A post-pandemic drive to help people stay well, greater use of technology to put power into the hands of patients and treating people closer to home should be at the heart of NHS plans, an independent report said today.
The NHS Assembly, an independent advisory group established in 2019, consulted staff, patient groups, carers, charities, and partners in health and social care for the report launched ahead of the 75th anniversary of the health service on 5 July.
The Assembly’s analysis found that the NHS should now focus on three key areas:
- preventing poor health
- creating more personalised care which better responds to patients views
- coordinated care closer to home, including by strengthening General Practice.
The creation of Integrated Care Systems (ICSs) allows the NHS to work with other bodies to find people at risk of conditions such as heart disease and tackle major causes of poor heath including obesity and smoking.
ICSs should also use new technology to help people manage their health so they can monitor their conditions, receive advice remotely through virtual wards and make appointments or change prescriptions via the NHS App.
In the report entitled, The NHS in England at 75: priorities for the future, the Assembly says the health service faces significant workforce and estates challenges, but it should be “emboldened by the resolve and agility it showed during the pandemic.”
Co-authored by Professor Dame Clare Gerada and Professor Sir Chris Ham, the analysis notes the demands on the health service are far greater now than when the NHS was founded with almost 3.5 million more people aged over 75 compared to 1948.
The report summarises more than 700 responses from health organisations and patient groups who reveal extensive support for the NHS being free at the point of delivery and note its success at landing deals which give patients access to the latest treatments at a fair price.
Professor Dame Clare Gerada, Co-Chair of the NHS Assembly, said: “This document gives permission to Integrated Care System to carry on the fantastic work they are already doing, and that means evolving primary and community care to deliver patient care closer to home.
“This visionary document based on the views of people across health and social care sets out three key aims for the sector – preventing people from getting ill, creating more personalised care and delivering this care closer to people’s home.”
Respondents to the engagement were immensely proud of NHS staff and its resilience but recognised the need to improve staff retention, reduce vacancies and provide better support to unpaid carers and social care.
It also noted that there was a greater need for prevention of ill health through wider societal change that falls outside of the NHS remit with the Assembly noting that 80% of health outcomes are determined by other factors such as incoming, housing education and employment.
The report calls for capital investment and a long-term infrastructure plan to tackle backlog maintenance and modernise primary care where a third of the estate was built before the NHS was founded.
The NHS Assembly document given to NHS England is an important contribution to help the NHS, nationally and locally, plan how to respond to long term opportunities and challenges.
NHS chief executive Amanda Pritchard said: “I am hugely grateful to the NHS Assembly for this important piece of work ahead of our milestone 75th anniversary.
“After some of the most challenging years in NHS history, I know how energising many colleagues have found having the chance to think about opportunities to improve health and care for the future.
“And by taking into account such a wide range of views from our patients, staff and partners, this report will help to build on the progress already made, both locally and nationally, for years to come.”
Aishah Farooq, a patient, carer and public voice NHS Assembly member, said: “It has been a privilege to contribute to NHS@75 – a report different to others. The report inspires a renewed sense of hope for all generations, shines a light on the collective accomplishments of our health service, and places patient and carer voice at the heart of their healthcare.”
Helen Walker, Chief Executive of Carers UK and NHS Assembly member said: “Unpaid carers gave us a clear vision for the NHS: one that would identify, recognise and support them by treating them as essential partners in care.
“With 4.7 million people in England supporting relatives and friends who are older, disabled or seriously ill, this is a key opportunity not only to deliver improved health outcomes for the millions of people carers support, but gain better health and well-being for unpaid carers themselves, improve their relationships and support working carers to stay in paid work whilst providing care.
“We’re delighted to have supported the NHS Assembly with the development of this report.”
Dr Habib Naqvi, NHS Assembly member and Chief Executive, NHS Race and Health Observatory said:
“The NHS Assembly has overseen critical work to build a consensus view by bringing together broad contributions to help the NHS grasp opportunities and tackle challenges to meet the needs of our diverse patients, communities, and the workforce.
“This is only the start of the conversation – it is essential that tackling health inequalities is prioritised, and the NHS continues to draw on the important insights gained from the Assembly’s NHS@75 engagement work.”
The chief executive of NHS Providers, and NHS Assembly member, Sir Julian Hartley said: “It’s heartening to see resounding support for the founding principles of the NHS we approach the NHS’ 75th anniversary. As well as tackling health inequalities and delivering care closer to home, we heard from patients and the public that investment in staff and capital, alongside social care reform, is vital to give this and future generations safe, high-quality services.”
Louise Ansari, NHS Assembly member and Chief Executive of Healthwatch England, said: “Seventy-five years after the NHS’s foundation, public support for its founding principles remains rock solid. People want good care available to all, which is free and based on need, not ability.
“This anniversary year should be one of appreciation for all the NHS has done. But, with our society facing significant challenges, we must also reflect on what needs to change. How can the service do more to deliver joined-up care closer to home, which gives patients more control and involves them in the decisions that affect them? This report helps highlight where the public wants the NHS to focus to make sure that it is fit for the future and delivers good care for everyone.”
Jacob Lant, chief executive of National Voices said: “The NHS is of one of our country’s greatest achievements and has a long history of developing ground-breaking new treatments and ways of delivering care. But as it turns 75 the health service faces some of its biggest ever challenges, and while support for the model is as strong as ever, public satisfaction with the service has been going in the wrong direction.
“The Assembly’s new report seeks to help the NHS, both nationally and locally, think through how to address the current pressures and strikes the right balance of optimism and realism. Optimistic about the potential for integration and technology, and realistic about the need to prioritise getting the basics right, like improving how people access care and better communication with patients so people know what is happening with their treatment.
“National Voices is delighted to have been able to feed into this work, bringing together our members with other key partners like Healthwatch England, to ensure the Assembly’s thinking is grounded in what people and communities have been saying matters most to them. By continuing to work with patients, carers and communities to make sure it is getting things right, the NHS can ensure it thrives in the years ahead, delivering compassionate and patient centred care for all.”
Rachel Power, Chief Executive of the Patients Association and NHS Assembly member, said: “We welcome the report from the NHS Assembly on the NHS at 75 and were delighted to have contributed to its development. As champions of patient partnership, we’re heartened the report makes patient and community involvement the golden thread that links the report’s themes and recommendations to the NHS.
“It is absolutely right the NHS should deliver care tailored to meet the needs of different communities and that services should be based on the insights and priorities people have for their own care. When patients and their clinicians make decisions together about care and treatments, it leads to better outcomes for both patients and the NHS and can reduce unnecessary treatments. There are benefits all round from patient partnership and we’re delighted that the report recognises and emphasises this. But as the report says, to achieve this across England will require changes in culture and practice across the NHS. This will take strong leadership to deliver a learning and improvement culture that can foster the creation of an NHS that works in partnership with those it serves.”