As the UK government’s current tenure draws to a close The King’s Fund is warning that health services are “under significant strain” and that there is “a real risk that patient care will suffer as the NHS heads towards a deficit”.

Under the coalition’s direction, the NHS budget has risen in real terms, the numbers of doctors and nurses have increased, management costs have been significantly cut, patient experience remains positive, and the number of health-care acquired infections has fallen.

But, on the downside, the NHS is likely to record “a substantial deficit” in the final year under the coalition, the report concludes, and warns that all areas of NHS care are feeling the strain, “with general practice under huge pressure and concerns being raised about access to mental health services for vulnerable patients”. 

Also, target waiting times for A&E, hospital treatment and cancer treatment have all been missed in recent months, hospital bed occupancy is surging, and there are signs that NHS staff are under significant pressure, it says.

The NHS has made some progress in improving efficiency, but it can no longer rely on salary caps and other cost cutting to deliver savings, and additional funding of some £8 billion a year by 2020 “is the minimum requirement for the NHS to continue to meet patient needs and maintain standards of care”.

“The next government will inherit a health service that has run out of money and is operating at the very edge of its limits,” said John Appleby, The King’s Fund’s chief economist. “While the NHS has performed well in the face of huge challenges, there is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming”.