For this NHS budget to 'fix the foundations' we must unlock frontline ideas
30 October 2024, 19:17
The new government promised a budget that would 'start fixing the foundations' of the NHS.
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Today’s major funding increase is both welcome and necessary – you can’t rebuild a house without any money to spend, and the same goes for our health service. Yet the hard part is how to spend this money well.
This requires more radical reform than leaders have grappled with so far - reform based on democracy and decentralisation to improve decisions throughout the NHS.
Today’s budget announcement equates to a 5.8% increase in funds for daily spending in 2024/25 compared to the previous government’s plans – with a further increase the following year, and an extra £4.7 billion for capital such as surgical hubs over two years.
Yet since the pandemic, the English NHS has struggled to turn money into the maximum volume of care.
Fewer patients are being seen per doctor across A&E, inpatient and outpatient care, and any patient who has sat in a chaotic waiting room can tell their own stories of inefficiency hampering care.
As Health Secretary Wes Streeting said: “I owe it to taxpayers that their money is well spent.”
Yet if we continue with post-pandemic poor productivity, this is far from guaranteed. Just as a home renovation could backfire without the right priorities and expert input, NHS leaders should beware of spending without a new approach to listen to those who know best.
The problem is that NHS decision-making is broken. Every frontline staff member can describe a long list of frustrations that waste their time, yet just 56% feel able to make improvements happen at work. This is because funding and power are held far from the frontline.
Decision-makers spend more on locum doctors when what is needed are computers; purchase new software before a discharge co-ordinator; or top-up winter crisis funding but not community physio to help people stay well.
This is why staff voice is key. It opens the way to better decisions across the NHS – and greater impact from the new money committed today. The 10-year-plan public consultation is significant, but the conversation cannot stop there.
The NHS needs to listen to staff and patients every time important decisions are made, from prioritising between new clinics or operating theatres, to redesigning rotas and childcare.
Today’s budget was described as a 'productivity downpayment' by Chancellor Rachel Reeves.
To unlock this potential and rebuild a healthy nation that supports a thriving economy, we can't rely on the ideas of the past. True reform is needed to rewire the NHS for success.
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Dr Annie Williamson is a Research Fellow at IPPR and medical doctor.
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