Theresa May’s recent promise of a multi-year plan for the NHS England to address its long-term financial challenges ahead of the spring 2019 Spending Review has been well received by most quarters, but arguably presents more questions than answers.

It is pleasing to see the Prime Minister is thinking about the big picture and moving away from the annual ‘top-up’ approach to funding, which plainly isn’t working. Since 2010, the health budget has grown 1% a year on average, while annual increases sit at around 4% since the NHS was established. A plan that maps spending requirements for the next 15-20 years, rather than five, is required.