What did the Chancellor announce?

The overall day-to-day budget for the Department of Health and Social Care (DHSC) will rise by 3.1%, while its total budget (including capital spending) will rise by 2.9%.

Is it enough?

2.9% growth is below the 3.3% the Health Foundation and the Institute for Fiscal Studies estimate is needed just to maintain current standards of care, with a growing and ageing population and a rising burden of chronic disease. And it is some way short of the 4.1% growth required to invest in improvements in the health service.

The day-to-day budget for DHSC will rise by 3.1%, while its total budget (including capital spending on buildings and IT) will rise by 2.9%. This is largely driven by increases in the budget for NHS England, which accounts for about 90% of DHSC spending, but doesn’t include education and training, the public health grant or capital spending.

The wider DHSC budget, outside NHS England, is growing by £0.2bn in real terms. This is largely accounted for by growth in the budget for Health Education England (HEE), which will grow by 3.4% in real terms. Most of this is focused on investing in the continuing professional development of staff. While welcome, this level of investment in HEE is still only a third of that called for by the Health Foundation, the King’s Fund and the Nuffield Trust. As a result, it is unlikely to make any improvements in the numbers of nurses coming through training, which is particularly critical as research published this week shows a quarter of nurses drop out or suspend their training before graduation

Data obtained by Nursing Standard and the Health Foundation show that of 19,566 UK nursing students who began three-year degrees due to finish in 2018, a total of 4,695 left their courses early or suspended their studies.

The average nursing student attrition rate in the UK is therefore 24.0%. With the NHS facing a shortage of an estimated 40,000 nurses in England alone, new nurses are needed more than ever. 

Previous research has shown students who leave their courses cite reasons such as finances, academic issues, placement quality, workload and lack of support. Charlotte Hall, who started a children’s nursing degree in 2014, explains why despite always wanting to be a nurse, she was forced to drop out after her first year.

Photo of a nurse telling her story

Earlier in the year, the Government announced plans to invest in artificial intelligence to improve the prevention, early diagnosis and treatment of chronic diseases. The Spending Round confirms the Government will invest £250m in the programme, of which £78m comes in 2020/21.

This 2.9% growth for DHSC is below projections by the Health Foundation and the Institute for Fiscal Studies (IFS) that just to maintain current standards of care with a growing and ageing population and a rising burden of chronic disease will require total health spending to increase by 3.3% per year. And it is some way short of the 4.1% required to invest in improvements in the health service.

Growth in Department of Health and Social Care budget planned and required to keep up with demand or modernise

The capital budget is confirmed to be £1bn higher than previously planned for this year, at £7bn, but with no growth next year – standing at £7bn again in 2019/20 prices. While the increased budget this year is an improvement on recent years, it falls well short of the levels of investment required to make significant inroads into the maintenance backlog of £6bn, and leaves us lagging behind comparable countries when it comes to spending on health care capital.

While a multi-year capital settlement is promised, it is hard to see when this happens given the current political uncertainty.

The capital budget of the Department of Health and Social Care (DHSC) is used to finance long-term spending in the NHS, such as new buildings, equipment and technology. It also covers research and development, and some maintenance and upgrades to keep everything running smoothly.

Capital spending is a critical input in health care, with new technology able to transform services and improve workforce productivity.

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