Key points

  • This report presents the REAL Centre’s projections of future health and social care funding requirements, both for the next 3 years and longer term funding to 2030/31. The projections are based on two scenarios: stabilisation and recovery. The scenarios differ according to different levels of government policy ambition and different trajectories for the level of impact of COVID-19. 
  • For health care, stabilisation would require average real-terms annual increases of 3.2%, with 3.5% for recovery. This equates to between £63bn and £72bn in additional annual funding in 2030/31 over 2018/19. 
  • For social care both the recovery and stabilisation scenarios would mean much higher growth than in recent years. Our projections show an additional £8.9bn and £14.4bn is needed in 2030/31 over 2019/20 for the stabilisation and recovery scenarios respectively. 
  • By 2030/31, up to an extra 488,000 health care staff would be needed to meet demand pressures and recover from the pandemic – the equivalent of a 40% increase in the workforce, double the growth seen in the last decade. Alongside this, up to 627,000 extra social care staff would be needed to improve services and meet need – a 55% growth over the next decade and 4 times greater than the increases of the last ten years.

This report presents the REAL Centre’s projections of future health and social care funding requirements, both for the next 3 years and longer term funding to 2030/31.

The report sets out what it may cost the government to fund the NHS and social care system in England along with workforce requirements over the next 10 years. The projections are based on underlying funding pressures – such as population size and age structure – and additional funding pressures, such as policy choices, 
The projections in the report are based on two scenarios: stabilisation and recovery. The scenarios differ according to different levels of government policy ambition, for example how ambitious the government’s plans for improving adult social care services are, and different trajectories for any continued impact of COVID-19.  
Rather than recommending a course of action, the report sets out the funding implications of different choices about the speed of service recovery and staff pay. Scenarios and sensitivity analysis are presented to reflect considerable uncertainty, including in the external environment, particularly regarding COVID-19, and in the trade-offs and decisions government will need to make about its level of ambition for the pandemic recovery.

Note: The analysis was prepared ahead of the government announcements for health and social care funding on 6 and 7 September 2021. The analysis presents a benchmark to compare those funding announcements against.

Cite this publication

Rocks S, Boccarini G, Charlesworth A, Idriss O, McConkey R, Rachet-Jacquet L. Health and social care funding projections 2021. The Health Foundation; 2021 (

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