New NHS waiting times data out today. The share of patients waiting ≤18 weeks for elective care dropped a little in Apr, but is still (with rounding!) 65%. List size has gone up a bit. See my thread from last month on how the NHS pushed hard to reach the 65% intermediate target

The constant rumours around marginally different top ups to defence spending alongside the Defence Investment Plan over the last few months have been frustrating. As Max sets out, the DIP is just one part of the govt's overall plan to increase defence spending and capabilities

Lots of discussion in recent weeks about how to fund the (much-delayed!) Defence Investment Plan. While this is important, it is only the first step in the longer-term and much larger defence spending increase this government has committed to. A short thread:

Reaching the NATO defence spending commitment and increasing UK defence spending to 3.5% of GDP by 2035 would reshape the British state. Last week @maxwarner.bsky.social set out the big societal questions this raises at Treasury Select Committee @hoccommittees.parliament.uk.

It's really striking some of the changes in the NHS workforce in recent years. Overall staffing growth has slowed down a lot. Doctor and nurse numbers still rising, but other groups are seeing slow downs or even falls

My colleagues have a report out today on civil legal aid, an important part of the justice system. Restrictions to eligibility in 2013 brought down spending/caseloads. The # of legal aid providers has continued to fall over time, and more and more areas have no provider at all

We now have data for NHS staffing and hospital activity in England for all of 2025–26. There’s a lot of interesting things going on, so here’s a short thread on some of the key patterns. As the chart below shows, most staff groups and most types of activity are up year-on-year

IFS economists are giving evidence to the Treasury Select Committee twice this week: 🟢Tues at 9:45am: Kate Ogden on student loans 🟢Wed at 2:15pm: @maxwarner.bsky.social on defence spending Find out more about the sessions and how to watch here: committees.parliament.uk/committee/15...

Any PM and Chancellor will be constrained by the same set of fiscal challenges. In this episode @helenmiller.bsky.social @chrisgiles.ft.com and I explain the public finance backdrop - debt, borrowing, tax and spending plans - that will shape political choices over the coming years

If you like your economics to be reality-based, impartial and not always doom laden, listen to this @theifs.bsky.social podcast on the public finances with me @helenmiller.bsky.social and @maxwarner.bsky.social ifs.org.uk/articles/tou...

This is most striking figure from Millburn Review. They estimate that around half of the 18-24 population who are not in education, employment or training (NEET) are not claiming any benefits. This limits how effective any reforms to the benefit system can be in reducing the NEET rate.

It's still unclear what the shift to community will do in the NHS. But in a middle-income context, @bancalaria.bsky.social et al find that El Salvador's multidisciplinary community health teams increased preventative appts, shifted the mix of care and reduced preventable hospitalisations.

It wasn’t the biggest story yesterday, but the NHS in England hit its intermediate target that 65% of patients should be waiting 18 weeks or less for elective care by Mar26. That’s after big recent improvements from 61.5% in Jan to 65.3% in March. So how was this achieved?🧵

It wasn’t the biggest story yesterday, but the NHS in England hit its intermediate target that 65% of patients should be waiting 18 weeks or less for elective care by Mar26. That’s after big recent improvements from 61.5% in Jan to 65.3% in March. So how was this achieved?🧵

Here is our summary of the parties' plans for the Scottish NHS. A lot of consensus on e.g. more primary care and prevention. Some parties have set out plans for total health spending, but they imply quite slow growth - reflecting the tough fiscal reality faced by the next govt

One thing I find really striking on defence spending: the Strategic Defence Review was meant to be deliverable with *slower* defence spending than currently planned. The govt accepted all its recommendations. But it's long looked very ambitious to deliver within spending plans

Important work from my colleagues. If you care about wealth inequality, you need to be able to measure wealth well. That's hard. With an improved methodology, it looks like wealth gaps by age were smaller than official statistics would suggest

Do listen to our latest podcast on the challenges facing the next Scottish government. One is that public services, inc. the NHS, are still struggling to recover from the pandemic. Hospital activity, for example, is still below pre-pandemic levels, unlike in England or Wales

I'm looking forward to taking part in this event on NHS productivity on the 30th April - do sign up to come along

We have just updated our @theifs.bsky.social public spending tool. It allows you to explore how and where the government spends its money in the UK, now up to 2024-25. You can check it out here: ifs.org.uk/calculators/...

A year ago we published @theifs.bsky.social analysis of whether and how the govt could hit their 18 week waiting time target. Performance has improved over the last year, and lies between our scenarios. Things could change, but it still doesn't look like we are on track for 92% by 2029

NEW: How is the Welsh NHS performing, and how does it compare to England and Scotland? We have a new @theifs.bsky.social report out today looking at public service spending and performance in Wales, in advance of the Senedd elections. 🧵on the key Welsh NHS takeaways [1/10]

How is the Scottish NHS performing, and how does it compare to England and Wales? On Saturday we published a new @theifs.bsky.social report looking at public service spending and performance in Scotland, in advance of the devolved elections. 🧵on the key Scottish NHS takeaways [1/10]

The Spring Forecast confirmed that the Spending Review next year looks tough. Plans are currently for departmental spending to grow by just 0.9% per year on average in real terms in the next Spending Review period, much slower than planned for the first part of the parliament.

