Against a backdrop of demographic change increasing and changing demand for care, workforce pressures and an unresolved need for greater investment in social care, there is a need for a greater recognition of the task trusts face to recover care backlogs, sustain quality and deliver financial balance.
Trust leaders are acutely aware that the NHS received a relatively generous multi-year settlement from government in the recent spending review, compared to other public services. They remain ambitious for their staff and patients and fully committed to recovering care backlogs, reflected in the unprecedented numbers of patients being seen for different services, and clear progress against a number of measures.
However, there must now be a shared understanding across government, national NHS bodies and the provider sector that balancing the operational challenges and achieving the financial ask remains challenging for trusts and systems.
This survey demonstrates that there is a significant shortfall between the efficiency ask required by government and NHSE and the level individual trusts consider to be realistic and deliverable in 2022/23 due to a combination of reduced income levels, inflationary pressure, operational demands, and the sustained impact of COVID-19. It is imperative that unrealistic demands are not placed on an already pressured and over stretched NHS workforce, that any uplift in pay awards beyond existing allocations are fully funded centrally, and that the impact of inflation continues to be closely monitored.
Alongside this, the need for greater investment in social care, its infrastructure and workforce remains. Given the interdependence of health and care services, without it we will not make the necessary progress to meet significant challenges of this year and beyond.