This website is intended for healthcare professionals only.
Take a look at a selection of our recent media coverage:
23rd June 2025
Speaking at Hospital Healthcare Europe’s Spring 2025 Clinical Excellence in Respiratory Care event, Dr Uta Hill focused on redefining the clinical landscape of cystic fibrosis, with insight into the game-changing impact of CFTR modulator therapy. Here, you have exclusive access to the session recording.
Since the cystic fibrosis transmembrane regulator (CFTR) modulator therapy ivacaftor was first approved in England in 2012, the potential for precision medicine in cystic fibrosis has grown exponentially, driving up standards of care and offering patients and their families more hope than ever before.
With Medicines and Healthcare products Regulatory Agency approvals racking up, evidence emerging of CFTR safety and efficacy for even the youngest of age groups, and the launch of a new Cystic Fibrosis Innovation Hub to accelerate the development of new tests and treatment approaches in the UK, it’s an exciting time in the management of this debilitating condition.
Dr Uta Hill is a consultant in respiratory medicine and the cystic fibrosis lead and bronchiectasis co-clinical lead at the Cambridge Centre for Lung Infection at Royal Papworth Hospital NHS Foundation Trust.
In this Clinical Excellence session, she provides an overview of cystic fibrosis before delving into recent advances in its care, including the development of CFTR modulator therapy and its impact for patients, as well as the changing pathways for adult care and the transition from paediatrics.
Watch more Clinical Excellence event sessions via our Clinical Excellence Catch-up zone and watch this space as the autumn schedule for Clinical Excellence will be announced soon.
You can find brand new interviews and case studies on respiratory care – plus round ups of previous Clinical Excellence event sessions by looking out for the orange Clinical Excellence tag – and much more content that can help to inspire your practice in our Respiratory zone.
Speaking at Hospital Healthcare Europe’s Spring 2025 Clinical Excellence in Respiratory Care event, Dr Zaheer Mangera brought delegates up to speed on modern smoking cessation, with a focus on e-cigarettes and vapes. Here, you have exclusive access to the session recording.
The so-called ‘Vape Debate’ has been intensifying in the UK for two decades and polarising medical opinion, with strong evidence both of their value in smoking cessation and the damage they cause to the health of young people.
While it is hoped that the recent ban on single-use vapes in the UK has gone some way to improving the latter, as well as aiding sustainability efforts, there is a significant role for clinicians to play in supporting patients to quit smoking and effectively use e-cigarettes as part of their evidence-based smoking cessation programmes.
Dr Zaheer Mangera is a consultant respiratory physician and the lung cancer lead at North Middlesex University Hospital, where one of his specialisms is tobacco dependency. In this Clinical Excellence session, he discusses pharmacotherapy smoking cessation strategies, including the effectiveness of e-cigarettes and vapes, the risks of cessation and how to guide patients.
Watch more Clinical Excellence event sessions via our Clinical Excellence Catch-up zone and watch this space as the autumn schedule for Clinical Excellence will be announced soon.
Dr Mangera previously spoke to Hospital Healthcare Europe about his tips for optimising tobacco dependency services in secondary care, which is well worth a read.
You can also find brand new interviews and case studies on respiratory care – plus round ups of previous Clinical Excellence event sessions by looking out for the orange Clinical Excellence tag – and much more content that can help to inspire your practice in our Respiratory zone.
This includes Dr Mangera’s other Clinical Excellence sessions on topics such as the early diagnosis and screening of lung cancer, the neoadjuvant lung cancer pathway and diagnostic imaging for respiratory conditions as part of an expert panel discussion.
20th June 2025
MPs have voted to legalise assisted dying in England and Wales by a narrow margin of 23 votes in the final reading of the bill in the House of Commons, following five hours of debate.
The draft legislation, which will allow terminally ill adults with six months or less to live to receive medical assistance to end their own lives, was initially backed by MPs in a vote in November. It has since gone through committee and report stages, with MPs debating amendments and voting on proposed changes at its third reading on 20 June.
