the Confederation. 
  5. The only way to achieving true parity of esteem for mental health is by increasing the spend on mental health as a proportion of the entire NHS budget, eradicating the maintenance backlog and boosting mental health research spending.

Niall Dickson, chief executive of the NHS Confederation, said: “The prime minister has made big promises on social care – now we need action to sort out this shameful mess which is leaving thousands of vulnerable people without the care and support they need. An extra £1 billion of new money, none of it recycled from previous years or announcements, would be a good start but much more is needed, and without it key NHS services will be placed under further pressure.

“Some may believe the NHS funding debate is settled following last year’s announcement. But other key areas which will be critical if we are to deliver the Long Term Plan. At the top of this list is extra capital investment to enable hospitals and community services to tackle a massive maintenance backlog, and invest in new equipment and facilities.

“We also need a realistic budget to restore investment in training doctors, nurses and other professions who deliver front line care. We have a major workforce crisis and without investment the service will not have the staff to provide the care that is needed.

"The government could also help by allowing NHS organisations to use some of the apprenticeship levy to support a wider range of training activities for apprenticeships.”

The Royal College of General Practitioners has similarly set out the key areas that it hopes will be addressed in the Spending Round.

Chancellor Sajid Javid will announce the conclusions of the Spending Round in a statement to Parliament. 


Image courtesy of UK Parliament (CC BY 3.0)

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