Ahead of the Autumn Statement on 22 November, NHS Providers submitted our representation to the Treasury setting out the details of our immediate and long-term asks to the government. Our representation was submitted to the Treasury ahead of the 13 October deadline.

 The key messages from our submission are as follows:

• Trust and system leaders are committed to managing over-stretched NHS budgets effectively, but it has become increasingly clear that forecasts made at the beginning of the year based on financial and operational assumptions have now been significantly overtaken by events. In order to return them to a sustainable path, trusts will need sufficient support from government to mitigate the financial impact of industrial action. 
• The publication of the Long Term Workforce Plan (LTWP) is welcome but its success is dependent on sufficient investment in infrastructure and social care. The plan rightly recognises the vital role played by capital investment in the NHS estate and new technology in order to improve NHS labour productivity. 
• HM Treasury should work closely with NHS England (NHSE) and trusts to better understand the NHS productivity challenge, and to ensure that providers have the analytic support to better capture productivity growth in all settings, including acute, ambulance, community and mental health trusts.  
• Trust leaders want to see government deliver on much-anticipated reform of the social care system and, ahead of the next spending review, begin to develop and provide a long-term, multiyear settlement to ensure delivery of its key priorities.  
• The government must also work with the health and care sector to invest more holistically in prevention and in reducing health inequalities, in primary care, and in intermediate care and rehabilitation, considering the role that primary care, community services and mental health services can all contribute to enabling people to be supported at home, and on discharge from hospital. 
• If the government is serious about improving population health and tackling health inequalities, it cannot continue to underinvest in the public health grant. Funnelling more investment into public health will prove to be both cost effective and deliver value for the taxpayer over a longer period of time.