Confed chief calls for a decade of above-inflation funding

Ahead of the confederation’s conference in Liverpool this week, Mr Taylor (pictured) told The Sunday Times that many of the baby boomer generation – those born in the two decades after 1945 – will be reaching the end of their lives in the next 10 years. This would lead to a ‘bulge’ in death rates, with a third more people dying than now. And, as people tend to use more NHS resources in the final year of their lives, there will be a rise in NHS costs.

He continued: ‘This won’t be forever. You don’t have to sustain that rate of funding once you get through the bulge in population ageing and I believe many of the innovations in data and digital technology can ultimately save us money.'

Mr Taylor told the paper that, by embracing new technology and ways of working, the NHS is becoming more efficient and is reducing waiting times. However, he added that there is a ‘huge and widening capacity gap that is sucking into it the energy and hope of our staff and the confidence and trust of the public’.

He insisted the NHS had ‘a great future’ and could improve quality and health outcomes. But politicians must act to close the capacity gap, and be honest about what the health service can deliver, he added.

Senior NHS leaders told the confederation that the reduction of waiting lists and efforts to implement the government’s digital ambitions were being hampered by a lack of capital investment. In a survey, nine in 10 said a decade of underinvestment in buildings and estate is hindering attempts to cut waiting lists. The same proportion said capital is needed to transform patient services.

Later in the week, NHS England announced that the waiting list for elective care had grown to 6.53 million (6.4 million a month earlier), though it insisted the health service was making progress – reducing the waiting list for diagnostic tests and those waiting more than two years for elective care. Discharging patients to social care continued to be an issue, with fewer than half those ready to be discharged leaving hospital.

Leaders also warned that ageing buildings and outdated computer systems presented a risk to patient safety. The capital application system was disjointed and confusing, and more than 80% admitted they did not have the funding to provide services in the most efficient way or to increase productivity.

Though the government injected capital into the system in last year’s spending review, the confederation warned that it did not make up for under-investment in the last decade.

The NHS has backlog maintenance of more than £9bn, and one provider chair said their trust was constantly juggling capital spending priorities. A non-executive director told the confederation that their trust was unable to build on investment in an electronic patient record because they did not have the capital to upgrade the IT network and wi-fi infrastructure.

Others were concerned about how they would find space for the additional staff needed to improve services. Members of the flagship scheme to build 40 new hospitals by 2030 said they had seen no practical benefit – instead they were expected to maintain buildings that were ‘short-term wasting assets with massive backlog maintenance issues’.

Mr Taylor said: ‘The government needs to urgently unlock the capital funding that has already been promised so that work can finally begin up and down the country on new builds as well as addressing the maintenance backlog.

‘The government then needs to revisit capital funding in the autumn Budget to address the shortfall that has been created. We should be ahead of the pack when it comes to the amount we invest in capital compared to other OECD countries, rather than lagging behind as we currently are.’ 

The conference, NHSConfedExpo, will be held on 15 and 16 June with a focus on health inequalities, post-Covid NHS recovery, workforce, collaboration, and quality and clinical improvement.

Speakers will include NHS chief executive Amanda Pritchard and HFMA policy and research manager Sarah Day, who is due to deliver a session on the role of finance in reducing health inequalities.