The government plans to reduce government borrowing by 2.5% of GDP over the next four years – a sizeable fiscal consolidation. The question is now one of delivery. And past experience clearly shows that promising lower borrowing is easier than delivering lower borrowing.

We at @theifs.bsky.social will be presenting our overnight analysis of the Spring Forecast from 10:30am. @nickridpath.bsky.social and I will present on the government's plans, the risks to their delivery and the broader UK fiscal position. You can watch online here: ifs.org.uk/events/sprin...

The OBR’s current budget forecast has barely changed, with borrowing still set to fall over the next few years. Past governments have often set out plans for a current budget surplus, but it’s very rare that they’ve achieved it. That will be the key challenge going forward.

Here it is, my magnum opus: an analysis of what’s wrong with the UK’s approach to fiscal policy (under this and previous governments), and a proposal for what an alternative to pass-fail fiscal rules could look like. I’ll follow up with a longer thread later.

Very pleased that our paper examining how doctors respond to changes to their pensions is now published in the Journal of Health Economics. We find that consultants in the English NHS responded to changes in their pensions similarly to how existing evidence suggests they may respond to pay.

There is an increasing sense that the UK's approach towards fiscal policymaking, and in particular the excessive focus on "headroom", isn't delivering good outcomes. Come along on 19 February to hear me make the case for how we could do things differently, and to hear from our terrific panel.

The @lowpaycommission.bsky.social annual report is out. As always contains lots of insights. This is key chart for me: 20% of jobs are now paid within £1 of the minimum wage, up from 14% in 2015. Whatever you think of the minimum wage, its increasingly important!

NEW PODCAST: Why isn't the NHS improving faster? @helenmiller.bsky.social, @maxwarner.bsky.social and Olly Harvey-Rich examine the latest data on NHS performance, progress on waiting lists and the big challenges around staffing, winter and flu cases. 🎧 Listen here: ifs.org.uk/articles/why...

DHSC published its impact statement for the 10 Year Health Plan this week (yes, that is 6 months after it published the plan) It's more measured and clear-eyed than the original document and quite a contrast to some of the effusive optimism in the plan Some of the things that caught my eye 👇

There's now data out about the resident doctor strikes last month So how disruptive did they end up being? And what can we say about how the NHS is responding to ongoing strikes? Short 🧵👇

This is important as last month's OBR forecast (no monthly breakdown of this yet) expects a big increase in receipts by 2029/30 from higher inflation, boosting the public finances. That may materialise, but it’s concerning that it hasn’t yet - one watch out for in the new year

New ONS public finance data today shows central government revenues are still lagging significantly below March expectations. Given inflation has been higher than forecast, this is surprising - even VAT receipts, which one might expect to rise with inflation, are below forecast

A short seven years (!) after I started writing the code, it’s great to see this paper published. We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.

NEW: How did the introduction of the Ultra-Low Emissions Zone (ULEZ) change London’s geography of work? In a new @theifs.bsky.social paper, @joelkariel.bsky.social, Fizza Jabbar and I have taken a look – and it turns out people adapt in surprising ways. A thread. 1/

NHS England has now produced two sets of productivity growth rates for each NHS acute trust. These are year-on-year growth rates, only 3 months apart (so have a 9 month overlap). But what's striking is that they are essentially uncorrelated!? [1/2]

Hospitals currently have a lot more people admitted with flu than at the same time in recent years. It remains to be seen how the peak will compare to previous years. (Half the IFS healthcare team are also currently laid low with it...) www.bbc.co.uk/news/live/c6...

NEW: Hospital productivity growth is beating the government’s targets. So why hasn't the NHS made more progress on cutting elective waiting times? In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities. 1/11

Would you like to lead our @theifs.bsky.social work on healthcare? We are looking to recruit an outstanding economist to become an Associate Director and lead a programme of economic research on health and/or healthcare. Job advert here: app.beapplied.com/apply/jfzr0z...

NEW: What are Rachel Reeves’ options if she decides to change departmental spending at next week’s Budget? 📗 @beeboileau.bsky.social, @benzaranko.bsky.social and @maxwarner.bsky.social explain: ifs.org.uk/articles/cha...

The IFS has calculated that the effective carbon price on household use of gas is negative, thanks to its lower VAT rate. ifs.org.uk/articles/tax.... This obviously sets back the carbon transition. Let's hope the Government is looking to make this better!

Elective waiting times in the NHS have improved since Labour came to office, but relatively slowly. Improvements in 18 week performance will have to pick up speed considerably if the government are to hit their headline NHS target by the end of the parliament.

On the question of one vs two OBR forecasts per year... The IMF said first best option would be to operate with more ‘headroom’. They did not call for one forecast. They suggested that the rules could be assessed only once per year, but explicitly said that two forecasts per year is best practice!

NEW PODCAST: The end of the peace dividend? UK defence in a changing world 🎧 @helenmiller.bsky.social, @maxwarner.bsky.social & @rusi.bsky.social's Matthew Savill chat all things defence spending: what it covers, how it's changed and what reaching 3.5% of GDP would mean: ifs.org.uk/articles/end...

One of my favourite charts from our new report on defence spending: For decades, the 'peace dividend' of falling defence spending as a share of GDP has allowed more spending on things like health without such a big rise in the size of the state. That is no longer the case