MPs were given a ‘free vote’ on the bill, meaning they could vote independently rather than follow a party line.
The Terminally Ill Adults (End of Life) Bill passed with 314 votes for and 291 against. This final vote in the House of Commons, meaning that the bill will now proceed to the House of Lords for further scrutiny.
Under the current bill, two doctors would first need to assess the person seeking assisted dying and provide sign-off and the ‘coordinating doctor’ who is overseeing the patient’s end-of-life care provision may be accompanied by ‘other such health professionals’ – including registered nurses, registered medical prescribers, registered pharmacists and registered pharmacy technicians – that they think are needed.
However, no registered medical practitioner or ‘other health professional’ would be under ‘any duty’ to raise assisted dying with patients or to ‘participate in the provision of assistance’ if they do not wish to do so.
Last year, a survey found that nearly half of General Medical Council-registered doctors thought that a physician-assisted dying law ‘would negatively impact the medical profession’.
The Royal College of Physicians (RCP) has always maintained a neutral stance on the principle of assisted dying, which it says reflects ‘the range of views across our membership’.
Commenting on the passing of the Terminally Ill Adults (End of Life) Bill at third reading, Dr John Dean, clinical vice president at the RCP said: ‘We believe that several concerns raised by the RCP and others on the bill – including safeguards for vulnerable patients, equitable access to care, clinical responsibilities and the need for complex decisions to be made by multidisciplinary teams, and the potential impact on the doctor-patient relationship – require further consideration. As the bill now heads to the House of Lords, we urge Peers to address these issues to ensure the bill includes robust protections for both patients and healthcare professions.
‘Parliament and the Government must now work closely with the medical profession to ensure that all people, regardless of the choices they may face at the end of life, receive the highest quality care and support.’
Slush ice drinks containing glycerol are not suitable for children under seven due to the risk of glycerol intoxication syndrome, the Food Standards Agency (FSA) has said in updated advice.
It follows research published in the Archives of Diseases in Childhood journal earlier this year reporting 21 cases of children aged between two and seven years in the UK and Ireland who needed hospital treatment after drinking a ‘slushy’.
Previous advice had been that they should be avoided in the under-fives.
The FSA also called for a ‘greatly enhanced voluntary approach’ for industry to help manage glycerol intake in young children over the longer-term.
Most slush ice drinks that are marketed as being sugar-free instead containing the sweetener glycerol which stops them from freezing completely solid.
Researchers wanted to see stronger warnings because of cases of glycerol intoxication syndrome where children lost consciousness and showed signs of low sugar and high acidity in the blood.
One of the cases reported had suffered a seizure and four of them needed brain scans.
While recommendations around avoiding such drinks in young children had previously been based on weight, estimating a safe dose was not easy and could be influenced by how quickly an ice slush drink is consumed or whether the child has eaten or been very active, they noted.
An assessment by the FSA incorporated information from ‘recent glycerol intoxication incidents’ and assessed the impact of one serving of slush ice drink (350ml with 50,000mg/L glycerol) on children with a lower-than-average body weight for their age.
It took a more ‘precautionary approach’ than the previous risk assessment conducted in 2023, which was based on average body weight.
At a meeting on 18 June, the FSA Board endorsed advice that slush ice drinks containing glycerol are not suitable for children under seven, which should be clearly communicated to parents and carers.
Professor Susan Jebb, FSA chair said: ‘In the warm weather, children may be more likely to consume slush ice drinks containing glycerol, so it’s important that parents and carers are aware of the risks.
‘As a precaution, the FSA is recommending that children under seven do not consume slush ice drinks containing glycerol.
‘With our counterparts in Scotland, we will be talking to parent groups and charities to provide updated guidance that is useful and applicable across the UK.’
She said the board expected industry to share data on the quantity of glycerol in their products to inform future work.
‘Meanwhile, there are immediate actions they can take that can help protect children and reduce the risk from these products. For example, retailers should limit cup sizes and should not offer free refill promotions to children under 10,’ she added.
