Public deliberation on NHS funding and system reform

Public are not aware of the extent of the NHS cash shortfall.

25 October 2018

3 minute read

As part of our work, we are conducting research on the long-term sustainability of high quality health and social care services in England and Wales. In June 2018 CPP launched Diagnosis Critical, first major inquiry on health and social care.

CPP commissioned Populus to conduct public engagement on the topic to collect qualitative data on public attitudes towards health and social care funding to build on and support its own quantitative analysis outlined in the Diagnosis Critical report.

The aims

  • To make participants consider the current demand and supply pressures facing health and social care in England and the impact this is having on access to, and quality of care and health outcomes
  • To explore scenarios about future funding and the implications these might have for services under the current syst
  • To assess the viability of alternative policy options
  • To identify areas of broad-based consensus

Key findings

The research published shows that

  • The public are not aware of the extent of the NHS cash shortfall.
  • Any new money should be spent on improvements to existing services and nurses’ pay, not in filling in holes in the current finances which the public attributed to overpaid management staff and the cost of waste.
  • Participants struggled with the idea that even the extra £20.5bn per year of promised government funding would be insufficient given the increasing demand and pressures on the NHS.
  • The public felt that the NHS could get better value by reducing waste and cutting numbers of non‐clinical staff.
  • The public believed that reducing reliance on agency workers and restricting use of NHS services for non‐UK citizens were ways to find further savings.

Members of the public were asked a series of questions about health and social care funding and reform. After rigorous discussion, participants were asked to vote where to spend additional government spending: improving health and social care services, keeping people healthy throughout their lives, or a combined approach. The majority of participants (39 out of 50) voted for a combined approach.

However, when forced to decide between the two options, 70 per cent suggested the money should be spent on health and social care services, while the remaining 30 per cent of participants said it should be spent on keeping people healthy.

Participants saw the case for why, as CPP argues in its recent report, Diagnosis Critical, there should be investment in wider social and economic infrastructure as a driver of health and wellbeing. However, there was a sense amongst the participants that this was already happening, and many community activities were not within the government or NHS’ remit.