PLMR's On The Pulse Newsletter | 6th September 2024

This week’s announcement from Holyrood of ￡116 million in cuts to healthcare spending has raised significant concerns, not only in Scotland but across the UK. The proposed cuts reflect the “enormous and growing” financial challenges facing the UK, as devolved administrations and Westminster wrestle with constrained budgets, inflationary pressures, and rising demand for services.?

The announcement comes as part of the Scottish government’s ￡500m package of spending cuts, which Finance Secretary Shona Robison suggests is the result of expensive decisions made in Westminster, though the Institute for Fiscal Studies has disputed this claim. ?

Facing what Chancellor Rachel Reeves has described as a “￡22bn blackhole” in public finances, the UK government may similarly target public services for cuts in the upcoming Autumn Budget. This is in spite of the fact that health and social care in particular are facing unprecedented strain and have already been victim to numerous cuts in recent decades.?

While funding for the NHS has gradually been chipped away, it has historically avoided the brunt of deep, sweeping budget cut decisions, perhaps because its institutional status in the national psyche has made politicians wary of public backlash. Scotland’s decision represents a marked shift in this thinking and suggests that we may well be entering a “new era of austerity” as Robison argues.?

Importantly, the announcement bodes poorly for another sector – if even our beloved NHS may face cuts this October, where would that leave social care??

The current state of the UK’s health and social care budget?

Though NHS spending has increased in real terms at an average of 3.6% per year since 1955/56, reaching ￡181.7 billion in 2022/33 , this has failed to match the needs of the sector, with increasing demand, workforce challenges, and a global pandemic leaving our National Health Service well and truly “broken” , as described by Health Secretary Wes Streeting.?

The picture is even more perilous for social care. No stranger to budget cuts and political pinballing, social care’s antiquated ‘poor relation’ status has driven the sector to the point of crisis.?

The UK’s ageing population and the increasing prevalence of chronic diseases will only drive demand for social care in the coming years. The sector will be hoping that the new government has a firm plan up its sleeve to create a resilient system in response to this and reverse the history of spending cuts and inaction.?

However, Labour’s decision to scrap both the planned Dilnot reforms to social care funding and ￡53.9m package for adult social care training so early in their tenure may speak to a willingness to further sacrifice social care investment in the face of intense fiscal constraints.?

As the UK government approaches its Autumn Budget, the pressure to balance public finances must not come at the expense of the services that keep us well. The cuts from Holyrood send a clear message: despite increasing need and unrelenting challenges faced by the sector, health and social care may well be on the chopping block.?

Here are the highlights from this week’s news:?

BBC News : Budget cuts will have 'profound effect' on Scottish services - Robison?

Scotland’s Finance Secretary has warned that proposed budget will have a marked impact on public services, as she claims the UK is entering a “new era of austerity” under a Labour ?

government in Westminster.?Part of their proposed ￡500m package of cuts will be a ￡116m reduction in health and care spending.?

Caring Times : Local authority adult social care spend up ￡1.5bn in 2023-24??

In 2023-24, English local authorities spent ￡1.5 billion more on adult social care, a 7% increase, reaching ￡23.3 billion. Children's social care rose by ￡821 million (6%), with total local authority spending at ￡123.4 billion, up 2.4%. Increased spending was driven by higher costs for elderly physical support and learning disability support.???

The impact of Keir Starmer's upcoming budget on future spending is still uncertain.?

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UK Parliament : Nominations open for the Health and Social Care Committee Chair??

MPs are electing a new Chair for the Health and Social Care Committee, with nominations open until September 9 and voting on September 11.?The Chair will be a Liberal Democrat. Layla Moran is the only candidate so far, supported by party colleagues and MPs from other parties.?

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BBC News : Nurse tells PM to fix social care to end overcrowding??

A nurse, Silvia Marko from Wexham Park Hospital, told Prime Minister Keir Starmer that fixing the social care crisis is key to reducing overcrowding in A&E departments.?A BBC report found that 13,300 patients in England are stuck in hospitals daily due to this issue.? ?

While the prime minister didn't offer an immediate solution, he said it was something to consider.?

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Care Home Professional : Monitoring technology in social care could free up to two million bed days??

A report by health-tech company Lilli suggests that lifestyle monitoring technology in social care could save the NHS ￡1.2 billion and free up two million bed days by detecting health issues early and reducing hospital admissions.???

By 2035, it could save councils ￡3 billion, create capacity for 10,000 care workers, and improve care for thousands.?

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Nursing Times : ‘Social care is at the forefront of nursing – it really is the future’???

Jemma Sharratt, winner of the Chief Nurse Adult Social Care Gold Award, is now a support manager working toward CQC registered manager status. She oversees nursing care, staffing, and end-of-life care. Starting as a care assistant, she values social care nursing's growing recognition.?Career highlights include piloting a professional development module.???

Sharratt encourages others to pursue social care, describing it as challenging but highly rewarding.?