What does the Spring Budget mean for the NHS and social care?

Posted on: March 17th, 2020

This was inevitably going to be an unusual Spring Budget. It was the first Budget since the general election and the UK leaving the European Union; the first Budget for a new Chancellor who has only been in the post for four weeks; and a Budget delivered under the shadow of coronavirus.

So, partly by choice but mainly by circumstance, this became a dual budget where the Chancellor tried to focus on both the immediate challenges of coronavirus and some of the longer-term goals of the Government. Here, we unpick what the spring Budget means for the NHS and social care.

Coronavirus (COVID-19)

As the Chancellor said, let’s get straight to the issue on everyone’s mind – coronavirus. The government promised to give the NHS and public services whatever they need to deal with the impact, ‘whether its millions of pounds or billions of pounds’.

It’s going to be billions. With that in mind, the government has now created an emergency response fund. It has been designed to be used for the following:

  • To help the NHS pay for treating coronavirus patients and maintaining staffing levels;
  • To help local authorities to support social care services; and
  • To support wider public services that need to prepare for coronavirus.

Initially set at £5 billion, the size of the fund will be reviewed as the impact of coronavirus develops. Alongside this fund, the increased costs and financial disruption to smaller businesses from the effects of coronavirus will, it is hoped, be smoothed by measures such as refunding Statutory Sick Pay, business interruption loans and extending discounts and relief for business rates.

Much more detail will be needed in the coming weeks on how organisations can access this funding, exactly what constitutes ‘coronavirus-related spending’, and, most significantly, what practical support the funding can deliver to staff and patients.

NHS and health spending
There was an announcement for an extra £6 billion of health funding over the course of this parliament, although a detailed breakdown of annual spending has not been provided yet. The £6 billion includes about £5.4 billion of revenue (day-to-day) spending over the remaining four years of this parliament. This is aimed at delivering the government’s manifesto commitments on more clinical staff, more GP surgery appointments, greater community-based care for people with learning disabilities or autism, and free hospital car parking for some groups.

Health and care workforce
Before coronavirus, the most pressing issue facing the health and care sector was the workforce shortage. But there was little in the spring Budget that looks to speed up the upcoming NHS people plan (which was delayed till after the spring Budget) that will set out how the government will deliver the major funding commitments on nurses, GPs and other primary care staff already well trailed in the Conservative Party manifesto.

The government has pressed ahead with its plans to increase the Immigration Health Surcharge – which asks many new arrivals to the UK to pay a charge to the Home Office as part of their immigration process. In the absence of a plan to recruit and train more workers from within the UK, It is hard to see how increasing financial disincentives for immigrant health and care professionals makes sense at a time when the service is in need of new international recruits.

Adult social care
Additional funding for social care was notably absent and has drawn some criticism across the sector. Adult social care is the exception to the rule of ‘no news is good news’. Once again, a government has decided that the much-needed reform of adult social care financing is a ‘big issue’ that must be ‘tackled head on’ – but not today.

So, what to make of all this? Some uncertainty remains after a Budget that provided some more pieces of the jigsaw but not a complete picture. The government has certainly acted to mitigate the financial impact of coronavirus on the health and care sector. But for a Chancellor who is so keen on ‘getting things done’, he will certainly recognise there is still plenty more to do.