Accelerating NHS net zero goals through medicine carbon footprinting

By Samantha Semmeling

With medicines accounting for a quarter of the NHS carbon footprint, Nazneen Rahman, Founder of YewMaker and co-creator of MCF Classifier, explains how AI-driven medicine carbon emissions data can support practical, scalable strategies that align clinical excellence and environmental stewardship.

The climate crisis is resulting in acute and chronic health challenges, which are putting pressure on global health systems. In turn, the healthcare sector is estimated to account for 5 per cent of global greenhouse gas emissions. This places a unique responsibility on the sector to both manage these impacts and reduce its contribution to climate change.

More than 20 countries have committed to delivering net zero health systems. In the UK, the Health and Care Act 2022 embedded the commitment for the NHS to become net zero by 2045 into legislation, making it the first health system worldwide to do so.

Progress on sustainable medicines

Medicines make a sizeable contribution to the NHS’ carbon footprint (an estimated 25 per cent), so a comprehensive strategy to reduce medicines-related emissions is necessary for the NHS to reach its net zero goals.

The NHS is already making headway. Green plan guidance now recommends that systems and trusts use lower carbon inhalers and anaesthetics, which has already seen successful uptake.

However, of the 25 per cent attributed to medicines, inhalers and anaesthetics only account for 5 per cent. The remaining 20 per cent comes from the manufacture and supply of the billions of medicines prescribed across the NHS every year.

Progress on reducing these emissions has been hindered by a lack of accessible product-level emissions data. Manufacturer data is rarely made available and is not standardised, making it difficult to use as a baseline for carbon reduction strategies.

MCF Classifier – Medicine emissions data at scale

YewMaker creates science-based solutions to help make healthcare more sustainable. Chief Executive Officer, Nazneen Rahman and Chief Technology Officer, Haroon Taylor saw an opportunity to harness industry standards in green chemistry, using AI and data science to develop a standardised methodology for calculating the carbon footprint of individual medicines. The resulting technology suite, MCF Classifier (MCF = Medicine Carbon Footprint), provides data and tools that enable the manufacture, supply, emissions, procurement, and prescription of medicines to be carbon-informed.

“We developed MCF Classifier to make medicine emissions visible, consistent, and usable,” says Nazneen. “Without that foundation, it’s difficult for anyone – whether in procurement, policy or practice – to take meaningful action.”

The methodology behind MCF Classifier has been peer-reviewed and published, bringing transparency and credibility to an area where data has been limited and inconsistent. Research using MCF Classifier has shown wide variation in medicine carbon footprints across all therapeutic areas, highlighting significant opportunities for carbon-informed decisions in procurement, supply chain planning, and prescribing.

YewMaker is now building MCF Classifier tools and products to drive awareness and action. MCF Formulary, supported by NHS funding, provides standardised per-dose carbon ratings for thousands of medicines through a free, user-friendly web portal. It allows healthcare practitioners to explore the relative carbon impact of medicines and integrate sustainability into medicine optimisation strategies.

For manufacturers and suppliers, YewMaker uses MCF Classifier to deliver a range of data products and services, including product carbon footprint reports, large-scale emissions analyses, portfolio-wide carbon assessments, and therapy emission comparisons. These support organisations to understand and mitigate the carbon impact of their medicines and to meet reporting requirements.

Advancing NHS net zero goals

The NHS has committed to reach net zero by 2045 for emissions influenced through the procurement of goods and services, including medicines. To help suppliers align with this goal, the NHS has developed a roadmap outlining key milestones. By 2027, all suppliers are required to publish a Carbon Reduction Plan, and by 2028, they must provide carbon footprint data for individual products.

Reducing supply chain carbon emissions will be essential. However, delivering on these targets will require practical and proportionate approaches. Nazneen highlights the importance of ensuring that new expectations, such as product-level carbon reporting, are introduced in ways that support, rather than disrupt, medicines supply. Tools like MCF Classifier can help by providing suppliers with accessible, consistent data that supports engagement without creating unnecessary complexity or burden.

Nazneen emphasises that carbon data should not be seen as a compliance exercise, but as a resource to support informed, balanced decisions. As understanding of product-level emissions improves, suppliers will be better placed to identify areas for reduction while maintaining stability and quality across the supply chain.