The updated advice applies to ready-to-drink slush ice drinks with glycerol in pouches and home kits containing glycerol slush concentrates, the FSA confirmed.
A version of this article was originally published by our sister publication Pulse.
19th June 2025
Women who work night shifts are more than 50% more likely to suffer from moderate or severe asthma than women who work during the day, a new study has suggested.
Researchers from the University of Manchester analysed data from nearly 270,000 shift workers and found that for all women working night shifts, the risk of asthma increased. The risk was more pronounced in women who only worked nights and in postmenopausal women who were not taking hormone replacement therapy (HRT). There was no association between working night shifts and asthma in men.
The findings, published in the journal ERJ Open Research, highlight the need for women working night shifts to monitor their health.
Using data from the UK Biobank, the researchers analysed data from 274,541 working people. Participants were categorised as day or night workers, or a combination of both, and statistical analysis was applied to determine how the increasing frequency of shift work affects asthma risk. To determine possible causes of any association, chronotype, sex hormones and menopausal information were also analysed and demographic and lifestyle factors were controlled for.
Of the people analysed in the study, 5.3% had asthma, with 1.9% suffering from moderate or severe asthma, meaning they were taking an asthma preventer inhaler and at least one other asthma treatment, such as an oral steroid.
The findings showed that women who work shifts were more likely to have asthma. Women who only worked night shifts were around 50% more likely to suffer from moderate or severe asthma compared to women who only work in the daytime.
There was no significant link between night shift work and asthma risk found in men, suggesting that biological sex, linked to either hormonal or physiological differences, plays a role in how night shift work affects a person’s asthma risk.
Dr Robert Maidstone, a research fellow at the University of Manchester and lead researcher on the study, said: ‘This is the first study to evaluate sex differences in the relationship between shift work and asthma. This type of research cannot explain why shift work and asthma are linked; however, it could be because shift work disrupts the body clock, including the levels of male and female sex hormones. High testosterone has previously been shown to be protective against asthma, and so lower testosterone in women could play a role. Alternatively, men and women work different types of shift jobs, and this could be a factor.’
Examining the impact of the menopause and associated HRT, the researchers found that women who are postmenopausal and not using HRT have nearly double the risk of severe asthma compared to day workers. Among postmenopausal women working night shifts, those using HRT did not exhibit the same elevated asthma risk.
Dr Maidstone added: ‘Our results suggest that HRT might be protective against asthma for night shift workers, however further research is needed to test this hypothesis in prospective studies and randomised controlled trials.’
The research group plans to examine whether sex hormones play a role in the relationship between shift work and asthma in future research.
A version of this article was originally published by our sister publication Nursing in Practice.
Patients will be able to register for clinical trials via the NHS App under new Government plans to revive the UK’s struggling research sector and speed up access to new treatments.
The initiative, part of the forthcoming 10-year health plan, aims to significantly reduce trial set-up times, increase public participation in research and boost the UK’s appeal as a destination for global life sciences investment.
According to the Department of Health and Social Care (DHSC), trial recruitment and performance data will now be collected from all NHS trusts and organisations. This will include data on the number of trials being conducted and the progress being made.
Data will be publicly available on how many trials are sponsored, which NHS organisations are performing well and which are falling behind. Funding will be prioritised for those who can ‘prove they can support the NHS to deliver the treatments of tomorrow’.
A new version of the National Institute for Health and Care Research (NIHR) ‘Be Part of Research’ platform, which will be integrated into the NHS App, will allow patients to browse and register for trials. The ambition is to automatically match patients with studies via personalised push notifications based on patient data.
Ministers claim the reforms will help address a major drop in UK clinical trial activity in recent years. It currently takes an average of 250 days to set up a commercial trial in the NHS, compared to just 100 days in countries such as Spain. The Government has set a target to reduce the UK figure to 150 days or fewer by March 2026.
