Health and social care: The Autumn Statement’s great unsaid
23 November 2016
Despite calls from across the board for additional funding for health and social care, the Chancellor’s last Autumn Statement had nothing new to offer the NHS. With just a reiteration of the £10 billion to support the Five Year Forward View, the service faces another winter under growing financial pressures.
It’s clear from those working across the service that the NHS cannot rely on efficiency alone to get it out of its current financial predicament. With the costs of drugs rising, increasing patient demand, agency use, and now an increase in the national living wage from April 2017, putting pressure on staff costs, unprecedented efficiencies and productivity gains will need to be achieved in parallel to system change in order to have a major and lasting impact on the levels of deficits. To add to the challenge, the NHS will also require an injection of sufficient capital in order to both maintain high quality standards of services and facilities in the short term and to drive the longer term transformation plans that STPs have set out.
The public are clear that maintaining the quality of health services is paramount and our most recent public polling, carried out in early November,  shows that even in the last few months health has become a bigger priority to the public. The vast majority of people (76%) think that the quality of health services should take priority over balancing the books - up from 68% when we last polled the public in April 2016. However, despite the pressures the NHS is under, there is little recognition from the public of the efficiency savings the service has made, with only 16% agreeing that the NHS has become more efficient over the past five years and 45% disagreeing. As STP plans progress, engaging the public in the difficult decisions ahead will be key.
For leadership teams across the NHS, the gap between what they’re being asked to do and the resources they have to do it grows daily. There is no ‘silver bullet’ solution to the challenges facing the health and social care system - the current system was designed to deal with yesterday's problems. Instead of just looking for quick solutions, the system itself needs to be reshaped to deliver improved outcomes, optimise resources and empower patients. Embracing technology, working collaboratively across systems, harnessing the potential of the NHS workforce and enabling the public to take a more active role in their own health and care will all play their part in shaping the service of tomorrow.
PwC's latest research, Redrawing the health and social care architecture, shows that in the long term, the balance of power needs to be shifted to local areas so they assume greater accountability for financing and control of services. This creates funds at a local level which can be spent in a tailored way by leaders who understand the challenges facing their own areas and can engage their local populations.
The Chancellor’s commitment to tackling the challenge of rising population longevity at the next Spending Review suggests some recognition of the pressure health and social care is under. For those working in the system and for patients, longer term change can't start soon enough.
 Polling carried out 8-11 November 2016, 2,000 UK adults nationally representative