Improving the sustainability of the medicines supply chain will require coordinated efforts among multiple stakeholders. Collaboration at the organisational, sectoral, national and global levels will be essential in creating a supply chain that is not only resilient and cost-effective but also environmentally responsible.

By embedding carbon considerations into decision-making, the NHS can continue to lead in aligning clinical excellence with environmental sustainability and take meaningful steps towards delivering a net zero health system.

Further information

Dr Nazneen Rahman is CEO and Founder at YewMaker, a purpose-driven business building science-based sustainable healthcare solutions, and the Executive Director of the Sustainable Medicines Partnership action collaborative.

If you are interested in this topic or PPP’s pharmacy and medicines work more broadly, please contact Samantha Semmeling, Policy and Programmes Manager, Public Policy Projects (samantha.semmeling@publicpolicyprojects.com).

Benefits of single-handed care highlighted at new qualification launch

By Integrated Care Journal

Level 2 Proportionate Single-Handed Care qualification formalises single-handed care principles into Ofqual regulated training for the first time. The qualification counters the misconception that it is unlawful to provide moving and handling care activities with less than two handlers.

Leading figures in the social care sector, including representatives from Care England, Department of Health and Social Care and the NHS, came together at the House of Lords on Wednesday 2 April for the launch of the Level 2 Proportionate Single-Handed Care Qualification, developed by the Royal Society for the Prevention of Accidents (RoSPA) and A1 Risk Solutions Ltd.

The event was hosted by RoSPA Vice President Baroness Watkins of Tavistock, who reflected on how her own background in nursing has demonstrated both the importance of greater recognition of care workers’ skills, and the need for improved pathways to developing them.

Watkins said: “Working as a nurse myself gave me firsthand experience of how care workers are the backbone of our health and social care system, delivering care, kindness and support to hundreds of thousands of people on a daily basis. Despite the increasing demand for social care, with requests for support from new clients reaching over two million in 2023-24, the vital contributions of care workers often go unrecognised.

“The qualification not only benefits individual care workers by enhancing their skills and job satisfaction but also promotes privacy, independence, and flexibility for service users. It ensures that care is delivered effectively, safely, and with dignity, without compromising the health and wellbeing of either party.

“By investing in our care workers, we are investing in the future of our health and social care system.”

In her keynote address, RoSPA Chief Executive Rebecca Hickman explained how the new qualification builds on the charity’s commitment to ensuring the highest health and safety standards across the whole of society.

Rebecca Hickman said: “The Level 2 Proportionate Single-Handed Care Qualification is a new addition to RoSPA’s suite of highly respected training qualifications for the social care sector, such as our Level 2 Adult Social Care Certificate and our Level 3 Award for Safer People Handling Trainers.

“Developed in collaboration with key partners and supported by sector leaders, this qualification is designed to enhance the skills and knowledge of professionals, empowering them to deliver safer and more effective care.

“This qualification is based on the latest evidence and best practice. By setting high standards, recognising excellence, and delivering comprehensive training, RoSPA continues to lead the agenda in making society safer for everyone.”

The Level 2 Proportionate Single-Handed Care qualification is the first time the principles of single-handed care has been formalised into an Ofqual regulated training programme.

Proportionate/single-handed care encourages a more personalised approach to supporting a person’s moving and handling requirements. This ensures the person receives the optimum amount of care and support in the correct environment. By enabling individuals to do as much for themselves as possible, proportionate/single-handed care reduces the likelihood of them becoming deconditioned and being readmitted to hospital or admitted to long-term care. This also has the benefit of freeing up capacity across the wider health and social care system.

Alongside training staff in areas such as risk assessment and the practical delivery of safe moving and handling, the qualification counters the misconception that it is unlawful to provide moving and handling care activities with less than two handlers. Care should not be over prescribed and should be proportionate to the needs of each person to ensure that it does not foster dependency.

Find out more about the Level 2 Proportionate Single-Handed Care qualification.

Acute Care, Community Care, Featured, News, Secondary Care April 10, 2025

Embedding social prescribing in secondary care: A toolkit from Barts Health

By Gabriel Blaazer

Barts Health NHS Trust and its partner organisation, Transformation Partners in Health and Care, have released a toolkit detailing their pioneering work embedding social prescribing in secondary care and specialist acute pathways. The toolkit aims to help providers address unmet social needs, improve patient outcomes and reduce demand on acute services, shaping a holistic, prevention-focused model for the future NHS.

