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RCP submission to the 2021 Spending Review

The Chancellor Rishi Sunak announced a Spending Review in early September. It is a multi-year Spending Review which will set resource and capital budgets for 2022-23 to 2024-25 and conclude on 27 October 2021, alongside Autumn Budget 2021.

Last year’s Spending Review only covered a year because of the uncertainty caused by the COVID-19 pandemic. This means that 2021 is the first multi-year spending review since 2015.

The RCP’s submission welcomes the funding the NHS has received to support the recovery of elective services but warns that without investment in the NHS workforce, the additional money for operations, checks and other procedures can only go so far.

Faced with a growing trend for less than full time working among doctors starting their careers and expecting a significant proportion of the consultant workforce to retire in the next 10 years, there is an urgent need to act. This multi-year spending review is a significant opportunity to invest in expansion of the medical workforce. The RCP report Double or Quits models the expansion of medical school places at a cost of £1.85bn per annum. This is less than a third of what hospitals spent in 2019/20 on agency and bank staff.

Workforce will be a limiting factor in managing the backlog, and in the government’s wider ambitions for healthcare. Investing in expansion of home-grown medics is part of the levelling up agenda – encouraging aspiring doctors to train and work in the communities they have grown up in.

The submission also calls for pilot funding for dedicated time for clinical research, and to address the funding gap for public health as part of a cross-government strategy to reduce health inequality.