The NHS budget in England stands at £103bn currently NHS staff are braced for job losses - despite the chancellor's pledge to ring fence the £103bn budget for England.
Historically, health spending has gone up by over 4% in real terms so unions say a small rise will feel like a cut.
This is because demands from factors such as the ageing population, obesity and the cost of new drugs mean about an extra 3% is needed just to stand still.
In preparation, the NHS has been asked to find large efficiency savings over the coming years.
The previous government set a target of between £15bn and £20bn by 2014 - which means finding nearly 5% of savings a year.
This target has been kept in place by the coalition despite its promise to increase the health budget in this parliament from April - the details of which will be given in the Spending Review.
While ministers say all savings from the efficiency drive will be reinvested into the NHS, unions have claimed "slash and burn" approaches are being taken.
The Royal College of Nursing estimates more than 10,000 posts have closed in recent months and said if this trend continues patient care will be hit.
A special BBC News season examining the approaching cuts to public sector spending
The Spending Review: Making It ClearThere have already been reports of hospitals closing wards and restricting access to minor operations, while fears have been voiced that waiting lists could rise in the future.
Nigel Edwards, of the NHS Confederation, which represents managers, said: "The public need to go into this with their eyes wide open.
"The NHS may have some limited protection to its budget but it still faces a potent cocktail of financial pressures."
Other parts of the UK will have to wait longer to find out about health spending with final decisions not expected until later this year.
Ministers in Scotland, Wales and Northern Ireland have talked about protecting parts of the NHS budget, although they have not been as categorical as their counterparts in England.
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Source: http://www.bbc.co.uk/go/rss/int/news/-/news/health-11582619
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