Social prescribing attempts to address the social determinants of health. These are the non-medical factors influencing 84 per cent of a person’s total health, with clinical care impacting the remainder. Social determinants of heath include income security and employment, education, housing and food insecurity, or social isolation.

Introduced in England in 2018, it typically involves signposting or referrals to appropriate services, but can also include emotional and mental health support for people experiencing social isolation or low-level mental health issues. Social prescribing is a holistic, person-centred and preventative approach and as such, is a key enabler of the government’s efforts to shift more care into the community and bolster prevention initiatives.

Emerging evidence suggests that social prescribing is an effective, yet low-cost, preventative intervention. However, its implementation has been more frequent in primary and community care, compared to secondary care. In 2023, Barts Health NHS Trust (Barts Health), one of Europe’s largest acute healthcare providers, started implementing social prescribing across multiple pathways, using different integration models to support a whole system approach to prevention and personalised care.

These services, delivered by social prescribers in collaboration with clinical and wider multi-disciplinary teams, support residents with their social needs while aiming to reduce demand on high-pressure services, including cardiovascular (CVD), renal, emergency care, and children and young people’s (CYP) services.

Encouraged by positive outcome data, the Trust and its partner organisation, Transformation Partners in Health and Care (TPHC), have developed a toolkit to help secondary care services embed social prescribing, public health and other community-led prevention initiatives within their specialties and pathways. The toolkit serves as a practical guide and checklist for secondary care providers looking to implement social prescribing and explore integrated, whole-system approaches to prevention.

Addressing unmet needs

While NHS England has established a standard model for embedding social prescribing, this has primarily focused on integration within primary care. In 2023, Barts Hospital’s Endovascular Team, led by Vascular Surgeon Dr Tara Mastracci, identified a high prevalence of unmet social need among patients in the hospital’s cardiovascular pathway – a well-evidenced correlation. Given that CVD disproportionately affects socially deprived populations, Dr Mastracci theorised that integrating social prescribing could benefit those at highest risk, simultaneously alleviating pressure on the pathway and improving patient outcomes.

A key data point supporting the use of social prescribing in secondary care was the gender split between typical users of social prescribing services and those presenting with acute cardiovascular issues. While 84 per cent of patients within cardiovascular pathways were men, 60 per cent of social prescribing users were women. Research has shown that women consult primary care services 32 per cent more frequently than men, suggesting that secondary care could play a central role in engaging men, who might otherwise remain underserved by traditional social prescribing models.

“Overall, we have found that we encounter a different group of patients compared with those who access social prescribing in primary care.”

Dr Tara Mastracci, Endovascular Lead for Complex Aortic Surgery, Barts Health

This reinforced Dr Mastracci’s belief in the merit of social prescribing within secondary care – clearly, more effort was needed to engage men, particularly for CVD patients who could benefit from greater social support.

Building a collaborative approach

Several specialties within the Trust had also identified unmet social needs as a key driver of service demand, and had begun implementing social prescribing programmes within their pathways. However, these initiatives were siloed, staff-led and reliant on temporary funding or fixed grants. To enhance collaboration and sustainability, Dr Mastracci established a multidisciplinary network of staff across primary and secondary care to drive a more integrated and formalised approach.

Finding limited guidance on implementing social prescribing within secondary care, Dr Mastracci’s CVD team set out to develop a replicable model for implementing it as part of secondary care pathways. Keen to apply the same rigorous standards as with a medical intervention, the team partnered with health economists at the University of East London. They incorporated EQ-5D instruments and QALY (quality-adjusted life years) metrics to evaluate the potential impact of social prescribing on both patients and the wider health and care system.

Recognising the need for greater institutional knowledge and community expertise, the team also partnered with the Bromley by Bow Centre (now Bromley by Bow Health), a leading VCSFE (Voluntary, Community, Social, and Faith Enterprise) community health organisation. This collaboration led to the embedding of a social prescriber within the hospital’s heart attack pathway, screening patients entering the pathway for financial or other social needs.

Implementation and outcomes

Once identified, social prescribers provided patients with six to eight support sessions, connecting them to local services and community groups tailored to their specific social needs. Beyond financial deprivation, patients received support for needs including housing, talking therapies, and healthy lifestyle support such as smoking and alcohol cessation, or physical activity and weight management – all of which play key roles in determining a person’s risk of developing CVD-related conditions.

