Ahead of the Chancellor’s Autumn Statement on 17 November, ARMA wrote to the Chancellor to outline the impact of the cost of living crisis on people with MSK conditions and the importance of the NHS for growth in the economy. I don’t think I was alone in fearing that the statement would see cuts in funding for the NHS and social care. Thankfully those fears were unfounded, although many feel that the funding announced was not enough.
We asked three things in the letter:
- That cost of living support be targeted at those who need it most, including those with health conditions where keeping warm is important.
Most health charities made similar calls and it seems we were heard. The reform of the energy cap in spring will include considering how to protect those with medical requirements for high levels of energy use. - That benefits should rise by inflation and the cost of living with a long-term condition be lowered, at least by pausing prescription charges.
Half of this ask was realised, with benefits rising by inflation. However, no other support was on offer to those whose long-term conditions cost them significant amounts to manage. - Now is not the time to reduce NHS funding and there is an urgent need to tackle the workforce crisis.
In fact, the NHS received £3.3 billion in each of the next two years. Not a reduction, but not a very large increase either. The Nuffield Trust estimated the NHS funding represents less than 1% real terms increase when adjusted for age.The announcement of the £500 million adult social care discharge fund is also welcome, funding improvements in social care and rehab staffing to enable more people to recover at home, which frees up hospital beds.
So, not as bad as I feared, but not as good as we need it? Perhaps….
We will be waiting for the already long awaited workforce plan a while longer. In spring we are promised an assessment of the NHS workforce needs for five, ten and fifteen years. If the assessment of workforce needs in fifteen years’ time is what we have now for an older population, then we will never be able to meet those needs, certainly not with the funding increases announced last month.
Do we assume that the rate of long-term conditions will continue to rise at a steady pace in line with the age of the population? How much of this long-term ill health is preventable, and what workforce do we need to prevent it? What workforce do we need to increase the ability of people with long-term conditions to manage their own conditions? How much pressure could this take off the NHS? My guess is that this will be a very different workforce from that needed to deliver the NHS as it is now.
What we have now is not good for anyone. Will we be brave enough to think beyond adequately funding the status quo and advocate for something different?