In this section we explore the possible costs of:
- restoring Health Education England’s (HEE) developing staff budget
- reversing planned cuts to the public health grant.
Table 13
As a consequence of the decision to protect NHS England’s allocation, there have been cuts to some other central NHS budgets which have directly and detrimentally impacted on providers, staff and patients.
The two most in need of restoring at the Health Education England budget for developing staff, and the public health grant.
Health Education England developing staff budget
Health Education England’s budget has been cut in cash terms since it was established in 2013/14 – falling from £5bn in total to £4.6bn this year. The authority has justifiably protected spending on the future workforce, but at the expense of other areas of spending – most significantly its workforce development budget (often used for continual professional development). Because of the cuts to this budget, the NHS has not been strengthening its workforce as it needs to, or sufficiently demonstrating that it values its staff (NHS Providers, 2017).
HEE’s budget for developing staff has fallen from £238.9m in 2013-14 to £83.5m in 2018/19. Restoring it to its original size in cash terms would cost £155.4m.
As a consequence of the decision to protect NHS England’s allocation, there have been cuts to some other central NHS budgets which have directly and detrimentally impacted on providers, staff and patients.
Public health grant
Another key budget which has been placed outside of the NHS ringfence is public health. Although now commissioned by local authorities, these are crucial services for many NHS trusts and patients, particularly those such as community and mental health providers which run school nursing, health visiting, drug and alcohol and sexual health services.
Failure to invest in prevention is the wrong thing to do for the public and undermined the Five year forward view’s vision of a shift to community based care. If the new ten year plan for the service is to be credible, it will need to properly fund services which help people live healthier lives.
According to the Health Foundation, during the current comprehensive spending review period the public health grant is set to fall from £3.47bn in 2015/16 to £3.07bn in 2020/21. Reversing this decline in full would therefore cost £400m.