It is encouraging that the chancellor has acknowledged funding pressures faced by the NHS which mean the service can’t deliver the levels of patient care set out in the NHS constitution [key waiting time standards such as A&E treatment within four hours and planned hospital care within 18 weeks]. This winter we have seen the impact of under-funding and a lack of staff. We need to see urgent steps put in train to ensure sustainable long term funding for health and social care, because the current situation is unsustainable. It is also vital that any deal that is reached on pay is fully funded, as promised in the budget.