The biggest stories and talking points in the NHS

Three is the magic number

Before the NHS turns 70 on 5 July, the government will have revealed its broad ambitions for the “sustainable long term plan” and the accompanying “multiyear funding settlement” promised by Theresa May in March.

How big an increase in the health budget that settlement will provide is understandably the question receiving the most attention, but there are also others worthy of examination.

When it comes to “how much”, the Treasury will know anything lower than 2.9 per cent real terms per year is likely to be rejected by the NHS, while those negotiating for health realise that anything above 4 per cent is likely to get short shrift from the chancellor.

Therefore, the final settlement will start with a three.

This is rich fare compared to the gruel the service has had to live on since 2010, but it is also below the average historic funding growth received by the NHS.

Next, people will want to know how long the new funding commitment will be made for and what shape it will take.

Within the corridors of power, the prime minister’s promise is often referred to as “a 5-10 year plan”.

This is not just people keeping their options open – it is also a recognition that there are, in effect, two plans being developed – one to take us to the end of this Parliament and the other to the end of the next decade.

The distinctive part of this reform package will be the “10 year plan” for longer term investments, particularly in workforce. Here all the negotiators are trying to avoid the mistakes made too often by past policymakers and ensure they plan now for medium and long term increases in demand. This will no doubt be informed by the workforce strategy being developed by Health Education England.

We should not expect specific funding commitments, but will hopefully get an unambiguous view on the number and mix of clinical staff the service will need by 2028, and a strategy for delivering them both.