Reckoning-up time



A new briefing from NHS Providers and NHS Confederation calculates the COVID-19 pandemic has increased the cost of running frontline NHS services by £4-5bn a year.

The briefing: ‘A reckoning: the continuing cost of COVID-19’, is based on survey data from 54% of the provider sector. It explains the long-term impact of the pandemic on the NHS’s day-to-day running costs, and calls on the government to ensure these costs are met in full. 

The £4-5bn costs are in addition to other key financial factors, and they will remain in place for the duration of the three-year period that is expected to be covered by the upcoming Comprehensive Spending Review (CSR).

The briefing lists 15 key factors that are driving this increase in NHS running costs for 2022/23, providing greater detail on each:


• Infection prevention and control

• Staff absence and backfill

• Service expansion and ‘cohorting’ to cope with higher demand and activity

• Miscellaneous workforce-related costs

• Non-backlog-related output gaps

• Reduction in income

• Extra capital and depreciation charges

• IT costs

• Demand from COVID-19 patients

• Supporting staff wellbeing

• Admin costs of managing a larger waiting list


• Long Covid

• Tackling inequalities

• Testing, excluding costs reimbursed by test and trace.

Other key financial factors, which have not been considered in the above, include the need to fund capital investment and recover care backlogs.

The briefing calls on the government to not only recognise and cover these costs, but also to: provide the capital necessary to fulfil its manifesto commitments to invest in NHS infrastructure, staff training and development and social care reform; fund additional activity to recover backlogs of care; factor in efficiency savings that could not be delivered as a result of the pandemic and its knock-on effect; and cover the centrally-funded costs of COVID-19, such as test and trace.

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