Many staff groups – including teachers, nurses, ambulance workers, barristers, civil servants, junior doctors and consultants – deemed the situation untenable and voted to strike, making pandemic recovery more difficult again. The government has resolved some of this industrial action (though, crucially for hospital performance, not with junior doctors and consultants), but Performance Tracker 2023 finds that the government’s approach likely extended strikes’ duration and so their level of disruption.

For years, the government has prioritised short-term decisions and pushed problems into the future. The result is a ‘doom loop’ where perpetual crises in public services put more pressure on staff and focus government attention on getting through the next news cycle, rather than prudent longer term thinking.

Current spending plans will likely mean further declines in performance

When it was first announced, the 2021 spending review (which runs until the end of 2024/25) looked relatively generous. But higher than forecast inflation and pay deals has gradually eroded that generosity. The government topped up some services – the NHS, schools, and adult social care – at the 2022 autumn statement, leaving the rest to make do with cash settlements that are now worth far less than in 2021. We forecast that of the nine public services we cover, only police has sufficient funding to return to pre-pandemic performance levels by the end of this spending review period. Even then, that is only because of a relatively high settlement in the three years before 2021.

The outlook for the next spending review is worse. Both parties have committed to plans which see resource spending rise by 1% in real terms per year. Given commitments on the NHS Long term workforce plan, defence spending and foreign aid, that implies average cuts of 1.2% per year in real terms for other public services.