To achieve this, a new national standardised contract will be introduced to avoid site-by-site agreements, and duplicative processes across regulatory bodies are set to be streamlined.
Health and social care secretary Wes Streeting said the UK should be at the forefront of the ‘emerging revolution in life sciences’, adding that the NHS App will be key to giving the public a greater role in clinical trials and putting them ‘at the front of the queue for new cutting-edge treatments’.
‘By slashing through red tape and making it easier for patients to take part, reforms in our 10-year plan will grow our life sciences sector, generate news funds for the NHS to reinvest in frontline care, and benefit patients through better medicines,’ he said.
Commenting on the plans, Professor Lucy Chappell, chief executive of the NIHR, said: ‘We know the benefits of embedding clinical research across the NHS and beyond. It leads to better care for patients, more opportunities for our workforce and provides a huge economic benefit for our health and care system. Integrated into the NHS App, the NIHR Be Part of Research service enables members of the public to be matched to vital trials, ensuring the best and latest treatments and care get to the NHS quicker.
‘Ensuring all sites are consistently meeting the 150-day-or-less set-up time will bring us to the starting line, but together we aim to go further, faster to ensure the UK is a global destination for clinical research to improve the health and wealth of the nation.’
The Government said it also plans to target underrepresented groups – including young people and people from ethnic minority backgrounds – through a new national research awareness campaign.
To this end, Kirsty Slack, head of policy, public affairs and campaigns at the Teenage Cancer Trust, said: ‘Young people in the UK with cancer find it extremely tough to access potentially life-saving clinical trials. The launch of this new service on the NHS app is a welcome innovation, giving young people the power to quickly search for opportunities through technology that’s integral to their daily lives.
‘However, there are more access barriers to overcome before young people with cancer move near to the “front of the queue” for clinical trials.’
Nicola Perrin, chief executive of the Association of Medical Research Charities, added: ‘Clinical trials are good for patients, the NHS and the economy. But both commercial and non-commercial trials in the UK have closed because of failures to recruit.
‘[This announcement] will help to maximise opportunities for everyone to take part in research and speed up access to innovative treatments. We warmly welcome the focus on driving up the participation of diverse and under-served groups – something that is incredibly important to our member charities.
‘It’s encouraging to see the Government recognise that boosting access to clinical trials must be a key part of the 10 Year Health Plan. Transforming clinical trials is an important step in truly embedding research in the NHS, securing the UK’s position as a leader in life sciences and offering a lifeline to patients.
The 10-year health plan is expected to be published in full in the coming weeks.
Last week it was announced that more patients will receive appointment reminders, screening invitations and test results via the NHS App, with the ambition for it to become the NHS’s ‘go-to patient communication method’ within three years.
In April, it was announced that the NHS App had been adopted by 87% of hospitals in the UK, saving 1.26 million clinical hours since July 2024.
13th June 2025
Artificial intelligence is playing an increasingly prominent role in automating segmentation in cardiac magnetic resonance imaging. However, concerns persist about racial bias stemming from imbalanced training datasets. Tiarna Lee, a PhD candidate at King’s College London, is exploring the root causes of this bias through her research, discussed here, to develop fairer and more equitable models.
Cardiac magnetic resonance (CMR) imaging is widely used for diagnosing and predicting cardiovascular conditions. However, studies have shown that AI-based segmentation of cardiac structures can exhibit bias.1
When training datasets are imbalanced, AI models tend to perform better on individuals from majority groups than those from minority groups. This disparity can lead to less accurate clinical biomarkers for under-represented populations, resulting in poorer diagnosis, prognosis and treatment. Increasing the diversity of training data can improve model performance for these under-represented groups.
AI models are susceptible and influenced by the data on which they are trained. For example, if a model is trained on 99 images of healthy patients and only one image of a patient with a particular disease, it will become much better at recognising healthy patients.
A key concern is that AI models may rely on superficial patterns, such as race, as a bypass for diagnosis. This phenomenon, known as shortcut learning, occurs when a model makes decisions based on irrelevant or misleading features rather than the true underlying indicators of disease.
