Daily Insight: Budget day maths

Balancing the books

There were a lot of very large numbers in Rishi Sunak’s first Budget.

The important ones for the NHS were:

• A £5bn contingency fund has been set for the NHS and other public services to respond to the covid-19 outbreak;
• A £1bn lift to the Department of Health and Social Care’s budget for capital investment in 2020-21, compared to previous plans;
• An additional £1bn in revenue, most of which relates to pledges around primary care funding from the Conservative manifesto; and
• Part of that revenue increase will also cover changes to pension taxes for senior doctors, apparently removing the risk of sudden major tax bills from all who earn less than £200,000.

However, there were no specific new spending announcements for training budgets, public health or social care.

NHS England has been pressing in recent weeks for confirmation of multiyear budgets for education and training — which would enable it to set out a comprehensive workforce plan — but this call does not appear to have been answered.

Coronavirus round-up

While the chancellor had plenty to say on coronavirus, developments also rumbled on away from Parliament (which was without health minister Nadine Dorries, who has tested positive for covid-19 and is now self-isolating at home). 

Those attending a session with Keith Willett, NHS England strategic incident director, reported he had warned chief nurses to plan for a huge increase in intensive care capacity — of up to “seven-fold”, as the NHS ramps up preparations for coronavirus. Professor Willett later insisted he had in fact said “several”; though not wishing to put a figure on it.

HSJ also revealed the UK’s four chief medical officer and the General Medical Council will be writing to all UK doctors to reassure them they won’t face reprisal (within reason) if they end up working outside their areas of expertise during the coronavirus outbreak.

The letter will also urge doctors to be flexible and not resist new ways of working, with senior figures expecting many clinicians working in other specialties or locations as the NHS grapples with the spread of the illness. 

Meanwhile, NHSE revealed it would be upping the ante on testing, with NHS laboratories going from testing 1,500 samples a day to 10,000. 

And Sir Simon Stevens used his platform at the chief nursing officer’s summit event to call on third-year undergraduate trainee nurses to join the NHS’ fight against covid-19, adding NHS England was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”.

Sir Simon also suggested the Care Quality Commission would need to suspend the majority of its routine inspections during the outbreak, while the NHS Confederation shortly afterwards called for it to stop routine work immediately. The CQC has previously said it will not yet cancel all routine inspections, but that it will take a pragmatic approach.