Auditors cannot be sure the National Health Service’s is financially viable despite the government’s long-term funding settlement.
This is because it will not be clear until the spending review later this year how much money will go to social care, public health and clinician training, all of which affect the NHS’s viability, the National Audit Office said.
It added: “Without a long-term funding settlement for social care, local NHS bodies are concerned that it will be very difficult to make the NHS sustainable.”
The NAO report NHS Financial Sustainability noted NHS England’s budget will rise under the settlement by an extra £20.5bn by 2023‑24, equivalent to an average annual real-terms increase of 3.4% from 2019-20.
In the current year “the growth in waiting lists and slippage in waiting times, and the existence of substantial deficits in some parts of the system, offset by surpluses elsewhere do not add up to a picture that we can describe as sustainable,” the report said.
The NAO said it could only judge future sustainability after the spending review because the 3.4% uplift applied only to NHS England and not to Public Health England, local authority prevention initiatives, NHS capital investment or clinicians’ training.
“Spending in these areas could affect the NHS’s ability to deliver the priorities of the long-term plan, especially if funding for these areas reduces,” the report said.
NAO head Amyas Morse said: “The plan we have seen so far seems to be based on prudent assumptions, but we will really be able to assess whether the ambitions set forth are supported by funding when we can see the results of the spending review for the non-NHS England parts of the health service, and the funding for social care.”
Chris Hopson, chief executive of NHS Providers, said: “Without addressing the crisis in social care, we risk devaluing every pound invested in the NHS. We look forward to the [social care] green paper due in the coming weeks.”