How much is spent on health and social care in the NHS?

“We have got the vast majority of our Hospital Trusts on the edge a cliff. I think it’s 61% of acute hospitals are in deficit at the moment. We have had cuts to the likes of which we have never seen before to our NHS budgets. £6.3 billion from social care, £600 million from mental health.”

Rebecca Long Bailey MP, 14 December 2017

It’s correct that 61% of acute hospital trusts were in deficit by the end of 2016/17. So far this year the figure is 83%.

Spending by councils on adult social care in England has fallen by around £1.3 billion since 2010, according to experts. Councils have reported that they have made, or plan to make, savings of £6.3 billion on adult social care services since 2010.

We’re planning to publish a more detailed factcheck of mental health spending soon, so for now we haven’t covered the last part of Ms Long Bailey’s claim.

How many hospital trusts are in deficit?

It’s correct that 61% of acute hospital trusts were in deficit by the end of 2016/17. Acute trusts make up the bulk of NHS providers in England and offer a wide range of services. Other types of trust include ambulance, community, mental health and specialist trusts.

Those other types of trust are less likely to be in deficit. That means across all types of trust, 44% were in the red that year.

Looking at the most recent figures, 83% of acute hospital trusts were in deficit by the end of September 2017, and 65% of all trusts were.

Between 2015/16 and 2020/21 spending on NHS England is set to increase by £8.7 billion (in 2017/18 prices), though overall health spending is set to increase by about half as much. Because of an increasing population though, spending on the NHS per person is set to fall in the coming years.

NHS England has been asked to make £22 billion of savings between 2016 and 2021 in order to keep up with rising demand and an ageing population.

We’ve looked more at spending on the NHS and other health services here.

Have social care budgets fallen by £6.3 billion?

Spending on adult social care by councils in England has fallen by around £1.3 billion in real terms since 2010, according to health think tanks. It went from £19.1 billion in 2009/10 to £17.8 billion in 2016/17—a fall of 7%.

Following calls for more money to be put into adult social care earlier this year, the government promised an extra £2 billion for adult social care over the next three years. We’ve looked at this in more detail here. But health think tanks still estimate that there will be a funding gap of £2.5 billion by 2019/20.

Ms Long Bailey seems to have been referring to findings from a survey done by the Association of Directors of Adult Social Services (ADASS) when she said social care budgets had been cut by £6.3 billion. We’ve asked her office for more information.

ADASS, which is made up of leaders of council social care services, found that councils across England plan to have made savings of £6.3 billion since 2010 (by the end of 2017/18) on adult social care. We’ve asked ADASS if this figure accounts for inflation and for more details about the survey.

In 2017/18 councils expected these planned savings would come mainly from efficiency savings, and things like reducing services, increasing charges above the level of inflation and increasing pay by less than inflation. But only 31% of councils responding to the survey were fully confident they would be able to make planned savings this year.

The survey was conducted before some councils knew the full details of the money towards adult social care that they would receive from the NHS and increasing council tax. It’s possible that this money may affect the level of savings councils plan on making.