Post-pandemic recovery as big a test as Covid, says NHS chief

Recovery from the pandemic will be at least as big a task for the health service as coping with coronavirus itself, the head of NHS England has said.

Amanda Pritchard, speaking at the Financial Times Women at the Top Europe summit in London, warned on Wednesday that “budgets will only stretch so far”.

Pritchard said she had thought the Covid-19 emergency would be “the hardest thing we would ever have to do as a health service”, but now thought “the recovery challenge . . . whilst we still have the ongoing challenge of Covid, is harder”.

About 6.8mn people are waiting for non-urgent NHS hospital treatment, a record figure, and the service is operating with 130,000 staff vacancies and a threadbare social care system making it harder to discharge patients.

At the same time, Covid infection rates are rising in many parts of the UK, with health leaders warning a fresh wave will add strain on the health service in the coming months. As of last week, about 10,000 people were in hospital with the virus.

Last week, NHS finance director Julian Kelly warned at a board meeting that unexpected extra costs, caused in part by inflation, could leave the NHS budget £7bn short next year. Services such as general practice, mental health and cancer might suffer, he said.

Pritchard said the NHS had signed up to some “quite ambitious productivity and efficiency goals” in the government’s spending review last year, designed to save £12bn over three years. As a taxpayer-funded service, “it’s right that we do that”, she added.

But, she argued, the NHS was “already one of the most efficient health services in the world in terms of managerial and administrative costs”, spending about 2p in the pound on administration, compared with 6p in France and 4p in Germany.

It is “really important that we are challenging ourselves all the time about making best use of that funding . . . [but] the reality is budgets will only stretch so far”, she added.

The government has called for fiscal discipline within Whitehall departments in the face of rising inflation. Pritchard said against a backdrop of rising costs, “we will need to be working with government to make sure we have fully understood the implications”.

Pritchard’s predecessor, Simon Stevens, was known as a skilled politician, sometimes intervening publicly to press the case for more funding and engaging in direct discussions with the chancellor and Number 10.

Pritchard described Stevens as “an absolutely extraordinary leader of the NHS”, but said: “His skill sets are very different to mine. He was absolutely fantastic at understanding and being able to work with colleagues across government. I think I’ve taken the clear view that actually my job is to run the NHS.”

Part of that involved forming as strong a partnership as possible with the government, to which the service was accountable, she emphasised.

Stressing the importance of long-term planning she said capital investment in digital technology, diagnostic equipment and workforce was needed to make the NHS “a sustainable high quality service for patients”.