As we reflect on this week’s Spring Statement and approach the beginning of the Government’s new financial year, the mood across the health and care sector can be summed up in one word: concern. April is expected to bring lighter days, sunnier skies, and a whole cascade of changes for the system. Anticipated shake ups to leadership, funding, policy and structure come with little reassurance of sufficient resource or strategic clarity. Instead, there is a growing sense that the sector is heading towards a perfect storm.
Chancellor Rachel Reeves’ Spring Statement on Wednesday confirmed the day-to-day NHS budget for 2025/26 will grow by less than 2% in real terms – a figure that the Nuffield Trust argues will fail to keep pace with inflation, rising patient need, or the growing complexity of care. The Chancellor pointed to savings made by the dismantling of NHS England itself, as an opportunity to reinvest in frontline care. But these efficiencies alone are unlikely to plug the ever-worrying gap in funding. This year has already required an £800m emergency top-up for the NHS just four months after the Autumn Statement, and the concern is that history is set to repeat itself.
Meanwhile, adult social care has once again been left neglected. With no funding set aside to cover the impact of National Minimum Wage and employer National Insurance contribution increases, providers are continuing to warn of closures, reduced capacity, and growing gaps in support for those most in need of care across the UK. Following a House of Commons vote last week to dismiss proposed amendments to the increases, Care England has launched a judicial review in response to the decision, warning that “there is a fundamental lack of understanding about the importance of our sector, and its social and economic contribution to local communities” within the Government. Councils, too, are ringing alarm bells. New analysis shows a looming £6.2 billion funding shortfall for local authorities in England, prompting warnings from the Local Government Association that statutory services may be at risk.
Perhaps most starkly, Health and Social Care Secretary Wes Streeting has confirmed that the share of NHS funding spent on mental health is set to fall next year – a move branded “deeply disappointing” by NHS Providers and described as a sign that we are “going backwards” on mental health by Mind Chief Executive Dr Sarah Hughes, in spite of safeguards like the Mental Health Investment Standarddesigned to ensure a reasonable baseline of funding for these services. With record numbers of people seeking mental health support and many languishing on waiting lists, the drop in relative investment will have far-reaching consequences, including on Government ambitions to reduce A&E demand, tackle waiting lists, and support people back into work.
The Government’s plans to cut disability benefits have added a final layer of concern, with their own impact forecast predicting that proposals for welfare cuts could push 250,000 people into poverty by 2029/30, including 50,000 children. This comes alongside the Department for Work and Pension’s estimate that child poverty rates have now reached a record high, impacting 31% of the UK’s children. Mencap Chief Executive Jon Sparkes OBE has come out strongly against proposed changes to the UK’s welfare system and their impact on people living with learning disabilities, warning that many have already contacted the charity out of fear and concern over the possibility of facing “a lonely future living in poverty”. As the cost of living and scarcity of existing services and support continue to hit these communities hard, these cuts risk undoing the very efforts to support disabled people into employment and independence that ministers claim to be prioritising.
Next week, new Chair Dr Penny Dash takes the helm at NHS England, stepping into an organisation still reeling from its announced abolition. Though the process is projected to take two years, the centre will still be expected to oversee procurement, innovation, and national performance targets before its functions are fully absorbed into the Department of Health and Social Care (DHSC). The NHS being brought back into ministerial control is a fundamental reset for the system, and with the 10-Year Plan for health and care promised later this year, attention is already shifting to whether the Government will be able to deliver much-needed transformation.
All of this comes at a time of profound transition, with major reforms to the health and care system promised but not yet realised. The sector is being asked to think long-term while dealing with serious and immediate challenges that threaten to overwhelm or even close services and undermine the health and wellbeing of the public. If April marks the start of a new chapter, it may be one defined less by transformation and more by survival.