The social prescribers were drawn from diverse backgrounds and communities, to work in collaboration with clinicians and consultants from secondary care, patient advocate groups, VSCFE organisations and others. This multidisciplinary approach facilitated a holistic and patient-centred approach. The experiences and lessons from creating the CVD social prescribing pathway were later used to inform other specialties as they implemented similar services within their pathways.

“We believe strongly in the importance of ‘place’ and thus many of our social prescribers meet patients in the community where they live to engage and provide support.”

Dr Tara Mastracci, Endovascular Lead for Complex Aortic Surgery, Barts Health

Dr Mastracci acknowledges that it will take years to fully assess the impact of Barts Health’s social prescribing programmes. “We know these target groups are admitted at higher rates than their peers,” Dr Mastracci told ICJ, “but it will take years to evaluate the long-term effects.”

Despite this, early results have been promising, notably within children and young people’s (CYP) diabetes services. Led by Dr Myuri Moorthy, Diabetes Consultant and Clinical Lead for Young Adult Diabetes (YAD) at Barts Health, clinicians in the pathway had noticed a concerning increase in non-adherence to self-management protocols, often linked to concurrent financial and psychosocial issues. The service also saw high numbers of patients not attending appointments (DNAs), largely due to distress, burnout, and the intense mental health toll associated with diabetes.

Poor diabetes self-management is well known to increase the likelihood of complications. This prompted the diabetes team to adopt a co-designed and personalised model, including a multi-disciplinary team of social prescribers, youth workers and a psychologist. The aim of the YAD Social Prescribing Service was to improve patient engagement, reduce DNAs and maximise the impact of each clinical appointment.

Together with service users, the team co-developed a series of interventions, including monthly peer support meetings, a WhatsApp group and a ‘walk and talk’ group, securing funding from NHSE for two and a half years. During this time, the team successfully:

Reduced the DNA rate across the Trust from 39 per cent to 12.5 per cent
Cut diabetes-related hospital admissions of CYP by 36 per cent across all Barts sites
Generated financial savings of an estimated £62,500 per year across the Trust

More outcomes from the prevention initiatives across Barts Health, including economic and demand savings, stronger integrated community networks and improved outcomes and patient experience, can be found on pages 26-30 of the toolkit.

Gaining leadership buy-in

As with many prevention-based interventions, the impact of social prescribing on health and care systems can take years to fully assess. In its paper on integrated neighbourhood teams (within which social prescribers typically sit), The National Association of Primary Care suggests that “savings will be non-cash releasing, but this is not as issue as what is required is capacity and health improvement.” However, this long-term approach does not easily align with NHS funding cycles, which typically require demonstrable return on investment within 12 months.

Currently, all of Barts Health’s social prescribing pathways are funded individually, on an ad hoc basis. The CVD project, for example, was initially funded by NHSE, but is now supported by Barts Charity. To move towards trust-wide funding, TPHC’s Secondary Care Project Manager, Mollie McCormick, emphasises the need to develop:

Robust databases and coding frameworks to accurately track interventions and outcomes over time
Qualitative data collection from patients benefiting from social prescribing, with an emphasis on reduced need for healthcare services and thus cost savings

Bridging the gap between identifying social needs that drive demand and demonstrating short-term cost savings remains a challenge. However, securing the backing and support of senior clinical leadership is critical in building the case for long-term investment.

For social prescribing initiatives to gain trust-wide funding in future, structural changes are needed to prioritise long-term prevention and strengthen outcomes-based commissioning. Different approaches could involve integrated care systems incentivising prevention by:

Setting realistic and appropriate prevention targets for NHS trusts to influence commissioning decisions towards the implementation of personalised care and prevention initiatives
Introducing penalties for avoidable readmissions

These targets could be assessed by monitoring readmission rates for specific condition cohorts or high-demand service areas, ensuring a measurable focus on prevention.

The toolkit: Embedding and Connection Prevention in Specialist Care

Barts Health and Transformation Partners in Health in Care have now published their toolkit, Embedding and Connecting Prevention in Specialist Pathways. Along with background information on the benefits of social prescribing and community-led prevention, the toolkit addresses some of the key systemic barriers that Barts Health encountered while implementing initiatives across various pathways and specialties.

