BMA estimate NHS needs £9.5bn to secure its future

Credit: This story was first seen on The Guardian

Modernising and securing the future of the health service in England would cost at least £9.5bn in upfront spending, money that the NHS does not have, the British Medical Association has said.

Health managers in 44 areas have been charged with creating sustainability and transformation plans (STPs) to help the NHS repair its crumbling finances and meet clinical and organisation challenges, The Guardian reports.

But such an overhaul would need significant capital investment, according to the BMA.

The doctors’ union sent freedom of information requests to all the areas asking for their estimates to implement the STPs and 37 replied, with the figures quoted in responses totalling £9.53bn.

Dr Mark Porter, the BMA’s chief, said: “These figures are especially concerning given that everyone can see a huge crisis unfolding within our NHS, with record numbers of trusts and GP practices raising the alarm to say they already can’t cope.

“The NHS is at breaking point and the STP process could have offered a chance to deal with some of the problems that the NHS is facing, like unnecessary competition, expensive fragmentation and buildings and equipment often unfit for purpose. But there is clearly nowhere near the funding required to carry out these plans.”

More than half of the STP areas have told NHS England they would each need more than £100m of upfront funding to make changes. Six – Cambridgeshire and Peterborough, Cheshire and Merseyside, Greater Manchester, North Central London, North East London and West Yorkshire – have quoted capital needs of £500m or more.

The BMA says that NHS leaders are unlikely to have anything near the cash required to deliver the projects, with budgets already under severe pressure. The annual capital allocation of £4.8bn granted to the Department of Health from 2016/17 to 2020/21 is being used in part to cover large hospital deficits, it says.

At a hearing last month of the public accounts committee – which scrutinises government expenditure, the NHS Providers chief executive, Chris Hopson, said a quarter of the capital budget (£1.2bn) had been taken “to prop up revenue”, and the health department’s finance director, David Williams, said raids on the capital budget were likely to continue.

The BMA says there will be other demands on the budget, pointing to an NHS Digital report published last year which said that more than £2bn was needed to pay for significant or high-risk outstanding maintenance needs.

Although the NHS says the STPs are vital to the future of the service, they have proved highly controversial as they are likely to lead to the axing of thousands of hospital beds, A&E units being downgraded or closed and women facing long trips to give birth.

Porter said: “These plans are fast becoming completely unworkable and have instead revealed a health service that is unsustainable without urgent further investment, and with little capacity to ‘transform’ in any meaningful way other than by reducing the provision of services on a drastic scale.”

Tom Sandford, the Royal College of Nursing director of England, said: “We have always supported the aims of the plans – preventing ill health, joining up services, delivering care closer to home. But proper funding – and consultation – is key to making sure STPs solve instead of exacerbate the problems of England’s health and care system.”