Spending Review predictions from PwC Healthcare


Spending ReviewThe Spending Review needs to both provide short-term stability for the NHS as well as investing in the transformation that’s needed across the whole care system for the longer term. This means the promised £8 billion by 2020 needs to be allocated sooner rather than later. 2019 will be too late for an NHS that is £2 billion in deficit with providers facing the operational pressures of winter and a social care system – especially for older people – which is creaking at the seams.

A further £2 billion transformation fund could provide investment for the new models of care critical for the future. These funds need to be available for change in both health and social services and, critically, be tied to a clear plan for transformation in each care economy.

The challenges facing the NHS cannot be solved by organisations working in isolation. The NHS needs to drop its habit of defending buildings and move to models of care focused around outcomes for patients and the population.

For some places, like Greater Manchester and Cornwall, devolution will be part of the solution, providing acceleration for integration and transformation. For all, collaborative working across health and the wider public sector will be critical to delivering better population outcomes, with new thinking needed on models of risk and reward.

Alan Milburn, chair of PwC’s Health Industries Board, said:

“The ‘deal’ between the NHS and the Government over the Five year Forward View was that the £8 billion of extra funding was subject to certain conditions – front loading, protection for social care funding and the need for a transformation fund. The Spending Review is the opportunity for the Government to put its money where its mouth is.”

Quentin Cole, health partner at PwC, added:

“With the NHS potentially up to £2 billion in the red, some providers across the health service are facing an immediate cash problem. This Spending Review needs to achieve the double trick of providing the cash needed to survive winter, as well as the investment that will help turn Trusts around and put them on the path to transformation.”


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