English NHS could be £54bn in red by 2021 if budget or output doesn’t increase

The current squeeze on NHS spending in England is no short term measure but is likely to be sustained for many years, the Nuffield Trust has warned in a new report.

Without unprecedented gains in productivity or an economic turnaround leading to greater spending, the total costs incurred in running the health service in England are likely to exceed the cash available by a cumulative total of as much as £54bn (€66bn; $86bn) by 2021-2, says the report.1

This worst case scenario assumes that the current efforts to achieve efficiency gains of 4% a year to 2014-5 (the “Nicholson challenge”) fail, that funding remains flat in real terms, and that demand continues to grow at the historical rate of 4% a year throughout the period. If any of these assumptions is changed for the better, the gap narrows.

It would be eliminated totally if …