No new money was announced for the NHS as the chancellor vowed to stick with her policy of stabilising public finances.

Director of policy, Dr Layla McCay, said NHS Confederation and NHS Providers ‘wholeheartedly' agreed with the stability strategy but warned the financial context for the NHS had changed ‘significantly' since the Autumn Budget due to strike action, increases to medicines spending and potential inflation due to conflict.

Dr McCay added: ‘NHS organisations are coming under severe financial pressure, with leaders warning of cuts to services and staffing levels. Already several integrated care boards expect to end this financial year in deficit despite major efficiency savings and productivity gains. The Office for Budget Responsibility specifically highlights the risk of further industrial action across the NHS as a "significant risk" to departmental spending plans.'

The policy director said increasing financial pressures raised ‘very difficult questions' about how services will meet rising demand while pursuing the Government's ambitions for long-term transformation, adding: ‘Recent improvements in elective and cancer care show what targeted investment can achieve. Growing financial pressures, without fresh Government commitments, are putting this momentum at risk.'

Unison general secretary Andrea Egan said: ‘Any improvement in the nation's finances must be invested in essential services and the staff who provide them.

‘Right now, from the NHS to local councils, services are stretched to breaking point - asked to do more with less just when the country needs them most. That cannot continue.'

US trade deal

Nuffield Trust senior policy analyst, Sally Gainsbury, said the recent trade deal with the US had ‘put the uncertain promise of economic growth above the interests of the NHS and the health of the population as a whole'.

‘The Government has still not published the full details of the deal, but the implications are clear: the NHS will have to pay much more for new branded medicines and will only be able to afford that by reducing spending on other forms of care, including general practice and the treatment of patients on the waiting list,' Gainsbury added.