Planning guidance for systems will ‘hopefully’ be published before Christmas, NHS England and the Department of Health and Social Care (DHSC) have told MPs.
In a Public Accounts Committee session yesterday (25 November), chief executive of NHS England, Amanda Pritchard, chief financial officer at NHS England, Julian Kelly and permanent secretary for the DHSC, Sir Chris Wormald, gave evidence about the financial stability of the NHS.
A question was asked by Liberal Democrat MP Rachel Gilmour about why there was ‘such a delay in agreeing priorities and the final budget for NHS England in 2024/25’, which was published at the end of March.
In response, Sir Chris said: ‘That year was particularly complicated because of a very high rate of inflation, and that is both a problem in itself and it also makes budgets very unpredictable.
‘There was a delay in that year and there was quite a lot of reprioritisation that was going on, which was just a fact of a very high inflation shock cause.’
Then asked to confirm that the date set for the 2025/25 planning guidance was not as delayed as the previous year, Sir Chris said ‘we would certainly hope not’.
However, he would not confirm a deadline for the guidance to be published, only that the aim was to publish before Christmas.
‘It depends on external shocks’, said Sir Chris. ‘There is absolutely no point in going out early with a fantasy final budget. So, you do have a trade off between how early you do it and how certain you are about what the fiscal and economic situation will be.
‘I’m not going to give any guarantees.’
Mr Kelly added that ‘we clearly try and give early informal indications of what people should be expecting, but we do actually need to know what is our budget in order to be able to give a budget.’
‘If that process doesn’t conclude until October, November, or in the case of 24/25, we were still in discussions with colleagues on certain items up to the March budget,’ he said.
‘This year we still have some details to sort out with the department, but we are aiming to do those as soon as we can, so that’s this side of Christmas.
‘Let’s hope we can give clear budget allocations and be clear about what the rules and framework is.’
Chair of the committee and Conservative MP, Sir Geoffrey Clifton-Brown, suggested that ‘it must cause inefficiency’ for ICB leaders to not know their final settlement on time.
‘Let me ask you a very simple question for the 25/26 budget, when will you give ICBs their final allocation?,’ he said.
Sir Chris reiterated that they ‘hope to do it as early as possible’.
‘Ideally, as we said, we would do it before Christmas. Now, whether that’s possible is not always entirely in our hands,’ he said.
The committee also heard that systems as a whole are £650m ‘off plan’ as of month six of the year, which is equal to about 0.7% of their spend. However, that this is ‘better than last year’, according to Mr Kelly.
‘We are working with every system across the country to see how close to those plans we can actually get,’ he added. ‘There is a fair risk that we will not hit plan, though I think there is a fair chance that even in month seven, we are still in a better place than we were last year,’ he added.
MPs also asked about the proportion of NHS spending on primary care only being 6% despite the focus on prevention and care in the community.
Ms Pritchard said: ‘I think we can say if we can do something over the long term, when we don’t have a global pandemic to deal with in the middle of it, actually we do stand a reasonable change of being able to build on some of those early foundations to get to a place where that is a much more sustainable model for the long term.
‘I don’t think anybody would disagree, but it’s going to be a case now of really leaning into the 10-year plan opportunity to describe how we get there.’
Last month, Ms Pritchard said the 10-year plan would need NHS fingerprints ‘all over it’, as the Government launched a consultation to inform the document.
