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Securing the future: funding health and social care to the 2030s

Paul Johnson, Elaine Kelly, Tom Lee, George Stoye, Ben Zaranko, Anita Charlesworth, Zoe Firth, Ben Gershlick and Toby Watt
Report

On 5 July this year the NHS will be 70. In all its 70 years it has rarely been far from the headlines. It has been through more than its fair share of reforms, crises and funding ups and downs. Over that period, the amount we spend on it has risen inexorably. Yet, today, concerns about the adequacy of funding are once again hitting the headlines, as the health and social care systems struggle to cope with growing demand.

Looking forward, funding pressures are only going to grow. The population is getting bigger and older, and expectations are rising along with the costs of meeting them. Our analysis suggests that UK spending on healthcare will have to rise by an average 3.3% a year over the next 15 years just to maintain NHS provision at current levels, and by at least 4% a year if services are to be improved. Social care funding will need to increase by 3.9% a year to meet the needs of an ageing population and an increasing number of younger adults living with disabilities. If the widely acknowledged problems with England’s social care system – of limited eligibility, low quality and the perceived unfairness of the current, uncapped, means test – did result in reform, spending on social care would need to increase at a faster rate.

If we are to have a health and care system that meets the expectations of the population, we need to understand how and why spending has risen over time, where the money is spent, how costs are likely to develop in the future, and how we might go about meeting those costs. That is the purpose behind this collaboration between the Institute for Fiscal Studies and the Health Foundation, in association with the NHS Confederation.

How would you fund the NHS? Use this tool to try and reach these projected funding “targets” through increasing taxes and / or by cutting government spending in other areas.

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Interactive tool
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Book chapter
This is a chapter of The NHS at 70. To mark the BBC’s coverage of the NHS’s 70th birthday in July 2018, researchers from the Institute for Fiscal Studies, Health Foundation, The King’s Fund and the Nuffield Trust have come together for the first time, using combined expertise to shed light on ...
Report
To mark the BBC’s coverage of the NHS’s 70th birthday in July 2018, researchers from the Institute for Fiscal Studies, Health Foundation, The King’s Fund and the Nuffield Trust have come together for the first time, using combined expertise to shed light on some of the big questions on the ...
Observation
Yesterday, the Prime Minister announced a ‘70th Birthday present’ for the NHS, pledging average real annual increases of 3.4% per year for the next five years. One challenge for the Government is where the money to pay for this will come from. After social security spending, the NHS is the ...
Newspaper article
In new work with the Health Foundation, we estimate that it would require an average growth in health spending of 3.3 per cent for the next 15 years just to keep the NHS providing the level of service it does today — with a slightly bigger increase to address immediate funding requirements.
Newspaper article
Over the past 50 years we’ve pulled off a pretty remarkable trick. We have spent an ever growing fraction of our national income on the welfare state in general, and on health in particular, without apparently having to pay for it. The tax burden, at about 34 per cent of GDP, is not substantially ...
Observation
Recent IFS work (joint with the Health Foundation) documented the considerable pressures on health and social care spending over the next fifteen years. In the near term, an announced funding settlement for the NHS covering the next few years may be on the horizon.
Observation
Yesterday we heard the first details of a new five-year funding settlement for the NHS in England. It was announced NHS England funding would be slightly more than £20 billion higher in 2023-24 than in 2018–19 after adjusting for forecast economy-wide inflation over the period. This represents ...
Observation
Public spending on social care for older people in England has seen large cuts in recent years, falling by 21% between 2009–10 and 2015–16. This has led to growing concerns over the potential for adverse effects on other public services, and in particular the NHS.
Press release
With the older population growing rapidly, along with the numbers suffering chronic health problems, and a growing pay and drugs bill, demands on the health service will only continue to grow. Just to keep the NHS providing the level of service it does today will require us to increase spending by ...