In its new report The NHS Alliance called for political backing ahead of difficult trade offs in the year ahead.

Chief executive Sir Ciarán Devane said: ‘NHS leaders across the system need financial support to mitigate the impact of additional pressures such as rising inflation and industrial action – costs that are not factored into the 2026/27 budget. And, finally, they believe political and national leaders can help by being clear and consistent about what the NHS needs to achieve this year - balancing financial imperatives, improving performance, and transforming the way care is delivered.'

The report's key findings include:

• 76% of trust and ICB respondents said finances would be even tougher this year (2026/27) than last year
• 64% said they expected to cut or reduce services
• 57% expected to reduce clinical staffing
• 64% said that they were concerned about patient experience
• 83% were worried about the impact of financial measures on planned care and 78% were worried about the effect on emergency care
• 93% said they were worried about staff morale

nearly all (96%) GP respondents were worried about the impact of financial measures on on-the-day access, with a growing proportion (91%) expressing concerns over routine and proactive care and 91% worried about staff morale.

Unison head of health Helga Pile said: ‘Repairing years of underfunding and neglect will take time and investment. The long-term safety of the NHS can only be secured with sustained support.'

A Department of Health and Social Care spokesperson said: ‘We recognise the challenges NHS leaders face, but this Government has supported the health service with record investment, boosted productivity, and driven improvements in tech.

 

‘Waiting lists are at their lowest level in more than three years, and over half a million fewer people are waiting for treatment since July 2024. We've also expanded community diagnostics, surgical hubs and GP appointments to get patients seen faster.  

 

‘We will continue working closely with system leaders to improve productivity, cut waste and reinvest in frontline care so patients benefit from faster, higher-quality services.'