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Sarah Woolnough, Chief Executive of The King’s Fund responded to the Comprehensive Spending Review

‘Despite the tough economic climate, the government has prioritised health services by continuing to increase spending on the NHS for the rest of this parliament. A 2.8% average increase in total health department spending – 3% for day-to-day NHS spending – will have been hard fought for in the spending round negotiations, despite still being lower than the historical average the NHS has received over recent years. A key challenge now will be for the NHS to decide how it can deliver most value from the money that has been allocated. 

‘We know there are already trade-offs happening in the NHS due to tight finances. The Chancellor said she wants the public to have 'an NHS there when they need it'. It is hard to see how all the things she mentions – faster ambulance times, more GP appointments, adequate mental health services, and more – can be met by this settlement alone, particularly when large parts of this additional funding will be absorbed by rising costs, such as the higher cost of medicines which are currently being negotiated, and staff pay deals. But the government’s upcoming 10-year plan for health offers a huge opportunity, so we will wait to see how this money will be translated into better, more efficient services.

‘The three shifts in the upcoming plan are the right ones – preventing ill health sooner, more care into the community, and analogue to digital – and it is good to see the constancy of purpose by having these strategic shifts reconfirmed in today's commitments. However, while it is signalling all the right priorities, this is a spending review that raises some questions rather than providing definitive answers.  

‘The Chancellor has made some welcome steps to protect capital investment and set out budgets over longer time periods.  

But while capital budgets are being shown to increase, they do so by nowhere near enough to rebuild or replace the tired facilities and equipment on which large parts of the NHS currently rely, nor to develop the new hospitals and community facilities needed to deliver a modernised health service.  

‘We welcome a firm commitment to introducing a Fair Pay Agreement for social care workers – a measure to incentivise people to work in social care that can’t come soon enough given the government has already restricted overseas recruitment. But there is worryingly little detail on how much this will cost and whether it will come out of the relatively small amount of additional funding announced for social care, which would leave little left for other fundamental improvements to our ailing system.  

‘The NHS has faced financial pressure for more than a decade, but the signals of financial distress across the NHS have grown in recent years. This matters because financial pressures absolutely have an impact on the care patients and the public receive.  

‘Yesterday’s announcements show how much the government is willing to spend on the health service, but the real prize will be the vision of a better and more sustainable health care service that will be set out in the forthcoming 10 Year Health Plan.’ 

Notes to editors

For further information, or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585. 

The King's Fund is an independent charity working to improve people's health. Our vision is a world where everyone can live a healthy life. Our mission is to inspire hope and build confidence for positive change. We achieve this through expert insights and original research, developing leaders and their organisations, convening, and strategic, collaborative partnerships. Spending Review 2025