Health and social care funding projections 2021

Abstract

This report presents the REAL Centre's projections of future health and social care funding requirements, both for the next 3 years and longer term funding to 2030/31. The projections are based on underlying funding pressures -such as population size and age structure -and additional funding pressures, such as potential policy choices. The report seeks to answer the question of how much funding the health and social care system may need over the next decade. This includes overall Department of Health and Social Care (DHSC) budgets, day-to-day NHS funding and the funding made available to local authorities for adult social care.Although the report does not seek to recommend a course of action, it does set out the funding implications of choices about the speed of service recovery and staff pay. As such, scenarios and sensitivity analysis are presented to reflect considerable uncertainty, including in the external environment, particularly regarding COVID-19, and in the trade-offs and decisions government will need to make about its level of ambition for the pandemic recovery.The report presents two scenarios that reflect varying levels of ambition for the post-pandemic world -stabilisation and recovery. In the longer term to 2030/31, the scenarios require real-terms average annual increases in NHS funding of 3.1% and 3.5% respectively. In the short term, the stabilisation scenario would require additional NHS funding over and above that set out in the NHS Long Term Plan. This equates to an additional £4.7bn in 2021/22, £4.0bn in 2022/23 and £2.9bn in 2023/24. The scenarios include funding to enable a modest expansion in the availability of adult social care services, support provider sustainability and pay social care workers more. To achieve these aims funding for adult social care would need to rise more quickly than for the NHS. * See chapter 5 for a full breakdown of scenario assumptions. * Absolute values after 2018/19 include NHS pensions adjustment of £2.85bn in nominal terms; growth rates exclude this pension adjustment. Note, our DHSC RDEL estimate excludes the costs of running an ongoing test and trace system. Health and social care funding projections 2021 8 Table 3: Average annual increase in funding for social care, projected and historical Government Years Average annual increase for social care Coalition government 2009/10-2014/15 -2.0% Cameron and May governments 2014/15-2018/19 1.8% Johnson Conservative government 2018/19-2020/21 1.7% Scenarios 2019/20-2030/31* Projected growth rates Stabilisation Recovery 4.3% 5.8% Source: REAL Centre calculations. *For social care modelling, the baseline year is 2019/20.COVID-19's economic legacy has an impact on the share of national wealth that would be spent on health and social care in response to rising funding pressures. Under both scenarios, the share of national income required to meet the funding needs for the UK would be in the range of 10% by 2030/31. This is an increase of more than 2 percentage points against the 2018/19 baseline. This is similar to...

NHS workforce projections 2022

“…90 Our analysis suggests that based on historical pre-pandemic workforce supply trends and accounting for current policies, the NHS workforce would grow from around 1. These projections differ from the corresponding figures in the REAL Centre's 2021 funding projections report 12 due to changes in our workforce demand estimation methodology. Our updated projections account for potential improvements in the productivity of the acute hospital sector from reductions in the average length of stay and an increasing proportion of elective care delivered through day cases, which can lead to reductions in the average time spent by NHS staff per patient.…”

“…Projections of the overall gap between workforce demand and supply 55 preceding the pandemic, 3 and waiting lists have grown longer. 12 Whether and how these shifts persist or play out further in the coming years will have a bearing on the projected workforce supply-demand gap. *Note: These projections cover NHS HCHS staff and general practice staff in England.…”

“…11 Workforce planning is also inextricably linked with NHS funding choices and pressures. While the NHS did not suffer to the same degree as other areas of public spending from the past decade of austerity, 12 it did not receive the funding needed to meet growing demand pressures. 14 the size and composition of the future NHS workforce are key to any consideration of long-term service sustainability.…”

“…This is all the more relevant given the uncertainties inherent in funding needs in the latter half of the coming decade, particularly in the immediate aftermath of the pandemic. 12 4. Fourth, joined-up, holistic policymaking that accounts for the bigger picture from alternative perspectives -rooted in a systemic understanding of NHS staff numbers, the drivers of recruitment and retention, funding and activity pressures -is much needed.…”

Can ENGLAND'S National Health System Reforms Overcome the Neoliberal Legacy?

“…Increased use of high-cost agency staff added to financial pressures. 54 Meanwhile, demand was increasing. Between 2016 and 2019, the NHS faced average annual growth in elective referrals of more than 2%.…”