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NHS to get £4bn budget rise but student nurse bursaries set to go

  • 7 Comments
  • Spending review to give NHS England a real terms budget increase of £3.8bn in coming financial year
  • Redrawing of NHS “ringfence” will see cuts to public health and an end to nursing bursaries

Tomorrow’s comprehensive spending review will give NHS England a real terms increase to its budget of nearly £4bn in 2016-17, but is expected to see further cuts to public health and an end to free nurse education.

The plan to give NHS England £3.8bn of real terms growth next year represents a significant frontloading of the £8.4bn promised over the coming half decade.

It marks an attempt to staunch the financial crisis in the health service’s provider sector while also pump-priming the creation of new models of care set out in Five-Year Forward View.

As a result of the frontloading, after next year, the following four years will see real terms investment drop to just £500m in the third year, before rising again to £1.7bn in in 2020-21.

In a statement issued last night, NHS England chief executive Simon Stevens said the settlement represented “a clear and highly welcome acceptance of our argument for frontloaded NHS investment”.

However, the decision to draw the NHS “ringfence” around NHS England’s budget of around £101bn – rather than around overall Department of Health expenditure, as was the case in the last parliament – means other aspects of health spending will not be similarly protected. 

It is being widely reported that some of the money used to fund the NHS England increase will come from further cutbacks to public health and, as previously trailed, the current bursary system for funding nurse education is expected to be replaced with student loans.

According to Nursing Times’ sister title Health Service Journal, of the £3.8bn increase coming to NHS England next year, around £3.4bn will be new money from the Treasury. The remaining £400m will come from the Department of Health’s existing allocation, including some money from public health budgets.

It is understood that the precise real terms increase NHS England has secured over the coming half decade is £8.4bn. The profile of that investment will be: 

  • 2016-17: £3.8bn
  • 2017-18: £1.5bn
  • 2018-19: £0.5bn
  • 2019-20: £0.9bn
  • 2020-21: £1.7bn

The rationale for low rates of growth in the third and fourth years is understood to be in order to hold back some money to cover the cost of fully implementing the government’s seven-day services policy in the final year.

In a statement, the Treasury said in total the NHS would receive “an additional £10bn a year above inflation by 2020, with £6bn frontloaded by the first year of the spending review”.

As well as the new £3.8bn, this £6bn figure includes £2bn above inflation in NHS England’s budget for the current financial year that was allocated in last year’s autumn statement.

Chancellor George Osborne said: “You can only have a strong NHS if you have a strong economy and it’s only because we have taken the difficult decisions needed to cut the deficit and are delivering economic security that we are able to commit an additional £10bn a year by 2020 to the NHS.

“We will deliver £6bn a year extra investment straight away, as those in charge of the NHS have requested. This means I am providing the health department with a half a trillion pound settlement – the biggest ever commitment to the NHS since its creation.”

“Employers will be concerned to ensure any action taken doesn’t deter applications for training places”

Danny Mortimer

He said this would mean “world class-treatment for millions more patients”, deliver a “truly seven-day health service”, and allow the NHS to implement the Five-Year Forward View.

However, the decision to redraw the NHS “ringfence” to exclude budgets like public health and health education is likely to prove highly controversial and unpopular with many in the nursing profession.

The suggestion that seven-day services can be delivered within the £8bn settlement will also be greeted with scepticism by some in the service. 

Commenting on the expected changes to the way nurse education is funded, Danny Mortimer, chief executive of NHS Employers, said: “Employers will be concerned to ensure that any action taken doesn’t deter applications for training places or create an additional pressure on the pay bill to meet expectations that loans will be paid off as part of a recruitment package, and we will have to watch this closely.

“Employers will also hope that the introduction of any change will be done in a measured way and appropriately phased,” he said. “However there is a general recognition that we do need a training system that is more flexible and one that can quickly respond to changes in demand.”

“The NHS needs this immediate funding boost to stabilise itself, fulfil its essential functions and keep patients safe”

Janet Davies

Commenting on the overall cash injection for the NHS, Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “A realistic long-term funding settlement for the NHS has been desperately needed for some time. Short-term fixes over the years have caused huge problems in terms of deficits and staffing and patients have felt the brunt.

“The Five Year Forward View sets out clearly how the NHS needs to adapt to the demands placed on it, which are unprecedented in its 67 year history and it is right that implementing this vision should be a priority for funding,” she said.

She added: “The NHS needs this immediate funding boost to stabilise itself, fulfil its essential functions and keep patients safe. It is still unclear how exactly this funding will also deliver a shift to seven day services, or what those services would look like for patients or staff.”

 

  • 7 Comments

Readers' comments (7)

  • Why not? Nurses want degree status,well here it is! A loan may well keep out some of the dross of which there is too much! Bring it on!

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  • I wonder what percentage of applicants entering the profession have financial commitments (such as children/family/mortgage) and ordinarily bring those life skills that often contribute to being excellent nurses will now see this as a barrier to entering the profession.
    Tories know the cost of everything and value of nothing.
    As the lowest paid of the degree entry public servant professions will we see a raise in our salary so it matches others?

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  • @ Anonymous 24/11/15 4:52pm, I agree, getting rid of the student bursary will probably mean a decrease in the mature nurses with financial commitments.

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  • NHS budget rise. Perfect!

    More quangos and more CEOs!

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  • I just fail to understand anymore!!.
    every week we are reading how short the NHS are of nurses and struggling to fill vacancies. Who in their right mind is going to take up a course that is going to see them start off their career in such debt and take and age to pay back. Unfortunately (and not due to actual patient care) nursing is no longer an attractive carer, the pension is no longer attractive, sick pay is now basic and very soon they will be starting on the unsociable hours and annual leave. Add this to lack of decent pay rises and the NMC yearly costs that keep rising and I fear that this vocation will be in serious trouble, couple this with the restrictions on agency nurses and the fact that the minimum wage will be rising in 2020 ( at £9.00 per hour I can see a vast majority of HCSW seeking employment elsewhere) the NHS is facing a serious staffing crisis!. Good luck to all those who will have to deal with this whilst maintaining the MINIMUM STAFFING LEVELS!

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  • Cutting bursaries is way down the list of contemporary problems facing the nursing. All degree profession? Name me any other group of professional people that - in order to be able to continue to work - have to keep thank you cards and letters and have to write a little story every 3 years saying how they've learnt something? What a joke. God bless the NMC!

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  • I struggled enough to get through my course with the NHS bursary, and I'm still £12k+ in debt to Student Finance England.

    Coming from a deprived background, had I not have had the bursary I wouldn't be qualified and I would be highly unlikely to consider doing my training.

    What I am interested in is how the changes effect the provisions laid down by the 1968 act:

    "The Secretary of State] may, with the approval of the Treasury,—

    (a)make grants and pay fees to persons or bodies with whom arrangements under subsection (1) above are made for the provision of instruction under this section [F27and for ancillary administrative purposes]; and

    (b)pay travelling and other allowances to persons availing themselves of such instruction."

    I genuinely don't know.

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