• May announces £3.5bn real terms growth
  • Says long term plan will commit to primary and community care getting a ’growing share of spending’
  • Matt Hancock previously told HSJ this must begin in 2019-20, and not be delayed
  • Rapid response teams and health support in care homes are priority

The NHS long term plan will guarantee primary medical and community healthcare services “a growing share of overall NHS spending” over the next five years, the prime minister has announced.

Theresa May said in a statement that the money would contribute to spreading “community-based rapid response teams to care for those who would be better treated at home than in hospital”, and “national roll-out of support for care home residents”.

NHS England chief executive Simon Stevens said in the statement that ”as part of the NHS long term plan – for the first time we’re going to guarantee that these services get a growing share of the growing NHS budget”.

In an interview with HSJ published last week, health secretary Matt Hancock said primary and community services’ share of the NHS budget had to increase, and that this “can’t wait” and should begin next year.

Today’s statement said the commitment was “worth £3.5bn a year in real terms by 2023-4”. It is not clear this figure would amount to a substantial increase the share of the overall budget, which is due to grow by about £20bn in real terms over the same period.

Little reliable data about primary and community spending is available although the Nuffield Trust, responding to the announcement, said 2017-18 spend on GP, primary and community was £21.7bn. This means the promised £3.5bn is “broadly in line with the 3.4 per cent overall [annual growth] that the NHS in England is getting over the next five years”.

Nuffield senior policy analyst Sally Gainsbury said this meant that “far from representing a big shift in funding towards out-of-hospital services, this money will simply allow GPs and community services to keep up with demand over the next five years”.

She said: “In many ways this is unsurprising. There are many existing calls on the new money pledged by the prime minister, like getting waiting times back on track and upgrading mental health services. We’ve calculated this will leave relatively little for any significant reform over the next couple of years.”

The government has not been able to clarify the baseline spend, and NHS England has declined requests for these figures in recent years. It is thought the commitment is intended to apply only to community health and GP (primary medical) budgets - not community pharmacy or dentistry budgets.

The situation echoes concerns about the Chancellor’s announcement last month to “increase mental health investment by at least £2bn a year in real terms” over the same period, which itself would result in no growth in spend share. Claire Murdoch, NHS England’s national mental health director, subsequently emphasised the “at least” element of the commitment, implying the spending growth would be greater.

Ms May said in the statement: “Too often people end up in hospital not because it’s the best place to meet their needs but because the support that would allow them to be treated or recover in their own home just isn’t available…

“That’s why I’m announcing a major boost in funding for community healthcare, which will give more patients a genuine and high-quality alternative to hospital.”

Mr Stevens said: “We need to radically redesign how primary and community health services work together. For community health services this means quick response to help people who don’t need to be in hospital, as well as dissolving the 70-year-old boundary between GP practices and community nursing.

“But to will the end is to will the means. That’s why – as part of the NHS Long Term Plan – for the first time we’re going to guarantee that these services get a growing share of the growing NHS budget.”