The King's Fund responds to the Chancellor's Autumn Statement

Commenting on the 2023 Autumn Statement, Siva Anandaciva, Chief Analyst at The King’s Fund, said:

‘Today’s Autumn Statement appears to have offered nothing significant beyond the relatively small amount of additional funding for the health service recently announced, which we cannot pretend will be enough for the NHS to do everything needed to give patients the care they deserve and expect this winter. The government’s NHS funding announcements have now become caught in a vicious cycle of inefficient emergency cash injections and unrealistic expectations of what the NHS can deliver in return. To avoid the NHS facing a crisis every winter, ministers need to make long-term decisions that can bring demand, capacity and efficiency back into better balance.

‘One area in desperate need of longer-term thinking is investment in health and care infrastructure, with the buildings and equipment maintenance backlog currently standing at £10 billion. The government’s reported decision earlier this month to potentially raid limited capital investment budgets to prop up day-to-day services is a further indictment of the addiction to short-term thinking that has plagued the health service in recent years. Dilapidated buildings and outdated technology hinder productivity, harm staff and lower the quality of care patients receive.

‘Local authorities are also under intense financial pressure, with a forecasted £2.4 billion funding gap for 2023/24. The majority of directors of adult social services are worried that they cannot fully offer the minimum social care support required by law, and data published last week shows that the waiting list for people to have their care needs assessed is rising once again. The increase to the National Minimum Wage will be welcome for many people working in social care on low pay, but it will be vital that local government and social care providers are properly funded to meet these increased costs.

‘An increasing number of people are living with complex long-term health conditions – impacting their quality of life, affecting demand for health and care services, and taking a toll on the economy when people are unable to work. Good-quality work can be good for people’s health, and policies such as the expansion of programmes that help people with severe mental illness to find and keep jobs are welcome. However, punitive steps such as removing access to free prescriptions may only risk worsening people’s health, moving them further away from employment, and may lead to people needing NHS care further down the line, potentially with a more complicated or urgent condition. It’s a policy that could store up problems for the future.

‘To really get services back on track and show it is serious about improving the nation’s health, the government should build on its proposals to make England smoke-free and take further bold action to make working in health and care a more attractive career option, bolster out-of-hospital care such as primary, community and social care services, and help people live healthier lives through a focus on prevention.’

Notes to editors

As political parties prepare for the upcoming general election, The King’s Fund has identified three priorities where national action from a future government can help to ‘fix’ the NHS and social care and improve people’s health: The King's Fund's priorities for health and care at the next general election | The King's Fund (kingsfund.org.uk)

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The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.