Using case studies and the first-hand insights from patients, social prescribers and clinicians, the toolkit offers practical guidance for those looking to implement community-led prevention approaches, such as social prescribing, in secondary care. It also provides an overview of key Barts Health prevention networks and identifies the leaders driving this work across the Trust. The toolkit offers a valuable resource for anyone working in an acute setting wanting to embed social prescribing into their services or to prioritise the prevention of ill health in NHS Trusts across London and nationally.

Social prescribing: A key enabler of NHS prevention goals

Emerging evidence strongly supports social prescribing as a cost-effective intervention for tackling the wider determinants of health and addressing the often-overlapping health inequalities that contribute to high demand for NHS services.

Further, as the government seeks to move more care from hospitals to communities as part of its ‘three shifts’, initiatives like social prescribing will be increasingly vital. By reducing pressure on secondary care services and helping local systems meet their financial and operational goals, social prescribing plays a crucial role in shaping the future of preventative, person-centred and sustainable healthcare.

Special thanks to Dr Tara Mastracci, Endovascular Lead for Complex Aortic Surgery at Barts Health, and Mollie McCormick, Secondary Care Project Manager at Transformation Partners in Health and Care, for their time and input in developing this article.

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UK digital health company launches Prevention Innovation Fund to support ICSs

By Integrated Care Journal

Holly Health has announced a £320,000 fund, offering systems access to psychology-based digital health services, enabling system leaders to move forward with prevention initiatives.

Long-term conditions (LTCs), mental health challenges, and multimorbidity rates are rising, with lifestyle risk factors the biggest cause. This is impacting system costs (£18.4 billion, or over three quarters of NHS expenditure, is spent on long-term care per year) and workplace sickness (38 per cent of people of working age on long-term sickness, report having 5 or more LTCs). The vast majority of people living with these challenges currently get no tailored support for lifestyle health improvement.

Holly Health has today announced a £320,000 Prevention Innovation Fund, offering up to four integrated care systems (ICSs) (or equivalents in Scotland and Wales) up to £80,000 credit each towards deploying a proven, psychology-based digital health coaching service, to increase self-management support across their region.

The goal of the fund is to help NHS system leaders to move forward with large scale prevention initiatives efficiently, supporting progress towards the three new UK healthcare strategy ‘shifts’, from treatment to prevention, hospital to community and analogue to digital.

Holly Health is a fully digital, yet personalised, health coaching service which supports patients to develop sustainable health habits across mental and physical health and most lifestyle risk factors.

Backed by the NHS Innovation accelerator, and with more than 200 GP practices partnerships around the UK, Holly Health outcomes show significant average health improvements across areas like exercise, mental wellbeing, weight and blood pressure. Additionally, GP appointments show consistent reductions after using Holly Health, especially in more frequent service users.

Steve Woodford, NHS Non-Executive Director at NHS England, said: “The NHS has an opportunity to shift towards a proactive, preventive and personalised care system, with the help of technology. Services like Holly Health can help to drive these changes affordably and efficiently. This is a great opportunity for ICB teams, enabling scalable self-management support for people living with or at risk of long-term conditions.”

There are two main ways in which ICSs will be able to launch Holly Health at scale. One is via traditional routes, deploying Holly Health via primary care and public health services. The second, a route fit for the future NHS, is to launch Holly Health to members of the public, via the NHS App, made possible by a brand-new collaboration between Holly Health and Patients Know Best, also announced today.

Patients Know Best (PKB) is the UK’s leading personal health record platform, enabling patients to access and contribute to their health records using the PKB website and via the NHS App. The new Holly Health and PKB integration allows the Holly Health digital health coaching service, and PKB records to ‘speak’ to each other, so that members of the public can transfer blood pressure readings and lifestyle health data into their personal records. ICS teams will also have the new opportunity to reveal access to Holly Health coaching, via PKB and the NHS app, supporting the government’s vision for a single place for people to manage their health.

Grace Gimson, chief executive at Holly Health, said: “We’re extremely excited to make this double announcement: the launch of our Prevention Innovation Fund, and go-live of our partnership with PKB. Both have the potential to drive huge systemic changes in UK healthcare, driving prevention and personalised patient care forward, at population scale.”

