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NHS at 70 funding settlement

In 2018, the year of the 70th anniversary of the founding of the NHS, Prime Minister Theresa May announced a funding settlement that would increase NHS England’s budget by £20.5bn per year, in 2018/19 prices, by the end of 5 years. This represented a 3.4% real terms annual increase in day-to-day funding of the NHS in England.

The settlement did not cover other areas of the Department of Health and Social Care budget, such as public health, medical training, or capital spending on important resources such as buildings, equipment and technology.

Background to the announcement

The settlement followed several public calls for sustainable NHS funding by NHS England (NHSE), afforded greater independence from the government through the Health and Social Care Act 2012. NHSE had made the case for additional funding in the Five year forward view for the NHS in England in 2014.

In a planning paper produced for its board meeting on 30 November 2017, NHSE took the unprecedented step of stating that it may not be able to meet waiting time targets due to a lack of funding: ‘our current forecast is that – without offsetting reductions in other areas of care – NHS constitution waiting times standards, in the round, will not be fully funded and met next year.’

During a speech at the NHS Providers Conference earlier that month, NHS England Chief Executive Simon Stevens had called for a £20-30bn rise in the NHS budget to bring it in line with health spending in Germany, France and Sweden. 

A long-term plan and workforce plan

Alongside its announcement of the 5-year funding commitment, the government announced that the NHS would develop a 10-year plan later that year. The plan’s priorities would include delivering agreed performance standards that had been missed in recent years, improving cancer outcomes in line with other European countries, improving access to mental health services, greater integration of health and social care, and a focus on prevention.

In a speech to the House of Commons, Secretary of State for Health and Social Care Jeremy Hunt committed to publishing a long-term workforce plan alongside the 10-year plan.

Promises on adult social care

Hunt also repeated commitments regarding a green paper on social care reform – which had been announced in the Spring Budget 2017 and originally due to be published in Summer 2017 – but stated that: ‘because we want to integrate plans for social care with the new NHS plan, it does not make sense to publish it before the NHS plan has even been drafted, so we now intend to publish the social care Green Paper in the autumn around the same time as the NHS plan.’

Later developments

The NHS Long Term Plan was eventually published in January 2019, but the social care green paper and workforce plan (which came to be known as the NHS People Plan) remained unpublished.


Department of Health and Social Care.
Prime Minister sets out 5-year NHS funding plan.
UK government; 2018.

NHS England.
NHS England Board meeting papers – 30 November 2017 [webpage].
NHS England; 2017.

Campbell D.
NHS waiting list could soar to 5m without urgent cash, chief warns.
The Guardian; 8 November 2017.

House of Commons.
NHS Long Term Plan. 18 June 2018: Volume 643.
Hansard; 2018.