For example, imagine two hospital wards: one uses Scanner A to image severely ill Covid-19 patients, while the other uses Scanner B for milder cases. The AI model might learn to associate Scanner A with severe illness, not because it understands the disease, but because it picks up on subtle scanner-specific image artefacts. As a result, if a severely ill patient is examined using Scanner B, the model might wrongly classify them as less sick due to this incorrect shortcut.
This type of flawed reasoning can also apply to race. If disease prevalence differs between racial groups in the training data, the model might learn to use race as a proxy for diagnosis. Such bias can undermine clinical decision-making, potentially leading to misdiagnosis or unequal treatment depending on the scanner or other spurious correlations learned by the AI.
Our study used a race classification model to determine whether CMR images could be used to identify a patient’s race.2 We found that not only the raw images but also their segmentations contained enough information for the model to classify race accurately.
To understand what features the model was using, the regions contributing most to the classifications were analysed. Surprisingly, the model relied on areas outside the heart, such as subcutaneous fat and image artefacts, rather than cardiac structures. When the images were cropped to focus solely on the heart, effectively removing surrounding fat and artefacts, the model’s ability to classify race dropped significantly. Conversely, when we used a dataset in which the heart was blurred out entirely, essentially removing it, the model could still accurately classify race. This suggests that most of the race-related information recognisable to this model was located outside the heart.
We investigated whether cropping the images could reduce bias in segmentation models. Despite removing features such as the subcutaneous fat from the images, the segmentation models still exhibited racial bias. We then performed confounder analysis and found that factors such as the MRI scan year and high-density lipoprotein cholesterol were not correlated with segmentation performance for White subjects but were correlated for Black participants. This indicates that underlying biases persist even after removing visible race-related features.
Increasing the representation of Black subjects in the training data, from 0% to 25%, substantially improved model performance for this group without negatively compromising accuracy for the White majority group. This highlights the importance of diverse and balanced datasets in developing fairer AI models.
Cropping the images around the heart reduced the model’s ability to classify race, with accuracy dropping to 55% – close to the 50% chance level for binary classification. This suggests that images of the heart alone contain little race-related information, and that cropping can reduce bias in classification models.
However, this effect did not translate to segmentation models, where bias remained even after cropping. It is important to note that the cropping in our study was based on ground-truth segmentations, which are not always available in real-world clinical settings, such as when a patient undergoes cardiac imaging. To implement this approach in practice, an additional method would be needed to automatically identify and crop the cardiac region. A potential solution could be using a bounding box detection model to localise and extract the heart region before segmentation.
Bias mitigation methods can ensure that AI models perform fairly across different demographic groups. For example, we found that oversampling under-represented groups effectively improved model performance for minority populations, aligning with the performance seen in the majority group.3 Oversampling works by presenting images from the under-represented group to the AI model more frequently during training, giving equal importance and helping the model learn balanced representations.
In contrast, other bias mitigation techniques, and even combinations, were less effective in reducing disparities. This highlights the importance of choosing the right mitigation strategy based on the specific context and data.
Biases are prevalent across various medical imaging modalities. For instance, chest X-ray classification models were found to be less accurate for certain demographic groups, including younger individuals, females, patients under 20 years of age, as well as Black and Hispanic patients – all of whom experienced higher rates of underdiagnosis.4
Another study found that these models performed more accurately for male and older patients, highlighting disparities based on age and sex.5
Similar biases have been observed in dermatology.6 Model performance has varied based on age, sex and skin tone, with notably poorer results for individuals with darker skin tones.7 However, fine-tuning models using more diverse datasets helped reduce these performance gaps.
Research has also shown that self-identified race can be predicted from chest X-ray images alone, showing that the results are generalisable to other domains.8 The authors highlight that adopting a ‘colourblind’ approach to training AI models may not be feasible, as the models may still infer race from subtle, non-obvious features.
