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The government has asked NHS England to reduce core NHS funding by hundreds of millions of pounds in 2022-23, we reported today.

NHSE chief financial officer Julian Kelly told a meeting of NHS England’s board: “We have been asked to see if we can cut core NHS funding – at the moment that is probably to the tune of £500m.”

Mr Kelly said achieving this would likely involve “slowing down” some transformation programmes and ambitions from the NHS long-term plan, including “how fast we go on the change in technology, on some of the innovation stuff we have spoken about… and the prevention programme”.

The request from the Department of Health and Social Care was “as a consequence of needing to find funding to deal with the government’s Living with Covid plans and the cost of the public health policy around Test and Trace”, Mr Kelly said.

He added that rising inflation could add an extra £1bn in financial pressure, telling the board “we’re going to have to look at what that means for our ability to deliver NHS goals in the round.”

It was reported in February that health and social care secretary Sajid Javid and chancellor Rishi Sunak were at loggerheads over whether the DHSC should receive additional funding for covid testing on top of the health service’s spending envelope. It is thought the dispute ultimately ended with the DHSC receiving more than £1bn less budget than it believed it required in 2022-23 to pay for ongoing covid costs such as testing and vaccines.

All this marks a distinctly more robust approach from NHSE, with the government in recent months reiterating how it is pouring billions into the NHS, then painting it as an inefficient bureaucracy. That picture has been particularly frustrating for everyone trying to deliver against an overwhelming demand imbalance, under the strains of covid, with patients’ expectations riding high.

Emergency care emergency

Ambulance handovers of over an hour hit record highs in the last two weeks, with one day seeing more than 1,500 ambulances waiting outside A&E departments for more than 60 minutes, official figures revealed yesterday.

The week to 13 March saw 8,687 ambulance handovers of an hour or more, the highest level recorded since the data began to be published in 2017-18. The week to 20 March saw 8,484 hour-plus delays, with 1,503 ambulances affected on Monday 14 March alone. Overall, 10.5 per cent of ambulances were delayed more than an hour – the highest proportion this winter.

Meanwhile, the number of covid-related NHS staff absences has risen by a third.

The number of hour-long ambulance waits is higher than early December – when omicron started to hit – and during the difficult period around new year, which saw 1,540 ambulances waiting more than an hour on 4 January and 1,511 on 6 December.

Long ambulance waits have been at unprecedented levels all winter, with the number of hour-long waiters above previous comparable totals virtually every week. Before this winter, the highest number recorded was around 5,500 in January 2021.

Since the end of November, the numbers have only been below that number during the week to 26 December. While the end of January and February did see some reduction in these waits, the trend has been upwards since mid-February.