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NHS and social care need an extra £12bn to get back on track after pandemic, says think tank

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n721 (Published 17 March 2021) Cite this as: BMJ 2021;372:n721

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  1. Elisabeth Mahase
  1. The BMJ

The NHS and social care systems in England need an extra £12bn (€14bn; $16.7bn) a year to recover from the covid-19 pandemic, which has undone years of progress and could result in a decade of health disruption, a think tank has warned.1

In its State of Health and Care report the Institute for Public Policy Research said that an extra 4500 avoidable deaths from cancer and 12 000 from avoidable heart attacks and strokes were expected in 2021 because of pandemic disruptions. It also said that checks on people with severe mental illness had fallen below a third of their target level, while mental health waiting lists had reached a five year high.

Parth Patel, lead author and a research fellow at the institute, said, “A decade of austerity left our NHS running at the top of its capacity, rather than the top of its game. As a result, the consequences of the pandemic on people suffering with illnesses such as cancer and depression have been huge. There is a real risk now that this damage embeds and the NHS falls further down international rankings.”

The institute calculated that an extra £2.2bn a year for the next five years would be needed to catch up on the elective care backlog and to manage the surge in demand for mental healthcare caused by the pandemic. On top of that, a further £10.1bn of investment would be needed annually to get the NHS in England back on course to meet its own NHS Long Term Plan objectives.

The report set out several short and long term recommendations to help the health and social care services recover, but it said that the government needed to back its rhetoric with “tangible policy and new funding.”

Short term recommendations include:

  • Setting aside a minimum of £1.4bn to enable an average pay rise of 5% for NHS staff

  • Spending £1bn to guarantee a living wage for all care workers through government wage subsidy, similar to the furlough scheme

  • Scrapping the skills requirement and salary threshold for care workers to fill vacancies

  • Making social care free at the point of need, and

  • Ensuring everyone can access the internet by reimbursing internet costs for those most in need.

Chris Thomas, a senior research fellow at the institute, said, “It is high time this government backed its ‘build back better’ rhetoric with tangible policy and new funding. We have among the lowest numbers of nurses, doctors, and long term care workers per capita.”

“We are on the very edge of a precipice of a whole decade of severe health disruption. Now is no time to be timid. We urge the government to give the NHS the boost it so desperately needs and to protect the nation’s health in the decade to come.”

The report also set out long term changes, including raising spending on NHS infrastructure to match at least OECD levels and upgrade ageing buildings, and increasing spending on digital infrastructure to enable improvements in productivity, quality of care, and integration.

Meanwhile, a long term plan for social care should be created to drive low quality providers out of the market, put a cap on accommodation costs, shift ownership back to public and voluntary sectors, and bring care workers’ pay in line with NHS pay scales, the report said.

Researchers at the institute urged the government to reject a “new era of austerity” and instead reinvest in vital public services and the health of the UK.

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