Machine learning models are often ‘black boxes’, so the reasons for decisions are not interpretable and transparent. To build trust in machine learning models, developers must implement methods that make these decisions more apparent to clinicians and patients. This will also help uncover potential biases in the systems.
Our study explored the root causes of bias in AI-driven CMR segmentation. We found that the differences between White and Black subjects mainly stem from variations in the images rather than the segmentations. These variations appear to be linked to differences in body fat composition outside the heart, which likely drive the distributional shift and resulting bias. While cropping the images to focus on the heart reduces this bias, it does not eliminate it. These findings will be important for researchers striving to develop fairer AI models for CMR segmentation.
These insights are not limited to cardiac imaging, with similar biases having been observed across other modalities, including chest X-rays and dermatology, emphasising the generalisability of our findings.
It is crucial to develop and adopt bias mitigation strategies, ensure diversity in training data and foster transparency through explainable models. Multidisciplinary collaboration between data scientists, clinicians and imaging specialists will also be key to building equitable and trustworthy AI tools that serve all patient populations fairly.
Tiarna Lee MEng
School of Biomedical Engineering and Imaging Sciences, King’s College London, UK
A new liver cancer treatment that uses ultrasound technology to target tumours without surgery, is to be made available on the NHS, the Department of Health and Social Care (DHSC) has said.
The technology, called histotripsy, is a non-invasive interventional radiology procedure that targets tumours with minimal damage to surrounding organs and can be delivered in a single session, potentially around 30 minutes long, according to the DHSC.
It uses pulsed sound waves to create ‘bubble clouds’ from gases present in targeted tissue. These clouds form and then collapse, which creates mechanical forces able to destroy tissue.
Ongoing research is being done to explore the technology’s potential to treat hard to reach tumours, including kidney and pancreatic cancers.
It will be available at Addenbrooke’s Hospital in Cambridge, part of Cambridge University Hospital NHS Foundation Trust, with the first patients expected to be treated this summer.
Health secretary Wes Streeting said that it was ‘slashing red tape’ that had allowed this treatment to be rolled out quickly, after he gave authorisation for controlled early access to the device via an unmet clinical need authorisation.
He said: ‘Regulation is vital to protect patients. However, as the pace of innovation ramps up, our processes must be more agile to help speed the shift from analogue to digital.
‘Our common sense approach to regulation will streamline approval processes so countless more patients are liberated from life-limiting conditions.’
Roland Sinker, chief executive of Cambridge University Hospitals said: ‘Histotripsy is an exciting new technology that will make a huge difference to patients.
‘By offering this non-invasive, more targeted treatment we can care for more people as outpatients and free up time for surgeons to treat more complex cases.
‘The faster recovery times mean patients will be able to return to their normal lives more quickly, which will also reduce pressure on hospital beds, helping us ensure that patients are able to receive the right treatment at the right time.
‘We are delighted to be receiving this new state of the art machine.’
This comes as the Government announced the rollout of new radiotherapy machines that will deliver up to 27,500 additional treatments per year and save as many as 13,000 appointments from being lost to equipment breakdown.
A version of this article was originally published by our sister publication Healthcare Leader.
Patients in England are to receive all ‘appropriate’ NHS messages via the NHS App within the next three years, the Department of Health and Social Care (DHSC) has pledged.
More than £50m is to be invested in the app to increase the number of messages it sends this year by 70 million from the last financial year, to 270 million.
This will reduce the need for ‘at least 50 million letters’, the DHSC added.
Currently, almost 20 million patients are opted in to receive healthcare messages via the app.
Patients will receive push notifications of appointment reminders, screening invitations and test results directly through the app to improve their access to care. It will become the ‘go-to method of communication’ between the NHS and patients.
The DHSC said that where app messaging was not available, communication would be sent via SMS, or letter as a last resort. Accessible communications will also ‘continue to be supported’ for those with specific requirements, it added.
Those without smartphone access will also ‘benefit’ from the investment, according to the DHSC, as phone lines will be freed up.
