Health leaders have voiced disappointment that Rachel Reeves’ autumn budget offered broad assurances but little targeted support for the NHS and social care.

Sarah Woolnough, chief executive of the King’s Fund, said the Chancellor offered “apparent protection” to the NHS, adding that the settlement from this year’s spending review would help the health service “just about keep its head above water.”

She warned that the government “still lacks a clear plan” to meet rising demand, strengthen social care, and manage issues such as industrial action and rising drug prices.

Capital Funding Still Missing for NHS Estate

Matthew Taylor, chief executive of the NHS Confederation, said the budget did not address the urgent need for capital investment to “fix the NHS’s crumbling estate.”

He welcomed the move to allow private investment in 250 neighbourhood health centres, calling it “a first step.” He said this could free public funds to help reduce the £16 billion maintenance backlog. 

However, he cautioned that while Reeves promised to “renew” the NHS in her speech, finances remained under severe strain. Local services, he said, cannot continue absorbing the cost of strike action by the British Medical Association (BMA) “without consequences to patient care.”

BMA: Funding Increase Not Enough

The BMA said the highlighted 2.6% annual increase in health spending is insufficient to support recovery.

BMA council chair Dr Tom Dolphin said budget did not address pay restoration or dispute resolution, which he said were essential to retaining doctors. He noted that 4000 internationally trained doctors left UK practice last year.

He warned that wage increases for practice staff must be fully funded to avoid pushing “already precarious” GP budgets “further into jeopardy.” He also described the proposed private-sector partnerships for new health centres as “only dodges around the central problem of lack of investment.”

Community Pharmacies Warn of Staff Cuts

The National Pharmacy Association (NPA) said the rise in the national living wage and minimum wage could force community pharmacies to reduce staffing. 

NPA chief executive Henry Gregg said staff were “deserving of a pay rise”, but he warned that the additional costs would “add significantly to the financial pressures pharmacies are under.” The NPA urged the government to reverse “years of underfunding” and invest in community pharmacies to prevent further strain on GPs and hospitals.

Social Care Leaders Fear Pay Erosion

Professor Martin Green, chief executive of Care England, said urgent clarity was needed to ensure that the Fair Pay Agreement announced in September is not undermined by frozen income tax and national insurance thresholds.

He said social care is essential to the wider system and warned that the budget “leaves social care facing significant headwinds.” Without additional support, workers may keep less of any future pay rise, reducing “the real value of the Fair Pay Agreement.”

Sally Gainsbury, senior policy analyst at the Nuffield Trust, said the living wage rise was positive for low-paid social care staff but added that the absence of extra funding would place providers under pressure. With almost one quarter of the 1.5 million workforce paid close to the living wage, she said even small increases “can have a big impact” on care delivery. The trust estimated the rise could cost the sector around £1.2 billion.

Workforce and Safety Concerns Persist

The Royal College of Nursing (RCN) said the budget failed to provide the investment needed to strengthen the NHS workforce.

RCN chief executive Nicola Ranger said the NHS “was just a footnote” in the Chancellor’s speech. She warned of “cavernous gaps in the workforce” and said nursing staff were worried about patient safety.

She added that the budget did not deliver “long overdue” reform to “a broken, decades-old pay system” or investment to expand the student nurse pipeline.

Negligence Cost Pressures Unaddressed 

Health leaders also expressed disappointment that the budget did not address rising NHS clinical negligence liabilities, estimated to have reached £60 billion.

Dr Rob Hendry, medical director and chief member officer at the Medical Protection Society, said the costs were “diverting money away from improving patient care.” He called for urgent review, warning that continuing without reform was “clearly unsustainable.”

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.