Tiny fixes in the face of huge challenges for the NHS and patients

‘Government has set out a few short-term fixes for a health and care system under incredible strain. While welcome, they are tiny compared to the scale of the challenges. Without extra investment to cope with inflation or unfunded pay increases, the NHS is being asked to do more with less, which will not serve patients well. Per capita spend on health care in the UK is low compared to many Western European countries – and the public back additional investment.

‘Funding to support hospital discharges over winter may help in the short-term, but it’s not clear whether there will be new money to pay for it. Meanwhile, the social care system is on its knees. Staff shortages are widespread, pay and conditions are poor, and many people go without the care they need. People need support in the community to live independently – not just to free up space in hospitals. We estimate around £8 billion extra investment in social care is needed by 2024–25 to meet changing needs, improve access to care and boost staff pay.

‘Public satisfaction with general practice is falling and it makes sense for government to do more to support GPs. Expanding the primary care team is sensible but practices will need help to make the best of new roles, as well as investment in infrastructure. Most patients (around 85%) already get an appointment within two weeks of booking and 44% on the same day. People value speed of access but also convenience and continuity with their GP. A new target should be monitored for unintended consequences – not least putting extra pressure on GPs already under major strain. And the target doesn’t address the stark reality that there simply aren’t enough GPs. GP numbers are already 4,200 short of what is needed to deliver pre-pandemic levels of care. This shortfall could double by 2030–31.

‘Chronic staff shortages are holding back the NHS and social care and addressing them is a top priority for the public. Staff gaps stand at around 132,000 in NHS trusts and 165,000 in social care. Pragmatic measures to help recruit and retain staff right now are essential. But both the NHS and social care desperately need long-term strategies for expanding the workforce, backed by sustained government investment.

‘The government’s ABCD list of priorities seems to ignore the bigger task of improving the nation’s health, not just its health services. The NHS was not set up to go it alone: protecting and improving people’s health depends on wider services and support, like local government and social security, which have been eroded over the last decade. The NHS is often left to pick up the pieces. Failure to take prevention and public health seriously will store up even more problems for the future.

‘This plan is a baby step in the right direction, but there is a very long way to go.’