It added that this expansion was in addition to work currently underway to improve user experience, such as adding appointments to the calendar on patients’ phones, requesting help from their GP practice and faster logging in methods such as Face ID.
It comes after a new ‘Amazon-style’ prescription tracker has gone live on the NHS App enabling patients to track their prescriptions across 1,500 community pharmacies in England.
Health secretary Wes Streeting said: ‘People are living increasingly busy lives and want to access information about their health at the touch of a button, rather than having to wait weeks for letters that often arrive too late. This Government is bringing our analogue health service into the digital age, so that being a patient in the NHS is as convenient as online banking or ordering a takeaway.
‘The NHS still spends hundreds of millions of pounds on stamps, printing and envelopes. By modernising the health service, we can free up huge amounts of funding to reinvest in the frontline.
‘Through the investment and reform in our Plan for Change, we will make the NHS App the front door to the health service and put power in the hands of patients.’
Dr Vin Diwakar, clinical transformation director at NHS England, added: ‘More than 11 million of us now log into the NHS App every month to manage our healthcare, whether ordering a repeat prescription or seeking advice on a medical condition.
‘We’re supporting the switch from analogue to digital by harnessing the power of digital communication channels so that millions more patients can receive important messages about their health direct to their smartphones – all you need to do is enable notifications in the NHS App to see and open messages.
‘The NHS App is already empowering patients by giving them more information and now by increasingly becoming a world-class way of communicating – which will save millions of pounds and free up resources for patient care. I’d encourage anyone who hasn’t got the app on their smartphone to download it now.’
Earlier this year, NHS England said the app was aiming for 100 million logins a month by 2026.
In April, the Department of Health and Social Care announced that NHS App services were being offered by 87% of hospitals in the UK, saving 1.26 million clinical hours since July.
A version of this article was originally published by our sister publication Healthcare Leader.
12th June 2025
The chancellor Rachel Reeves has announced a £29bn real terms funding boost for the NHS over the next three years, in her much-anticipated spending review.
This equates to a 3% increase in annual day-to-day spending from 2023/24 to 2028/29, making the spending £226bn by the end of the period and therefore delivering the ‘largest ever’ health capital budget.
She added there would also be a £2.3bn real terms increase in the Department of Health and Social Care’s (DHSC) annual capital budgets from 2023/24 to 2029/30, which would include money for new technology, primary care and hospitals.
The chancellor also pledged additional funding by 2028/29 for the training of ‘thousands more GPs’, and an increase in funding of £4bn for adult social care in 2028/29, compared to 2025/26, which aligns with the Government’s ambition to treat more patients outside of hospital settings.
An investment of at least £80m per year for tobacco cessation programmes and enforcement to support delivery of the Tobacco & Vapes Bill was also announced to improve the health of the nation and reduce demand on the health service.
NHS technology and digital transformation is also set to get ‘up to £10bn’ by 2028/29 as part of the spending review settlement, which the Government said is ’an almost 50% increase from 2025/26’.
Announcing the spending review 2025 in the House of Commons, Ms Reeves said: ‘We are shifting care back to the community, providing more funding to support the training of thousands more GPs to deliver millions more appointments.
‘I am proud to announce today that this Labour Government is making a record cash investment in our national health service, increasing real terms day to day spending by 3% per year for every single year of this spending review, an extra £29bn per year for the day to day running of our health service.’
The DHSC has committed to delivering at least 5% of savings and efficiencies over phase two of the review period.
‘This includes savings and efficiencies identified through the department’s zero-based review (ZBR) and the technical efficiencies which DHSC has worked with the Office for Value for Money (OVfM) on,’ it said. ‘This includes £17 billion savings over three years released by achieving 2% productivity. The NHS will also reduce the need for temporary staff by setting limits on agency spend, including eliminating agency usage for entry level roles. This will build on the near £1bn reduction in agency spend delivered in 2024/25.’
The spending review sets out planned day-to-day spending totals for all Government departments for the years from 2026/27 to 2028/29, and investment spending plans for a further year (from 2026/27 to 2029/30).
