Government must address NHS deficit in autumn budget and include support for NHS social enterprises

I read with great concern the recent NHS Confederation release: More staffing and patient care cuts likely unless government addresses growing NHS deficit, which underlines the pressing need for government action in the upcoming autumn budget to mitigate the inevitable pressures the NHS will face this winter.

The situation faced by NHS leaders across the country is dire, with record demand coupled with increased costs due to recently announced pay awards. According to the NHS Confederation survey 31 out of 42 integrated health systems have a deficit plan for the year. Without immediate and significant funding, NHS leaders will be faced with impossible choices - choices that could have devastating consequences for patient care and the sustainability of the NHS.

UHUK represents a partnership of social enterprise urgent and integrated healthcare providers, who between them deliver urgent care services to over two thirds of the UK population. Every year, our members treat millions of patients who might otherwise call an ambulance, go to A&E, or visit their GP – reducing the pressure on those crucial services.

Our services - ranging from NHS111 and Out of Hours care to Clinical Assessment Hubs and Urgent Treatment Centres - are designed to streamline care through innovative use of technology, such as telephony, video, and online consultations. By triaging and redirecting patients to appropriate services, we not only ensure that NHS resources are used where they are most needed but also help to prevent the system from becoming overwhelmed, particularly during peak periods such as bank holidays and through the winter.

Our model is unique: as social enterprises, we reinvest any surpluses directly back into the services we provide. This stands in stark contrast to private enterprises, where profits may be distributed to shareholders rather than being used to enhance patient care. This reinvestment ensures that every pound is maximised for the benefit of patients and the NHS as a whole, making social enterprises a critical yet often overlooked component of the healthcare system.

We understand the difficult economic circumstances with which the government is faced, however, the current financial outlook is threatening our ability to continue providing this essential support. Unlike the integrated care systems we partner with, our social enterprise members cannot operate at a deficit.

The lack of understanding and investment into our sector, combined with the possible exclusion of our employees from recent NHS pay awards - even those transferred from the NHS under Agenda for Change terms - has left our employees feeling undervalued and financially disadvantaged. This disparity not only risks lowering staff morale but could also hinder our ability to recruit and retain the skilled professionals upon whom the NHS relies.

We echo NHS Confederation CEO Matt Taylor’s call for the government to provide the NHS with the long-term financial security it desperately needs to plan effectively. However, it is equally important that this planning includes recognition of the unique role that social enterprises play. By reinvesting surpluses into service improvements and innovations, we offer a sustainable model that aligns closely with the NHS’s goals of improving patient care and operational efficiency.

The looming winter crisis will be a test for the new government. A short-term cash injection is essential to address the immediate challenges, but without a broader financial strategy that includes support for social enterprises, the NHS risks undermining one of its key partners in delivering high-quality, sustainable care.

UHUK members are fully committed to playing their part in alleviating the pressures on the NHS this winter and beyond. With appropriate funding, we can continue to reduce the strain on emergency services, facilitate earlier patient discharge, and ensure that care is provided in the most suitable settings. We urge the government to recognise the value of social enterprises in this equation and to include our sector in their funding considerations, ensuring that we can continue to reinvest in and enhance the services upon which millions of people rely.