Skip to main content

Autumn Statement - Expert comment on NHS budgets

Professor Graeme Currie researches leadership and management of the NHS. Ahead of the Autumn Statement, Professor Currie gives his thoughts on NHS funding.

Professor Currie said: “The extra budget provided is, in part, a response to the winter demand pressures every year, and for which the NHS seems to be unable to capacity plan for. The winter demand hits hospitals, specifically A&E departments. Admittedly it is difficult for the NHS to have the sort of flexible labour force that private sector companies can develop (e.g. zero hours contracts), but surely something can be done to mediate winter pressures. Another pressure, and one which is less seasonal, is the changing population demographic, with people living longer and suffering from co-morbidity. Hence patient acuity increases and with it additional cost. However, again this might be predicted and responded to. Indeed, the ‘Nicholson Challenge’, on departure of the previous NHS CEO, was a call to transform healthcare delivery to save billions of pounds. So we might ask, how, instead, the NHS is asking for additional budget?

"Whilst it is hospitals asking for additional budget, it is not necessarily hospitals that are the problem. The problem is one that lies at the system level. The Nicholson Challenge was one that required transformation of healthcare delivery, and indeed in rhetorical terms at least, CEOs of healthcare providers and commissioners promised such transformation to make significant savings. Yet such transformation relies upon care delivered outside hospitals, in primary care settings or even extending to self-management. It requires greater emphasis upon public health and prevention, self-management of long-term conditions, use of digital technology. So why hasn’t this happened? Policymakers continually tinker with health and social care structures, with public health in a state of flux. Meanwhile, primary care hasn’t developed sufficient capability and resilience to reduce undesirable A&E attendance (witness the Health Secretary’s recent use of A&E because of this). Having suggested this, there are pockets of transformation that realise the savings required through reconfiguration of services away from hospitals. Perhaps, ultimately what the NHS needs is to learn more widely from such exemplars, so variation in quality and costs is reduced across local healthcare economies. “

To contact Professor Currie to arrange an interview,call 07876 218011 or email


To contact Professor Currie to arrange an interview, call 07876 218011 or email