“The choice for the NHS is stark: reform or die.”
Those words from the introduction to the new ten-year plan for the NHS in England clearly set out the challenge facing healthcare today. Warning that demographic changes and an aging population are putting unsustainable pressures on already stretched systems, the introduction highlights the need for a fundamental change in health delivery.
In drawing up the new ten-year health delivery plan the team has consulted widely, speaking to health staff and members of the public and considering the quarter of a million ideas submitted to the Change NHS website. This research led to the inescapable conclusion that “staff and patients are crying out for change.”
That change, according to the new plan, requires the harnessing of science and technology in order to deliver a patient-controlled system, supported by frontline staff who are empowered to reshape services. This, the plan’s authors envisage will deliver change in three fundamental areas:
Hospital to community. The review comments that the current health service is hospital-centric with care broken down into fragmented silos. The ten-year plan looks to shift the balance away from hospitals to a more integrated model which delivers continuous accessible care primarily in homes or neighbourhood health centres. Agreed care plans should also be available for 95% of those with complex needs by 2027.
We have already reported on some of the measures to be implemented including ending the 8am scramble for GP appointments and boosting community pharmacies. Other measures will see the development of neighbourhood health centres offering a one-stop shop for care delivered by multi-disciplinary teams. The personal health budget scheme will also be rolled out to more individuals to ensure it is available to all who may benefit from it by 2035.
Analogue to digital. Key to success in this area will be the expansion of the NHS App. This, it is envisaged with eventually enable patients not only to book GP appointments and manage repeat prescriptions but also to carry out functions such as receiving automated advice, booking specialist tests, or choosing a provider to deliver health treatments. It is also envisaged that the App will eventually help patients to manage long term conditions through the use of digital tools including data uploads and reporting.
Sickness to prevention. This plank of the plan requires a step outside of the health service, drawing on the expertise of a multitude of agencies and bringing forward legislation in order to improve health levels. Goals include the halving of the gap in healthy life expectancy between the richest and poorest regions whilst simultaneously improving health outcomes for all. Legislative measures look towards areas such as the tackling of obesity, the reduction of problem drinking and cutting down on smoking. Other measures aim to draw in employers, schools, industry partners and the community to promote healthy eating, exercise and good mental health.
Whilst the new plan has been widely welcomed, various bodies including the BMA, the Royal College of Nursing and the NHS Confederation have raised concerns about the staffing and funding changes required in order to bring about its successful delivery.