What's the NHS annual budget? How many doctors and nurses are there? What's the cost of an operation? Our press and public affairs team, library service and policy experts deal with hundreds of enquiries every year. Below are our answers to some key questions that have been frequently or recently posed to us. This money is used to fund a wide range of health and care services including public health, GP services, training, vaccinations, ambulance, mental health, community, hospital and some parts of non-NHS health and social care services.
Find out more about our position on NHS funding and investment. In the United Kingdom spent 9. When compared to similar countries those in the EU , G7 and Anglosphere this is slightly below the average of Consequently, the wage bill for the NHS makes up a substantial proportion of the budget. The cost of an operation varies depending on a range of factors, such as the complexity of the procedure and how long the patient stays in hospital. In the NHS in England, the national tariff outlines the average cost of procedures.
These average costs are then adjusted to take account of local variation, such as higher costs of staffing in London this is known as the market forces factor. When it comes to health and care funding, it can be hard to make sense of what the numbers being discussed will actually mean for patients, staff and the system.
In March there were , doctors, , qualified nursing staff including midwives and health visitors and 34, managers in the NHS out of a total workforce of 1,, all figures are full-time equivalent. Between March and March , the number of doctors and nurses rose while the number of managers fell slightly.
You can see and download the information by clicking on the links below. Pay uplifts for doctors and dentists, who work for the NHS, are determined by the government in light of recommendations made by the independent review body on doctors and dentists remuneration DDRB. This body takes evidence from across the four UK administrations, trade unions and NHS Employers before making their recommendations.
Pay uplifts for NHS staff working under agenda for change terms and conditions are determined by the government in light of recommendations made by the independent NHS Pay Review Body who take evidence from across the four UK administrations, trade unions and NHS Employers before making their recommendations. These numbers are important, but come with a significant degree of uncertainty — not least where the clinicians required to deliver thousands of additional operations and extra GP appointments will come from.
What can be more certain is what the NHS has been spending to date on a more or less recurrent basis. It is only by funding that baseline sustainably that the NHS can be given a firm and secure basis for tackling the challenges for which future costs — and resource availability — are less clear. In fact, the gap was not unique to the spending settlement — it can be seen in the planning documents for the NHS provider sector every year since the Spending Review.
As methods for reporting and calculating savings against efficiency targets have changed substantially during that time including the reporting of additional income as a "cost improvement" figures shown here are estimates and for illustrative purposes only. Trust income and expenditure reporting during the period was also subject to manipulation through the use of one-off accountancy adjustments.
Together those habitual flawed assumptions meant the NHS in England went into the current five-year spending settlement — announced in June and later incorporated into the Long Term Plan LTP — with the cost base of its hungriest beasts running some 2.
In cash terms, the LTP settlement worked out at an average 5. With NHS inflation running at around 2. On the face of things, a 1. That 1. Analysis by the health economic regulator NHS Improvement had found that average efficiency improvements by NHS trusts in the decade to — after stripping out advantages and disadvantages beyond their control as well as discounting temporary one-off savings — was around 0. To make the LTP figures work, that overspend first needed to be eliminated. Not surprisingly, that target was missed.
The effective merger of NHS Improvement originally responsible for overseeing NHS provider finances and NHS England responsible for the overall budget was accompanied by a rapid deterioration in the transparency of aggregate national financial reporting on the NHS trust sector as a whole. NHS England quickly and appropriately moved into pragmatic mode — instructing clinical commissioning groups to fund NHS trusts through block contracts based on the financial value of activity levels as they were towards the end of , rather than the tendency to base plans on the somewhat wishful lower activity levels that commissioners might like to see.
For current purposes — which are to assess how far the recurrent NHS provider cost base has strayed from the assumptions in the LTP — we need to estimate what the provider spending plan would have been in in a parallel reality where there was no Covid, and where everything had gone according to the Long Term Plan the year before it and indeed the year before that.
In addition to cost inflation, the LTP of course envisaged growth in provider activity, although there are no precise figures or ranges for this cited in the planning guidance. In the absence of an official figure, we can calculate the implicit NHS trust activity growth rate assumed in the original overall LTP spending trajectory by looking at the growth between planned provider income from NHS commissioners in and the plan for the same in , after adjusting for changes in the prices paid by commissioners.
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