Hospitals will have to start cutting services unless the NHS gets £8bn of extra funding within days, health service leaders are warning ministers. The NHS will not be able to tackle the huge backlog of surgery that has built up during the pandemic unless it gets the money to cover additional costs resulting from Covid, hospital bosses say. The Treasury and NHS England are involved in a standoff over the service’s demand for the cash, which is still unresolved with just 16 days to go until the start of the 2021-22 financial year. The threat is contained in a letter to the chancellor, Rishi Sunak, from Danny Mortimer, chief executive of the NHS Confederation, which represents most NHS organisations that provide care. “We are just 17 days away from the new financial year and yet the NHS has still not got a finalised budget in place,” Mortimer wrote. He cautioned that, if the Treasury did not agree this week to provide an agreed sum, “with the continued impact of the pandemic, the scale of the treatment backlog and additional demands for long Covid and mental health, this would put too many services in a perilous position at the start of the ‘recovery phase’ as the NHS plots a way out of the pandemic”. Mortimer said: “Should the Treasury’s budget discussions with the NHS fail to conclude this week, then we face the very real prospect of some services, particularly in the first few months of the new financial year, having to cut back.” NHS bosses believe they need to receive £8bn in 2021-22 over and above the service’s main budget, which covers its day-to-day running costs. That is to cover expenses the pandemic has thrown up, such as Covid testing for frontline staff, personal protective equipment and infection control measures. It is unusual for the NHS not to have finalised its budget for the forthcoming year so close to the wire. Sir Simon Stevens, NHS England’s chief executive, told MPs last week: “There is obviously an urgent need now to give that funding certainty to hospitals, to local frontline services.” He described £8bn as “the sort of ballpark” figure of what the NHS needed for April-September. Stevens pointed out that Sunak had already agreed to give test and trace more money for the first half of next year and to extend the furlough scheme until the end of September. In his letter Mortimer comes close to accusing the chancellor of breaking his pledge, made last March as the pandemic was unfolding, to give the NHS “whatever it needs” to fight Covid. “We are concerned that this commitment has not translated into budget certainty for 2021-22,” he wrote. The number of patients waiting for care in hospital in England last week hit a record 4.59 million and the NHS is under growing pressure to start doing as many operations as it can. But Mortimer said: “It is simply not possible for acute, community, mental health, ambulance, primary care and other key frontline services to address the recovery of NHS services whilst still dealing with the pandemic unless there is an agreed NHS budget for next year.” Sunak did not award the NHS any increase in its income for 2021-22 in his 3 March budget, though he did give it £3bn extra – for the surgery backlog and mental health care – in his autumn statement last November. The Treasury has been contacted for comment.