NHS bosses in England are meeting to discuss “what it is possible to deliver for patients with the money available” after the health service was not given the funds it requested from the Treasury in last week’s Budget.
Sir Malcolm Grant, chairman of NHS England, said the money promised by Chancellor Philip Hammond “will go some way towards filling the widely accepted funding gap”.
But he said the NHS “can no longer avoid the difficult debate” on what can be provided by the health service on existing funds. The NHS England board will meet on Thursday to discuss the topic.
The Treasury pledged more money for the NHS in England, with the specific aim of helping the health service “get back on track” amid soaring waiting lists and A&E targets.
But health leaders said that, within the financial climate, it is likely that waiting times could actually increase.
Mr Hammond acknowledged that the NHS is “under pressure” as he committed resource funding of £2.8 billion to the NHS in England.
This includes £350 million to cope with pressures over the coming winter, £1.6 billion in 2018/19 and the rest the year after.
Earlier this month, NHS England boss Simon Stevens said that, without more money for the NHS, the number of patients waiting to be admitted to hospital in England to have surgery will rocket to five million by 2021.
This means one in 10 adults will be on the waiting list, he added.
Mr Stevens also indicated that controversial rationing policies adopted in some parts of the NHS could be rolled out nationally without more money and he said expansion plans for mental health and improvements in cancer care could stall.
NHS England CEO Simon Stevens (Stefan Rousseau/PA)
He drew on a new analysis by the Health Foundation, the King’s Fund and the Nuffield Trust which calculated the NHS needs £4 billion more next year to prevent patient care from deteriorating.
In a post-Budget analysis, the three health think tanks concluded that the Chancellor’s pledges provided some “temporary respite” for the NHS.
But they said the money was “unlikely to be enough to get back on track” with waiting time targets – including the aim to treat non-urgent cases within 18 weeks of referral and emergency patients within four hours of arriving at A&E.
In a joint assessment, they wrote: “The extra money falls far short of what we estimate is needed to maintain standards of care.
“Furthermore, with all the additional money going to the acute sector, it is difficult to see how promises to increase investment in mental health and general practice can be met, let alone how progress can be made in developing new services, giving patients access to new drugs and delivering significant efficiency savings.
“It is therefore essential that politicians are honest with the public about the impact of continued funding constraints on NHS services.”
Officials will also discuss the future arrangements for congenital heart disease services.
It is hoped that a final decision will be made on the contentious issue, which has been debated for many years.
A consultation on the issue, launched earlier this year, proposed to cut the number of hospitals in England allowed to perform heart surgery.