A senior NHS comms source told PRWeek: "The NHS has been living hand-to-mouth since 2010. There has been a long-running comms battle between the Government and NHS leaders over the critical issue of how much funding to give the NHS, to the point where it now feels like there is open warfare between Number 10 and NHS leaders. This is likely to continue until the issue of a long-term settlement for the NHS is addressed."
The Chancellor, Phillip Hammond, announced last week that £350m would be ploughed into the NHS immediately to support services over the winter, while a further £1.6bn would be paid in 2018/19, followed by £850m in 2019/20.
But in a sign of the growing independence of NHS comms from central government, organisations – including NHS England, the NHS Confederation and NHS Providers – went on the offensive in the days following the Budget announcement.
Niall Dickson, chief executive of the NHS Confederation, called the Budget a "missed opportunity" that fell short of what is needed to relieve "massive pressure" on the NHS.
Meanwhile, Chris Hopson, chief executive of NHS Providers, said that while the extra funding is welcome and more than some people had expected, it was "disappointing" that the Government had not given the NHS what it needed to cover rising demand and meet performance targets.
NHS leaders have begun to make the case that the service will have to consider what services it can offer in the light of what it regards as a major shortfall.
Daniel Reynolds, director of comms at NHS Providers, said: "While the extra money is welcome, it leaves the NHS with some very hard choices about what it can and can’t deliver. There is now a public debate to be won around what level of funding we give the NHS over the long term, because the current level of service for the public will be hard to maintain."
Reynolds said the NHS now had to unpack the funding package to help the public understand what was at stake.
He continued: "The public could be forgiven for thinking the NHS has been given a generous settlement, against a challenging economic backdrop, but the reality is that waiting-time targets will be hard to recover and vital areas such as mental health and cancer care may suffer. It is important that the NHS is not seen by the public to be getting extra money, compared with other parts of the public sector, and then squandering it, when the reality is that we continue to fund the NHS below the required levels."
Comms, said Reynolds, was key to protect the reputation of the NHS from those who would seek to undermine it.
He concluded: "There will continue to be politicians and parts of the media that seek to run down the NHS, so it's vital that, as communicators, we demonstrate the high quality and efficient care that frontline services continue to provide – despite being under huge pressure."