Committee publication · Estimate memoranda · 29 April 2026
DHSC Main Estimate Memo 2026/27
Summary
DHSC's 2026-27 Main Estimate requests £212.3 billion in Resource DEL (day-to-day NHS spending), £13.9 billion in Capital DEL (infrastructure investment), £16.5 billion in Resource AME (provisions and depreciation), and £208 million in Capital AME. Resource DEL rises £1.6 billion (1%) from 2025-26, driven by the Autumn Budget 2025 settlement of £9 billion, offset by reclassification of £6.2 billion depreciation costs to AME. The department plans £9.1 billion annual efficiencies by 2028-29, including NHS 10 Year Health Plan productivity targets and NHS England headquarters headcount reduction of 50%.
Key findings
- Resource DEL of £212.3bn (up £1.6bn, 1% from prior year); includes £9bn uplift from Autumn Budget 2025 offset by £6.2bn depreciation reclassification to Resource AME
- Capital DEL of £13.9bn (up £313m, 2%) to deliver largest-ever health capital budget, representing 20% real-terms increase by 2029-30 and 75% increase vs 2019 levels
- £9.1bn annual efficiencies planned by 2028-29: £8.95bn from NHS productivity (2% annual growth target) plus £121m from DHSC and 12 ALBs via digital, estate rationalisation, and automation
- NHS Agenda for Change pay award of 3.3% for 1.4m staff from April 2026 (£12m cost absorption); funded within existing settlement via productivity gains, with no frontline service cuts
- £430m ring-fenced restructuring budget for 2026-27 (matched to 2025-26) to facilitate NHS England integration into DHSC and wider NHS reform; 50% planned reduction in NHS central headcount
Tone
ProceduralTopics
Key actors
Department of Health and Social Care (DHSC), NHS England, NHS Providers, NHS Resolution, Samantha Jones OBE, HM Treasury, Department Accounting Officer
Notable line
“The Government's ability to fund this pressure within the existing settlement is underpinned by the ongoing productivity and efficiency requirements placed on ICBs and providers.”
Key Quotes
“At Autumn Budget 2025, Resource DEL for 2026 ‑ 27 was set £9.0 billion higher than for 2025 ‑”
“The department plans to deliver £9.1 billion of annual efficiencies by 2028-29. The NHS productivity plan accounts for £8.95 billion of these planned efficiencies, which is underpinned by a target of 2% annual productivity growth across the SR period within the NHS.”
“As part of these plans, there is an ambition to deliver a substantial reduction in central headcount, with the NHS 10 Year Health Plan for England planning a reduction in central headcount by 50% by combining NHS and the DHSC.”
“This additional pressure above affordability will be managed by DHSC and ALBs (including NHSE central budgets) but none of the pay increases will be paid for by cutting frontline services.”
“Autumn Budget 2025 confirmed that DHSC's capital budgets will rise to £15.2 billion by the end of the Spending Review period (2029-30), to invest in the NHS and wider health infrastructure. This will deliver the largest ever health capital budget, representing a more than 20% real terms increase by the end of the SR period.”
Source · parliament.uk record ↗