Health leaders have warned the government that without an additional £3 billion in funding, the NHS could face longer waiting times and deeper service cuts. 

In a joint statement ahead of the Autumn Budget, the NHS Confederation and NHS Providers said the extra funding was needed to cover redundancy costs, industrial action, and higher drug prices.

They warned that, without support, the NHS would be forced to absorb these costs within existing budgets, leading to staff cuts and fewer tests, appointments, and operations. This would “derail key planks” of the government’s reform agenda and jeopardise progress against waiting time targets such as the 18-week target for planned care, the organisations said.

Rising Cost Pressures

The health bodies said the 2025-2026 NHS budget had failed to account for several major cost pressures, including redundancy payments, strike-related expenses, and higher drug prices.

More than £1 billion was needed this year to enable integrated care boards to reduce their running costs by 50% and for NHS trusts to reduce corporate spending, as required by the government in March 2025. Without this funding, savings could not be made as quickly as planned, forcing “deeper cuts” to services than already intended.

Recent industrial action by resident doctors has added an estimated £300 million in extra costs, with further strikes planned for November expected to increase the financial strain. Rising drug prices are also placing additional pressure on NHS budgets.

Longer Waits and Reduced Services

Efforts to reduce spending could hinder attempts to bring down waiting lists, such as weekend operating sessions or extra theatre lists aimed at boosting productivity.

Minimum waiting times for treatment could also rise, meaning more patients would wait longer for care. Some may be unable to work while waiting for treatment, reducing tax revenue and increasing welfare costs, the organisations warned.

Trusts and integrated care boards might also be forced to tighten eligibility for procedures that improve quality of life but are not life-saving.

A ‘Stark Choice’ for the NHS 

Matthew Taylor, chief executive of the NHS Confederation, said: “The threat from unbudgeted redundancy payments, higher drug prices, and renewed industrial action risks derailing progress on key waiting time targets and the wider reforms that are essential to getting the NHS back on track.”

He said NHS leaders wanted to “crack on” with delivering the government’s reform agenda but were being held back by a lack of upfront funding to pay for redundancies that would save money in the long term.

Daniel Elkeles, chief executive of NHS Providers, warned the NHS faced “a stark choice.”

“Either balance the books or cut waiting lists and face more deficits which threaten services,” he said.

He added that NHS trusts were making difficult decisions to reduce staff while protecting patient services, but redundancies were costly.

“It’s time for an honest assessment and discussion about what the NHS can really achieve this year, and about what is ‘doable’ to meet ministers’ ambitions in their 10-year plan for health,” Elkeles added.

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.