The Department of Health has today set out the measures being implemented following the Secretary of State’s announcement of the 2023/24 Budget.
The plans are detailed in an Equality Impact Assessment (EQIA) which has been published for public consultation.
The Department is projecting a funding gap of some £732million for this financial year.
In a letter today to party health spokespersons, Department of Health Permanent Secretary Peter May said:
“I wish to emphasise that, like all other Departments, we are in an impossible position of being asked to fulfil conflicting responsibilities. This involves trying to balance our responsibilities to live within the budget we have been given, act in the public interest and safeguard services. Decisions are required that we do not wish to take and that are not in the best interests of the health and social care system.”
The £732million shortfall includes estimated pay pressures of £375million, including the costs of fully implementing the English pay offer for Agenda for Change Staff.
Funding this pay offer under the current budget settlement would require large scale cuts on an unprecedented scale, with severe and lasting implications for health and social care services.
In his letter to party representatives, Mr May stated:
“Given the legislative basis supported by guidance from the Secretary of State, I have concluded that taking such a decision would be outwith my authority as Permanent Secretary.
“This means that, as things currently stand, it will not be possible to offer a pay award. I am very aware of the potential impact this could have on staff and on industrial relations.”
The Department had already made public plans for savings and efficiencies across the system totaling £260million, which will reduce the funding gap to around £470million. While some impact from these measures is inevitable, measures up to this value may be achievable without long-term or irrevocable damage to services.
Given the scale of the budget shortfall, an additional £100million in savings is now planned.
The Department’s priority is to mitigate where possible both immediate impact on frontline services and long-term irreversible consequences for the health and care system.
Cost saving measures are not currently being proposed for domiciliary care packages, nursing and residential care placements, or reduction in expenditure on community aids and adaptations for clients living in their own homes.
The £100million in savings includes £55million additional savings for Trusts and a £34.6million reduction in Waiting List Initiative funding. The Department will still invest £61.4million in Waiting List Initiative funding this year to help protect provision for patients requiring red flag and other time critical assessments and treatments.
Intensive efforts will be made to mitigate the impact of the reduced funding level. The ongoing drive to increase core health service activity should result in more assessments and treatments being provided in-house. A reduction in cancellations and Did Not Attend cases will support this goal. Importantly, Waiting List Initiative funding will continue at last year’s level initially, with the main impact of the reduction to be felt in the latter part of 2023/24. This will allow more time for the mitigation measures to make a difference.
The £100million savings also involve reductions in the Core Grant Scheme for community and voluntary groups; ceasing the Covid-19 Wastewater Surveillance Programme; and ending Covid-related support funding for dental services.