Intended for healthcare professionals


NHS finances: the tanker en route for the iceberg

BMJ 2014; 348 doi: (Published 08 May 2014) Cite this as: BMJ 2014;348:g3129
  1. Gareth Iacobucci, news reporter
  1. 1The BMJ, London WC1H 9JR, UK
  1. giacobucci{at}

Will it hit before next year’s general election?

In a report published last week, UK healthcare think tank the King’s Fund warned that a financial crisis in the NHS was now “inevitable” by 2015-16 and that, without urgent action to plug the funding shortfall, it could arrive sooner.1 Such warnings have become increasingly vociferous in recent months, as fears grow that the tanker may be about to hit the iceberg, to coin the phrase used by former NHS Confederation chief Mike Farrar.2

Before his departure earlier this year, the outgoing NHS chief executive David Nicholson warned that the NHS was facing a £30bn (€36.5bn; $50.8bn) funding gap by 2021, which could render it unsustainable without radical change to the way care is delivered.3 The onus has now fallen on Nicholson’s successor Simon Stevens to leverage this change while keeping the ship afloat, amid what Stevens describes as “the longest squeeze on NHS finances in our 65 year history.”4

Since 2010, there has been an unprecedented slowdown in the growth of NHS funding, as the accelerated investment of the previous decade dried up. The King’s Fund’s report …

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