Intended for healthcare professionals


Comprehensive spending review and the NHS

BMJ 2015; 351 doi: (Published 01 December 2015) Cite this as: BMJ 2015;351:h6477
  1. Kieran Walshe, professor of health policy and management1,
  2. Judith Smith, professor of health policy and management2
  1. 1Alliance Manchester Business School, University of Manchester, Manchester M15 6PB, UK
  2. 2Health Services Management Centre, University of Birmingham, Birmingham, UK
  1. Correspondence to: K Walshe kieran.walshe{at}

Financial crisis is deferred but not averted

Over the past few months an NHS financial crisis of unprecedented scale has emerged. After near zero real terms growth in healthcare funding from 2010 to 20141 most NHS trusts are now in deficit. Their accumulated shortfall half way through the year was already £1.6bn (€2.3bn; $2.4bn).2 Numerous commentators have called for urgent additional financial support and a longer term approach to tackling the causes of the NHS financial crisis3 4 5 6—a gap between funding and spending resulting from increasing service demand, a growing and ageing population, an expanded workforce to assure quality of care, deep cuts in social care, and various unfunded government commitments to new or extended services.

Much was expected of last week’s comprehensive spending review, but it turned out to be an exercise in smoke and mirrors.7 It delivered a modestly front loaded £8bn a year of extra funding for the NHS by 2020 …

View Full Text

Log in

Log in through your institution


* For online subscription