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The general election dominated headlines across the UK media in May and June, with the future of the NHS a key topic for all parties. Away from manifesto promises, however, a stark reminder of the task facing Keir Starmer’s incoming Labour government came as strikes continued right up until the week of the election.

All the main parties made the UK’s health sector a key part of their manifestos. The Conservatives committed to increasing NHS spending above inflation every year, while making a familiar pledge to build 40 new hospitals, just as they had in 2019. Labour promised to cut NHS waiting lists by creating 40,000 more appointments each week, some through having NHS staff work evenings and weekends, and training thousands of new GPs. Meanwhile, the Liberal Democrats put social care at the centre of their manifesto, with £3.7bn of its proposed £9.4bn health service rescue plan earmarked for ‘ending the social care crisis’.

The financial promises for the public sector made in the manifestos of the three main parties were given short shrift by the Institute for Fiscal Studies (IFS). It said neither Labour nor the Conservatives had set out any changes to the baseline funding for public services, which it argued will lead to wide-ranging cuts outside protected areas such as health. This ‘conspiracy of silence’, as it was described by IFS director Paul Johnson, meant neither party had provided any details on how they would deal with these cuts or how they would be avoided. Mr Johnson said the Liberal Democrats’ bigger tax and spend policies were likely to be hit by a shortfall in revenue, while the Reform UK and Green Party manifestos were ‘wholly unattainable’.

The British Medical Association (BMA) released its own manifesto ahead of the election, outlining the five areas it wanted each party to commit to: value the vital role doctors play across all health services and restore their pay; protect doctors from any further erosion of their professional role and employment rights; train and provide jobs for the next generation of doctors needed to meet demand; fund the services needed for the future of the health service; and safeguard the public’s health and wellbeing, prioritising preventative care.

The Royal College of Nursing’s general election manifesto consisted of 12 points to solve the nursing crisis, which included: higher pay for nurses; ending corridor care; introducing nurse-to-patient ratios; funding mental health support for nurses; and providing legal protection for people raising concerns about unsafe staffing.

After the general election, the main NHS commentators welcomed the Labour government into power, but were quick to emphasise the size of the task ahead. A common theme across the NHS Confederation, NHS Providers, the Health Foundation, The King’s Fund and the Nuffield Trust was that the new government must not ignore the NHS’s long-term needs as it rushes to shore up more immediate issues such as lengthy waiting lists and pay disputes. There was also broad consensus on the need for more capital investment to fix infrastructure and machinery.

Most of the health-focused organisations mentioned resolving the NHS staff pay disputes in their general election wishlists, and there was mixed news on this throughout the spring. In England, junior doctors continued to strike over pay, with the most recent round of action just days before the general election, from 27 June to 2 July. Elsewhere, specialist, associate specialist and specialty (SAS) doctors in England voted to accept the government’s pay offer in June, while consultants agreed a revised pay deal in April. Mr Streeting was quick to meet the junior doctors, in talks that were described as ‘positive’.

In other parts of the UK, consultants, junior doctors and SAS doctors in Wales accepted pay offers made by the Welsh Government in June. In Northern Ireland, consultants held a 24-hour strike on 26 June due to what they described as a lack of a ‘credible’ pay offer. Junior doctors in the country embarked on their third round of industrial action between 6 June and 8 June.

While its relevance has diminished given the party’s removal from power, the Conservatives used the spring Budget on 6 March to announce the NHS in England would receive an extra £2.5bn to cover its day-to-day running costs in 2024/25. This was followed by a further £3.4bn of capital being allocated to fund productivity improvements in the NHS, spread over three years from 2025/26. Of this investment, £2bn would be used to modernise IT systems, and £430m spent improving patients’ access to care.

The NHS’s planning guidance, released in March, demanded improved A&E waiting times, an end to waits of more than 65 weeks for elective care, and an increase in the percentage of patients that receive a diagnostic test within six weeks by March 2025. Faster and earlier cancer diagnoses and a reduction in the use of agency staff were also called for. 

Analysis by the Nuffield Trust showed promises to move care away from hospitals and into the community have not been matched by changes in funding for the different sectors. The government had often talked about spending more on community services that keep people out of hospital, but the trust said this shift in priorities could not be seen in its analysis of funding from 2016/17 to 2022/23.

On the topic of home care, an analysis commissioned by NHS England South East showed virtual wards in the region are reducing non-elective admissions to hospitals and delivering financial savings. According to the analysis of 29 of the region’s 76 virtual wards, on average one non-elective admission was avoided for every two virtual ward admissions. This led to financial savings, with an overall £10.4m net benefit for the virtual wards analysed.

Improving mental health services was a topic that featured prominently in the run-up to the election. To support this NHS England released details of a mental health currency to replace clusters, and announced it was looking for NHS providers to improve data quality ahead of more formal adoption in 2025/26. In March, analysis by the Centre for Mental Health showed mental illness in England costs £300bn a year – almost twice the sum spent on the whole NHS budget.

In Northern Ireland, the assembly passed its first budget in three years in May, despite the outgoing health minister warning it could result in ‘serious and potentially irreparable damage to health and care services’. The budget awarded the Department of Health £7.76bn for 2024/25 – 6.3% up on the opening funding for 2023/24, but 2.3% less than the department’s closing budget for last year. In early July, an extra £122m was allocated to the department for 2024/25.