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Spending on hospitals in England has risen since 2009/10, as has the size of the workforce. But the amount of work that hospitals are doing has risen faster. Hospitals have found ways of working more efficiently, meaning that they have been able to maintain the clinical standard of care in the face of growing workloads.

But these changes have not been enough to keep up with the growing cost of, and demand for, care. This has resulted in large financial deficits and longer waiting times for treatment. The new long-term funding settlement for the NHS announced in June 2018 may improve this situation, but will not fundamentally change it.