The impact of the NHS’ deficit on Party manifestos

In our last blog we looked at how the political parties were setting out their ambitions for social care reform ahead of the general election. As the election takes place today against the backdrop of the NHS’ and social care’s finances rapidly spiralling out of control, whoever finds themselves in power may well have to reign in their ambitions for social care revolution.

This week has illustrated the extent of the spending problems that these services are facing, with research showing 98 NHS trusts are projected to have a collective shortfall of £759 million this year. Applied to all 240 trusts, this would mean a total deficit of almost £2 billion. This is an unsustainable amount of debt, and the next government will have to tackle this by either increasing its revenue or making sweeping cuts to services’ expenditure. The impact of this on the parties’ proposed social policies from their manifestos could be severe. The Conservatives want to shift more of the social care burden onto local authorities as per the Care Act, but research from Prestige Nursing + Care shows that local authorities’ care responsibilities are likely to become difficult to manage as it is, without additional financial pressures. Furthermore, Labour’s social care policies appear equally difficult to implement in such tough circumstances. Recruiting an extra 5,000 homecare workers is excellent in principle, but seems farfetched given that many NHS frontline staff may have to lose their jobs. Ending the culture of 15-minute visits is another noble ambition, but one that may fall flat on its face with the limited amount of funding available. The Liberal Democrats, Green Party and UKIP all promise some variation of health and social care integration, which we have argued in previous Prestige blogs is an excellent approach to social care policy. However, this needs to be extremely well thought out before forming the basis of a concrete shift in service provision. With both areas stretched to what increasingly looks like breaking point, a costly and bloated integration process would be extremely hard to justify and could divert important resources away from actually delivering care. Perhaps a better policy in the present context would be to maximise the efficiency of the health and social sectors, and not risk fanning the flames further. One solution that the policymakers should explore is to rally the public around bringing some services out of hospitals and in to the community. Many people’s image of the NHS is solely based upon hospital services, which are often expensive and highly bureaucratic. Community based programmes such as homecare can provide affordable and effective solutions to mounting problems.

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