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Analysis from independent health charity Health Foundation and a separate survey of front-line health leaders from the NHS Confederation have said that the NHS Long Term Plan will struggle to meet its goals of improving patient care without wider health funding from the UK Government.

Health Foundation warned that if no more funding is provided, the NHS will struggle to cope with demands due to over-stretched, under-staffed services and poorly maintained facilities.

The Health Foundation report and Confederation survey support the vision of the NHS Long Term Plan, but they argue that success or failure will depend on whether the Government commits to supporting investment in the workforce, capital infrastructure, the prevention agenda, and social care. These areas of funding were excluded from the five-year NHS funding settlement, announced by the Department of Health and Social Care (DHSC) in June 2018.

Under the funding settlement, NHS England’s budget is set to increase by £20.6 billion and NHS leaders have laid out a plan to allocate the additional funding towards necessary improvements in mental health, primary and community services. But to meet growing patient demand, says the health charity, hospital activity will need to rise by at least 2.7 percent a year by 2023/24.

The Health Foundation’s new analysis reveals that if NHS earnings are to keep pace with wage growth for other professions, the extra money will only enable hospital activity to grow by 2.3 percent over this period. Managing demand to this extent would require a major change to recent trends as demand for hospital services has increased by three percent a year since 2010/11, says Health Foundation.

The Government has changed the planned phasing of the additional £20.6 billion in funding which means there will be modest increases over the next couple of years with the largest injection in 2023/24. The Health Foundation says that this runs contrary to the front-loaded settlement announced last summer and will make it hard to support a period of initial investment in care outside of hospitals.

It highlights that if demand for hospital services can’t be reduced, people are likely to experience increased waiting times and the planned investment for improvements will be diverted to assist struggling hospitals.

The Health Foundation and NHS Confederation say that improvements will only be possible if critical staff shortages are addressed and NHS Trusts can increase productivity through essential investment in buildings, technology and equipment.

The Health Foundation analysis confirms that to maintain current levels of quality and access to services over the next five years, the total health care budget would need to increase by 3.4 percent, meaning that funding for workforce, capital and public health would increase at the same rate as funding for front-line services.

The briefing also notes that the NHS Long Term Plan has been developed with the expectation of a sustainable settlement for social care and action to prevent ill health. With no action on funding, the money available for adult social care will rise at an annual average rate of 1.4 percent a year, which is lower than the 3.4 percent a year the Government has committed to the NHS.

The Health Foundation warns that, if this continues, there will be a social care funding gap of more than £4 billion in England in 2023/24 just to meet rising demand and address critical staffing shortages in the sector.

Dr Jennifer Dixon, Chief Executive at the Health Foundation, said: “The vision set out by NHS leaders in the long-term plan is the right one, and the extra funding announced by Theresa May last summer is welcome. But this is not job done.

“Policymakers need to face the fact that there is urgent unfinished business if the NHS is to deliver its vision to improve patient care. There are mounting workforce shortages, the social care system is starved of funding, capital investment is going backwards, and public health funds cut.

“This all piles demand on the NHS and risks swallowing up the extra money and leaving far less to modernise care, reduce waiting times, and prevent illness in the first place. The NHS is being seriously hampered in efforts to move forward. How can any industry significantly boost productivity without investing in staff training, technology and kit?

“The new government needs to honour last year’s promises to set out long-term funding for public health, capital investment, workforce training and social care, and ensure they receive sufficient funding to support the long term plan ambitions.”

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