“The government has done us a really good turn,” claimed NHS England chief executive Sir Jim Mackey after the chancellor, Rachel Reeves (right), unveiled what she called a “record cash investment” in the NHS in England as part of the government’s spending review. The settlement will see NHS spending rise by around 3% above inflation during the five years of this parliament.

Mackey told delegates at NHS Confed Expo, shortly after Reeves’s statement on 11 June, that the NHS now had “all the money the country can afford to give us”.

“It’s a huge amount of money by any, any standards,’ he said. “The government’s done us a really good turn compared to other parts of the public service. But it’s not going to allow us all to just take our feet off the pedal and just run loose… we’ve still got an awful lot of difficult things to do.”

Under Reeves’s plans, NHS spending will rise to £226 billion by 2028-29, an increase of £29 billion over the course of this parliament and £11 billion higher than this year’s budget.

The projected growth in NHS spending is well above the rates seen over the last 15 years, but below the long-term average before the pandemic of 3.7%, and less than the 3.8% growth seen over the last two years.

Redundancy costs from the government’s job cuts across NHS England, ICBs and trusts must be met within these budgets, and Reeves also confirmed the NHS would be expected to make 2% productivity savings each year for the rest of the parliament.

UNISON general secretary Christina McAnea welcomed the funding boost but warned “the reality on the ground now is very different”. NHS organisations across England were “making damaging cuts to jobs and services under ministers’ orders to balance this year’s budgets,” she said.

For the Conservatives, shadow health secretary Edward Argar said the NHS budget was “now roughly the equivalent of the entire GDP of Portugal” and criticised ministers for lacking detailed plans on how the money would be spent. “The Labour party has failed to come up with a plan for the NHS, with the exception of the abolition of NHS England, which will not happen for years and appears to be delayed and in chaos,” he said.

Health and care experts welcomed the settlement but most warned it would still not be enough to meet all the government’s promises on the NHS.

“We know there are already trade-offs happening in the NHS due to tight finances, said Sarah Woolnough, chief executive of the King’s Fund. “It’s hard to see how all the things [the chancellor] mentions—faster ambulance times, more GP appointments and adequate mental health services and more—can be met on this settlement alone. Particularly when large parts of this additional funding will be absorbed by existing rising costs, such as the higher cost of medicines… and covering staff pay deals.”