While healthcare leaders have welcomed the much-needed cash injection into the health service and investment in digital infrastructure, many have highlighted the urgent need to tackle the social determinants of health and close the gap on health inequalities and called for further improvements to support the workforce.
In response to the spending review, Dr Mumtaz Patel, president of the Royal College of Physicians commented that ‘the additional funding announced today is vital for the Government to get anywhere near its ambition to improve NHS services, achieve its waiting list target and deliver its proposed three shifts.’
He added: ‘The Government is right to back its analogue to digital ambitions with an increased £10bn NHS technology and transformation by 2028/29. We know many physicians on the frontline are currently using antiquated systems and are keen to see improvements in the analogue to digital shift. As we said in our Prescription for Outpatients report earlier this year, we support the NHS App being the digital front door to the NHS. It has the potential to reduce complexity, and mean patients can access care between or instead of traditional appointments.’
Responding positively to the Government’s spending review commitment to investing in the enforcement of the Tobacco & Vapes Bill and to support smoking cessation services, Dr Patel said there is still ‘more to do’.
‘There continues to be an almost 20-year gap in healthy life expectancy between the most and least deprived areas of England, with 2.5 million more people projected to be living with a major illness by 2040. Government came into office promising to tackle the social determinants of health. A clear strategy to tackle health inequalities, and avoidable illness, is vital to reduce NHS demand and ensure that the health service is fit for the future,’ he said.
Professor Steve Turner, president of the Royal College of paediatrics and Child Health, echoed these sentiments, saying: ‘As paediatricians we continue to call for greater ambition to tackle child poverty, which has untold harms on the health and wellbeing of children. This ambition must include scrapping the two-child limit, which continues to push many families into hardship.’
He added: ‘Knowing that investment in child health services lags behind adult services, a successful shift requires the health system to allocate this funding equitably between them. This is also true in the devolved nations where we hope today’s allocations will be used to support children’s health.’
Dr Katharine Halliday, president of the Royal College of Radiologists, commented that the significant funding boost announced in the spending review would help to revitalise and futureproof the health service, but she highlighted concerns over support for the workforce.
‘We hope to see this reduce agonising waiting times for patients and relieve pressure on hardworking staff. The continued investment in scanners and other essential equipment is a positive step towards this goal. Its success depends on recruiting, training and retaining the diagnostic and cancer workforce, which faces a severe shortage of doctors,’ she said.
‘We welcome efforts to cut spending on temporary staffing, but this must be matched by more permanent roles for doctors who spend years training to work in our NHS – and that means scrapping illogical recruitment freezes for radiologists and oncologists.’
The Royal College of Surgeons of England (RCS England) has said the spending review failed to sufficiently address the urgent need for capital investment to modernise surgical theatres and hospital infrastructure.
Professor Vivien Lees, RCS England vice president, said: ‘Every delayed operation is a patient left waiting in pain, or with loss of function. While the Government’s spending review offers a welcome day-to-day funding boost for the NHS, it falls short of what is needed to meet ambitious waiting time targets, and get back to providing timely care to patients.
‘It is disappointing capital funding for the NHS will remain flat for the next three years. The forthcoming 10 Year Infrastructure Strategy must outline how the Government will improve investment in NHS infrastructure. Otherwise, surgeons will continue to work in outdated theatres and crumbling buildings that hamper their ability daily to get on with the job of treating patients. You can’t deliver 21st-century care in 20th-century facilities.’
In the meantime, attention inevitably now turns to the imminent 10 Year Health Plan and NHS Long Term Workforce Plan refresh in the autumn, which healthcare leaders say must set out robust plans to meet growing demand for NHS resources and prioritise workforce retention.
IMPORTANT LINKS
MORE FROM COGORA
© Cogora 2025
Cogora Limited. 1 Giltspur Street, London EC1A 9DD
Registered in the United Kingdom. Reg. No. 2147432
