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The health department is pressing for about £1bn in additional funding for the NHS in England in the Autumn Statement to cover the costs of strikes that have led to the cancellation of almost 1.2mn operations and appointments.
The wave of industrial action by doctors, nurses and other staff since December last year has opened a hole in the health service’s budget as it incurred extra costs paying for cover for striking staff.
It has also had to cover extra administrative expenses to rearrange thousands of cancelled appointments, and lost revenue from treatment that did not take place.
NHS England chief financial officer Julian Kelly told a board meeting last month that the strike action had cost an estimated £1.1bn up to July, according to documents published online.
Health secretary Steve Barclay is pushing chancellor Jeremy Hunt to cover those losses by setting aside extra cash in his Autumn Statement later this month, according to three people briefed on the discussions. They added that “tough” discussions between the Treasury, the health department and NHS England were in their final stages.
The health service in England has faced an unprecedented wave of industrial action that started late last year when nurses and other staff walked out. Pay deals have been agreed with those groups but junior doctors and consultants remain in dispute, although pay talks with both groups have resumed recently.
Even before the strikes started, the NHS was struggling to mitigate the effect of high inflation on its budget.
The funding request for the NHS is competing with similar bids from multiple other departments and it was unclear whether Barclay would secure extra cash, the people warned. NHS England’s budget will reach £166bn annually by 2024-25, up £42bn on 2019-20.
The Treasury believes that the NHS should do more to limit the costs of the strikes, pointing to the high rates being paid to consultants to cover for junior doctors, the people said. Some NHS trusts have reportedly paid more than £3,000 a shift at times.
But some health leaders are concerned that even £1bn would do little to alleviate additional NHS funding pressures heading into winter, especially with additional strikes still possible. A record 7.75mn patients are on waiting lists for non-urgent treatment, according to government figures.
Matthew Taylor, chief executive of the NHS Confederation which represents health managers, said they were now facing a funding gap of “well over £1bn caused by their organisations having to cover the unexpected costs of ongoing industrial action for the best part of a year”.
This needed to be “plugged without delay and if it cannot be compensated in full, the NHS will need to understand from the government how it intends to adjust expectations on what its services will deliver with the resources available”, he added.
Adrian Boyle, president of the Royal College of Emergency Medicine, recently told the Financial Times that some hospitals were already coming under pressure to make difficult decisions ahead of winter. These included reducing the number of “escalation beds”, which provide much-needed extra capacity at times of high demand.
The health department and the Treasury said the government was “backing the NHS with record funding” and had invested up to £14.1bn to tackle the backlog caused by the pandemic and reduce waiting times.
They added: “Ahead of this winter, we committed an additional £200mn to boost the NHS’s resilience and have published the first-ever NHS Long Term Workforce Plan to grow and support the workforce, backed by over £2.4bn.”
NHS England did not respond to a request for comment.