Budgets and fiscal events

The UK’s major fiscal events, which includes Budgets, Spring and Autumn Statements, and Spending Reviews, are where the Chancellor sets out major policy announcements for tax and public spending policy. 

Location: England
Updated: Monday 11 March 2024
NHS Structure Article Illustration

Spring Budget 2024


On 6th March 2024, Chancellor Jeremy Hunt gave his Spring Budget setting out new government economic policy for tax and spending, and the OBR (Office of Budgetary Responsibility) published its forecasts of the economic outlook for the next five years. You can read the budget in full here. This briefing sets out key details and highlights the implications of the government’s most recent decisions on tax and public spending for BMA members.

Key points for members

  • The Chancellor announced a significant NI tax cut from April 2024, which is worth up to £754 per person.
  • £2.5 bn additional funding for the NHS in England for 2024/25 compared to previous plans, meaning that NHS funding will not be cut in real terms between 2023/24 and 2024/25
  • £3.4 bn funding from 2025/26 for the NHS in England to improve IT alongside a commitment to improve productivity.
  • As a result of more departmental funding for the Department of Health and Social Care, there will be additional funding for nations through Barnett consequentials. The Scottish Government will receive nearly £300mn additional funding compared to what was previously planned in 2024/25, the Welsh Government will receive nearly £170mn, and the Northern Ireland Executive will receive £100mn.
  • Inflation is forecast to come down faster than expected, but otherwise the economic forecast remains mostly unchanged. Lower inflation is good news for real wages, but also implies lower overall wage growth and less tax revenue. The announcements in the Budget are largely funded by borrowing, and leave the Chancellor with very little wiggle room against his fiscal rules for any future borrowing or spending.
  • There was no detail or clarity on specific departmental spending beyond 2024/25. The Chancellor announced that the next Spending Review will be after the next election.

Previous fiscal events

2023 Autumn statement summary for members

This document provides a summary of the key takeaways from the 2023 Autumn statement set out by Chancellor Jeremy Hunt on 22nd November 2023.

Heading into this fiscal statement, the Chancellor had more money to play with (so-called ‘fiscal headroom’) than had been projected at the March Budget 2023. That is largely because wages were higher than expected, resulting in increased tax revenue.
However, inflation was also persistently higher than had been projected. As such, planned budgets for departments, including the department of health, are no longer worth as much in real terms.

The Chancellor could have used the additional fiscal headroom to ensure departmental budgets were protected from inflation and other cost pressures – but he didn’t. This means there was no new health funding, despite the large deficits in the NHS’ finances due to higher than expected cost pressures – Nuffield Trust estimates a £1.7 billion overspend by NHS England by the end of this financial year, compared to available funding.

The majority of additional spending power available was used for tax cuts and welfare payments instead. The biggest areas of spending were:

  • National Insurance rates were reduced for employees and the self-employed,
  • Businesses can claim tax write-offs against certain forms of investment,
  • The state pension and main unemployment benefits were increased, and there were major reforms to the way people with long-term health conditions or disabled will be treated.

It is also worth noting that the Chancellor did not leave much leeway for additional spending. In general Chancellors try and keep some funding available in case of shocks or emergencies, but this Statement left very little available compared to recent historical fiscal events.

2023 Spring budget summary for members

This document provides a summary of the key takeaways from the  2023 Spring budget. set out by Chancellor Jeremy Hunt on 15 March 2023.

Key points for members:

  • The Chancellor committed to changes to pension tax thresholds after extensive BMA lobbying. The annual allowance threshold will increase by 50%, from £40,000 to £60,000, and the lifetime allowance threshold – previously set at £1 million – has been completely abolished.
  • No new announcements made on NHS pay including no funding commitments made to address pay restoration for doctors or other healthcare staff.
  • The Chancellor announced the extension of the 30 hours of free weekly childcare available to parents in England to cover children below the age of three and to eventually cover all children from the age of nine months.
  • Additional support with energy bills was also announced with the Energy Price Guarantee – set to end in April 2023 – to be extended for another 3 months to July, when both energy costs and usage are expected to fall. There was no extension to the EBRS (Energy Bill Relief Scheme) for businesses, putting significant pressure back onto businesses – such as General Practices – to manage risk.
2022 Autumn statement summary for members

This document provides a summary of the key takeaways from the Chancellor’s 2022 Autumn statement on 17 November 2022.

Key points for members:

  • The Department of Health and the NHS were promised £3.3 bn per year in additional funding for day-to-day spending, but when adjusted for inflation, the amount of money the NHS has next year is still less than what was promised previously, in the 2021 Spending Review.
  • The Chancellor committed to publish a workforce plan setting out independently verified numbers of doctors needed over the next 15 years.
  • Changes to personal tax policy will reduce the take home pay of all workers, including doctors.
  • Overall, the cost-of-living crisis and dire economic picture will increase poverty and impact health, increasing pressure on the health system.
2022 Spring statement summary for members

This document provides a summary of the key takeaways from the Chancellor’s 2022 Spring Statement on 23 March 2022.

Key findings on health and social care funding:

  • no increases or decreases to health spending
  • there was confirmation that the new health and care levy will go ahead (although the threshold at which you start to pay it will be raised)
  • the NHS efficiency target will double from 1.1 per cent to 2.2 per cent and this will include a review of Arm’s Length Bodies including NHS England and NHS Improvement.
2021 Autumn budget and spending review

Chancellor Rishi Sunak announced the Autumn budget and spending review to Parliament on 27 October. Our briefing covers the need to know aspects for doctors, the NHS, social care and public health and our analysis.