Mohammad Al-Ubaydli, chief executive at PKB, said: “Holly Health’s pioneering approach to preventative care, perfectly complements PKB’s mission of empowering patients with their health data. Together, we’re creating a seamless experience where patients can proactively manage their wellbeing and maintain a complete, holistic view of their health, all in one place to share with whoever they need to.”

ICSs, and their equivalents in Scotland and Wales, wishing to find out more about the Prevention Innovation Fund, and to apply, should contact hello@hollyhealth.io.

Catherine Davies, Director of Digital Healthcare Council, commented: “Holly Health’s new Innovation Fund is a great opportunity for NHS systems to deploy evidence-based solutions at scale. Their digital health coaching helps accelerate the Government’s three shifts, particularly from treatment to prevention, delivering measurable outcomes for the NHS while empowering patients to take control of their health.”

Health leaders call for national redundancy pot to fund NHS job cuts

By Integrated Care Journal

NHS leaders are urging the Chancellor to rapidly create a national staff redundancy fund to smooth the pathway to the major budget cuts they are being required to make this year by the government.

Integrated care boards (ICBs) have been charged with cutting their running costs by 50 per cent from October 2025, with individual plans to be submitted for government approval by the end of May 2025. Alongside this, NHS trusts have been told to reduce their “corporate cost growth” by half the amount from the year before the pandemic.

But without a national fund that NHS trusts and ICBs can access, NHS leaders say the redundancy programme will take much longer to deliver and will reduce the level of savings from job cuts that can be delivered this year.

This would mean that the NHS would then start the following financial year, the point at which the government’s Ten-Year Plan for Health would begin its implementation, in a state of financial deficit. Health leaders fear that doing this would put the reform agenda, including the commitment to reduce waiting times to 18 weeks by the end of Parliament and to shift more care into the community, at risk.

While recent media reports have suggested up to 30,000 roles across the NHS could be removed, including through the planned abolition of NHS England, and that the total bill could reach £1bn, the NHS Confederation has heard varying figures from leaders on the extent of their expected cuts.

Some leaders of NHS trusts have said they are each looking to cut between 200 and 500 roles, while some ICB leaders have said they are likely to remove anywhere between 300 and 400.

Several trust leaders said that they were budgeting for around £12m worth of redundancy payouts and associated costs.

When looking at the proportion of the workforce that could be removed across NHS trusts, individual estimates from leaders have varied from 3 per cent to more than 11 per cent.

Health service leaders have warned that without access to a dedicated redundancy fund, as was confirmed for NHS England staff in its abolition in the Spring Statement, the process of scaling down will take much longer than the government has asked.

If they are forced to provide the necessary payouts from their own budgets, they say the process will be markedly slowed down and risks stalling the efficiency savings they can make. Recent analysis has already revealed that the gap between trusts’ regular income and expenditure is £6bn, and that this underlying deficit could derail the government’s reform plans.

One NHS trust CEO said: “Essentially, without clear guidance on underwriting redundancy options, whether these are voluntary, mutual, or compulsory, we are dependent on natural turnover and … [other] processes, which are slow and cumbersome.

“Accelerating savings would be possible if the underwriting of impacts could be funded within the year.”

Another said: “We are not planning a redundancy programme as it will be unaffordable, our plan is to reduce headcount through natural turnover although this puts a level of risk on delivery.”

Matthew Taylor, Chief Executive of the NHS Confederation, called on the government to commit to urgently establishing a redundancy fund for NHS trusts and ICBs. He said: “Health leaders understand the troubling financial situation facing the country and the need to improve efficiency where they can, as they have already demonstrated by significantly reducing their planned deficit for the year ahead.

“However, the scale and pace of what has been asked of them to downsize is staggering and leaves them fearful of being able to find the right balance between improving performance and implementing the reforms needed to put the NHS on a sustainable footing.

“They have told us that unless the Treasury urgently creates a national redundancy fund to cover these job losses, any savings the government hopes to make risks being eroded, at best and completely wiped out, at worst. If the Ten-Year Plan for Health is to be realised, it requires the NHS to be in a position of financial stability.”

The call from NHS leaders to create a national redundancy fund comes as the government finalises its Ten-Year Plan for Health as well as the three-year funding settlement that will be announced as part of the Spending Review in June.

NHS leaders anticipate the settlement will be much less than the long term historical average increase of around 4 per cent per year with the government’s latest Spring Statement already revealing that the funding increase for 2026/27 will drop to 1.8 per cent in real terms.