A prominent think tank has called the incumbent government’s commitment to moving care away from hospitals into question after analysis found unequal funding provisions for key services.
The Nuffield Trust says that successive governments have “not put their money where their mouths are” when it comes to prevention and moving care further upstream into communities.
Via annual accounts from NHS trusts, NHS England and the Department of Health and Social Care, researchers looked into nine spending lines from 2016/17 to 2022/23:
- Acute care in NHS trusts
- Ambulance care by NHS trusts
- Community healthcare by NHS trusts
- Mental healthcare by NHS trusts
- GP primary care
- Ophthalmic and community pharmacy services
- Dental
- Prescribing
- Local authority public health grant
Of the nine, four saw average annual funding increases in real-terms, including acute (4.4%), mental health (5.3%), ambulance (5.2%), and general practice (3.3%).
Average annual real-terms cuts were observable in public health (-3.9%), dentistry (-2.2%), and ophthalmic and pharmacy (-2%).
Meanwhile, community services (0.5%) and prescribing (-0.5%) remained relatively flat on average.
“Quite simply successive Governments have cut back on the very services that are needed to support the ambition of moving care out of hospital,” said senior policy analyst at the Nuffield Trust, Sally Gainsbury.
“These trends are not an accident: when the chips are down, it’s the blue-light emergency services that swallow up what funding is available for healthcare in straitened times.”
The drop is only intensified when adjusted for the needs of our ageing population.
Needs-adjusted spending in NHS community health services was 4.2% below what it was in 2016/17 – the equivalent of £6 less per person.
It is a similar story in both dentistry and public health spending, with the two sectors seeing a drop of 20% and 24% respectively – or £11 and £15 less per person.
Mental health funding, on the other hand, has grown the most significantly when adjusted need is accounted for, with £43 more per person spent.
Sally added: “Whoever forms the next government will have a mountain to climb to reverse this trend without detracting from the very real spending pressures in acute care.”
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