The NHS is at a crossroads and needs to change and improve as it moves forward.
That was the message from NHS England’s Chief Executive Simon Stevens today as a Five Year Forward View for the NHS was launched.
As the Forward View document was published, Mr Stevens told an audience of key stakeholders: “Healthcare in this country has improved dramatically over recent years and has weathered recent financial storms with remarkable resilience, thanks to protected funding and the commitment and dedication of NHS staff.
“But the NHS is now at a crossroads – as a country we need to decide which way to go. The Forward View represents the shared view of the national leadership of the NHS, setting out the choices – and consequences – that we will face over the next five years.
“It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure the future that we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so.”
He explained: “We need to get serious on three fronts: we need to take our own health seriously, change the way services are provided, and yes ask the next government to support us financially to carry on delivering high quality services.
“There’s a broad health campaign that we need to take because the fact is if we keep piling on the pounds on our waistline we carry on piling on pounds needed to sustain the health service.”
Mr Stevens said the Forward View is not a blueprint for care throughout the entire country, adding: “England is too big for a one-size-fits-all plan, and nor is the answer to simply let ‘a thousand flowers bloom’. It’s horses for courses.
“The NHS continues to be highly valued by the British people. But what’s great about the NHS cannot disguise what needs to change in the NHS.”
The Five Year Forward View is a collaboration between six leading NHS groups including Monitor, Health Education England, the NHS Trust Development Authority, Public Health England, the Care Quality Commission and NHS England.
It represents the first time the NHS has set out a clear sense of direction for the way services need to change and improve.
Professor Sir Bruce Keogh, NHS England’s National Clinical Director, set the Five Year Forward View into context, telling stakeholders: “We need to find new ways of doing things or quality will suffer.
“We can cope with increased demand through better prevention and greater efficiency of care. Any financial debate must simply be a consequence of the value we place on healthcare.”
As well as the national leadership of the NHS, the Five Year Forward View has also been developed in partnership with patient groups, clinicians, the voluntary sector and think tanks.
The document, published in full on the NHS England website today, sets out why the NHS needs to evolve, the challenges that lie ahead and how these can be met.
It details the actions that will be taken to deliver transformed care for patients, and the help that will be needed from others.
It sets out the stark choices facing the country, arguing that unless decisive action is taken now, in five years’ time we will face a growing health and care quality gap.
Simon Stevens outlined how action needs to be taken on four fronts:
- Do more to tackle the root causes of ill health. The future health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health. The Forward View backs hard-hitting action on obesity, alcohol and other major health risks.
- Commit to giving patients more control of their own care, including the option of combining health and social care, and new support for carers and volunteers.
- The NHS must change to meet the needs of a population that lives longer, for the millions of people with long-term conditions, and for all patients who want person centred care. It means breaking down the boundaries between family doctors and hospitals, between physical and mental health and between health and social care. The Five-Year Forward View sets out new models of care built around the needs of patients rather than historical or professional divides.
- Action needed to develop and deliver the new models of care, local flexibility and more investment in our workforce, technology and innovation.
The document also concludes that action will be needed on demand, efficiency and funding. More action on any one of the three will reduce the pressures on the other two.
It shows how delivering on the transformational changes set out in the Forward View, combined with staged funding increases as the economy allows could feasibly close the £30 billion gap by 2020/21, and secure a far better health service for England.
Supporting the launch of the NHS Five Year Forward View David Bennett, Chief Executive of Monitor, said: “If the NHS is to provide the best service it can to the public, and live within its means, it has got to change the way it delivers care to people. The Forward View sets out our vision of an NHS which can deliver better care and a better experience for patients, and is able to do more of this for however much money we can give it, and is therefore sustainable.
“The NHS will do its best to achieve this, but we do need to ensure that funding reflects our growing population, and to invest in making this change happen in order to get all the productivity improvements we could achieve.”
Ian Cumming, Chief Executive of Health Education England said: “We simply cannot respond in the same old ways if we are to respond to the challenges of the new. That is why we have worked with other partner organisations to take a five year forward view and agree the actions we need to take together to secure the necessary improvements. At HEE we will ensure we have enough staff with the right skills and behaviours to deliver the future set out in the Five Year Forward View.”
David Flory, the Chief Executive of the NHS Trust Development Authority, explained: “The NHS has shown real and significant improvement over the last 10 years but to ensure those improvements can be sustained and built upon we need to address the challenges of the future. The Forward View gives us a strong platform to begin the conversation about how we meet those challenges.”
Duncan Selbie, the Chief Executive of Public Health England, added: “We are fully aligned with the actions set out here and agree that all this is possible with determined leadership from all of us.”
David Behan, Chief Executive of the Care Quality Commission said: “Our inspections are continuing to tell us there is too much variation in the quality and safety of health and social care. This is why we support the Five Year Forward View for the NHS, which sets out how the service needs to evolve, so that the needs of patients can be met and so that we can close the care gap.
“As the regulator of health and social care, our role is to use our inspections and what people tell us, to identify what is working well and why, and what does not work. We want this to drive improvement, with providers learning from the services that we rate as good and outstanding.”
The NHS Forward View details new models for how care could be provided in future. These include:
- allowing GP practices to join forces into single organisations that provide a broader range of services including those traditionally provided in hospital;
- creating new organisations that provide both GP and hospital services together with mental health, community and social care;
- helping patients needing urgent care to get the right care, at the right times in the right place by creating urgent care networks that work seven days a week;
- sustaining local hospitals where this is the best solution clinically and is affordable and has the support of local commissioners;
- concentrating services into specialist centres where there is a strong relationship between numbers of patients and the quality of care;
- improving opportunities for women to give birth outside hospital by making it easier for groups of midwives to set up NHS-funded midwifery services;
- improving quality of life and reduce hospital bed use by providing more health and rehabilitation services in care homes;
- finding new ways to support carers by identifying them more effectively and encouraging volunteering by, for example, offering council tax reductions for those who offer help and more programmes to help carers facing a crisis.