Estimates Day: Health and social care

The NHS and social care systems are facing significant financial challenges as a consequence of an ageing and growing population.

Although health spending has been protected relative to other public services, the NHS is required to find £22 billion of annual efficiency savings by 2020/21. There are concerns that increasing demand for health services and pressure on local authority budgets are threatening the financial stability and sustainability of the health and social care systems.

The House of Commons Library has produced a range of briefings on NHS and social care funding:

• The financial sustainability of the NHS in England
• The structure of the NHS in England
• Reform of support for healthcare students in England
• Health and Social Care Integration (England)
• Adult Social Care Funding (England)
• The care home market (England)
• Social care: paying for care home places and domiciliary care (England)
• Social care: Announcement delaying introduction of funding reform (including the cap) and other changes until April 2020 (England)
• Social care: how the postponed changes to paying for care, including the cap, would have worked (England)
• Brexit: impact across policy areas

The briefing paper NHS Indicators has statistics on the key trends in recent NHS performance. These include:

• A&E attendances in 2016 have been 5% higher than in 2015. The number of emergency admissions rose by 4.5%
• 21% of patients spent more than 4 hours in major A&E departments in Dec 2016, compared with 13% in Dec 2015 and 6% in Dec 2011
• Long waits for emergency admissions were 58% higher in 2016 than in 2015, and five times higher than 2011
• There were 23% more delayed transfers of care in 2016 than in 2015. Social care delays rose by 37%. Delays due to waits for homecare rose by 45%
• The waiting list for routine treatment grew 11% to 3.66 million between Dec 2015 and Dec 2016
• 92% of those waiting for treatment had been waiting for 20 weeks or less - above the target of 18 weeks
• More cancer waiting times targets continue to be met. The 62-day treatment target (85%) has not been met since Dec 2015
• Urgent ambulance calls rose 16% in 2016. The 8-minute ambulance response target (75%) has not been met since May 2015
• Waiting times targets for mental health talking therapy treatments continue to be met, with performance improving in October
• The number of GPs is estimated to have fallen by 3% between 2014 and 2015
• In the year to Oct 2016, the number of hospital doctors rose by 1.7% and the number of hospital nurses rose by 0.8%

Reports

• National Audit Office, Financial sustainability of the NHS, November 2016
• National Audit Office, Health and social care integration, February 2017
• National Audit Office, Discharging older patients from hospital, May 2016
• Public Accounts Committee, Sustainability and financial performance of acute hospital trusts, March 2016
• Health Committee, Public health post-2013, September 2016
• Health Committee, Impact of the Spending Review on health and social care, July 2016
• Local Government Association, Adult social care funding: 2016 state of the nation report, November 2016
• The King's Fund - Commission on the Future of Health and Social Care in England (Barker Commission), A new settlement for health and social care, September 2014

Further Reading

• Health Committee inquiry, Department of Health and NHS finances, October 2016
• Letter to Prime Minister from Chairs of Select Committees on NHS and social care funding, 6 January 2017
• Secretary of State for Health, Statement to the Commons on mental health and NHS performance update, 9 January 2017
• NHS Providers blog, The big questions for the year ahead, January 2017
• The King's Fund blog, What now for social care?, December 2016
• NHS England, Five Year Forward View, October 2014
• BBC News, 'Hospital cuts planned in most of England', 21 February 2017 (analysis of local NHS Sustainability and Transformation Plans)
• The Guardian, 'Brexit threatens social care jobs and funding', 21 February 2017

Ongoing inquiries

• Public Accounts Committee, Integrating health and social care
• Communities and Local Government Committee, Adult social care
• Health Committee, Brexit and health and social care
• Lords Select Committee, Long-term sustainability of the NHS