What do the speeches of the chancellor and the secretary of state for health mean for CSP members?

Progress on rehab?

On Wednesday Stephen Barclay set out his vision for the NHS in England. He highlighted an earlier announcement of £500million to address delayed discharge. Access to rehab helps people out of hospital, prevents readmission and improves quality of life. In his comments he specifically suggested that local bodies can use this funding to pay for physios to support people at home.

The CSP has long argued for better community rehab services, and the inclusion of this is a sign that we are having traction within NHS England. It is a success for us and a good step in the right direction. But we still need game-changing commitments on sustainable funding and developing the required workforce to make rehab an equal pillar of healthcare.

A missed opportunity from Jeremy Hunt was his desire to address rising economic inactivity. 630,000 fewer people of working age are seeking work. Unfortunately, there was no recognition that better access to rehab would enable many more people to be back at work, earning and contributing as taxpayers.

Cost of living

The Chancellor forecast that inflation is expected to fall but only to nine per cent and then seven per cent. This compares to the, on average, four per cent pay award to NHS staff in England. So how does the government see pay for NHS physios and support workers responding?  Steve Barclay presented ongoing pay disputes as challenges for local NHS leaders, rather than an issue he needs to address through fair pay. The Chancellor offered nothing more to NHS staff.

The CSP had joined other organisations in raising concerns about benefits and energy costs for patient with long term conditions. In the statement, Jeremy Hunt announced that benefits will increase in line with inflation, which is to be welcomed. However, there was no special support for patients with long-term conditions facing energy costs due to their conditions or impairments.

NHS funding

The Chancellor today suggested the NHS budget will increase by £3.3billion for each of the next two years. Integrated care boards (ICBs) are being challenged to tackle waste and inefficiency to release funding too. The spending on the English NHS also impacts on Scotland, Wales and Northern Ireland. Under the Barnett formula money will come to the devolved governments.

Despite the spin, the independent think tank the Health Foundation estimates that the English NHS needs £7billion extra next year, just to stand still, due to inflation and other costs. They also have pointed out that the UK spends £40billion less a year on health than other similar European economies.

Workforce

Steve Barclay only referred to the nursing shortage in his speech. Jeremey Hunt, when he was chair of the Health Select Committee, championed authoritative long term NHS workforce planning. So it is not surprisingly he reversed Treasury opposition to a long term workforce plan. This is very welcome, but action is needed now, like guaranteeing every newly qualified physio a NHS job, expanding pre reg apprenticeships and recruiting more support workers.

Long term workforce plans must cover all health sectors to work and should involve unions, professional bodies and academic expert input. The CSP has been promoting a whole pipeline approach to planning and developing the physio workforce and we need to see that approach reflected both in short term and longer-term plans.

So, what does this tell me?

• Health is not seen as an economic enabler but a cost, so NHS services will face ongoing financial challenges
• The struggle for fair pay is going to be a long one
• Despite this challenging overall environment, there are perhaps opportunities to influence in the longer term on workforce and on rehab, which we will need to push hard on.

What can you do now as a CSP member?

• If you are in England, ask how you service and integrated care system (ICS) plans to use discharge funding and suggest that physio led rehab can help.
• If you are in England or Wales, and work in the NHS, vote yes in the industrial action ballot to show the strength of feeling on unfair pay.