News release

Spending Review 2020: predictions for healthcare

Ahead of the upcoming Spending Review, the healthcare lead for Grant Thornton UK LLP shares his thoughts on what he expects to see in the announcement.

Malcolm Lowe-Lauri, head of health and life sciences consulting, Grant Thornton UK LLP, commented:

“We expect that the blank cheque extended to the NHS in the last Budget will be “filled in” in this Spending Review, given the fiscal constraints that government will inevitably be facing. There will, however, need to be a recognition that the costs of COVID-19 to the health service are still unclear and that some flexibility will continue to be needed, as the pressures facing both our healthcare workers and our healthcare infrastructure continue to evolve.

“Recent policy from NHS England and NHS Improvement - in particular the cash incentives and penalties for providers who do not deliver at least 80% of their 2019/20 elective activity levels - shows that government is increasing its expectations on the service to both respond to the pandemic and continue business-as-usual service provision, which in turn is increasing the strain on NHS finances and management. We expect that the service will need to redouble its efforts to manage the pressures of delivering within budget, while continuing to provide the safe and sustainable care so critical to every patient. This is no easy combination. We know that the service made it through wave one due to the heroic efforts of the NHS workforce, and now NHS England and leadership providers will need to be supportive as well as directive during wave 2.

“We also expect government to deliver on its capital commitments to the Health Infrastructure Programme – the delivery of 48 new hospitals. This will require further funding to be given to the delivery of the programme, as well as capital for ongoing COVID-19 resilience measures, carbon neutral commitments, regional capital needs and shoring up increasingly shaky hospital infrastructure. The need for government funding will also be increased compared to past years because of the end to the private finance scheme (announced in the 2018 Budget) which effectively closes the door to all non-NHS funding, other than the Budget and charitable sources.”

"Overall though, it’s likely that many of the current challenges facing the NHS will be overshadowed by the vaccination taskforce work that is set to take place over the coming months, given the emergence of three effective vaccines in recent weeks.”