Seeing the Covid Inquiry unfold will I’m sure have been a reminder for many in this room.

A reminder that…

…for all the outpouring of respect and appreciation from the public.

…for all the camaraderie and innovation NHS staff displayed…

…it was an incredibly difficult time for so many colleagues.

 

Just as we will never forget the contribution that every colleague made…

…so, we shouldn’t forget that many are still living with the effects of that period.

And particularly because we now face a more complex job.

I would say when I was here last year, I was open about the challenges in front of us.

What I didn’t predict was the NHS needing to tackle those challenges whilst also managing now more than 70 days of industrial action.

 

I didn’t predict your clinic teams needing to reschedule more than a million planned appointments…

…your senior clinicians needing to ask all but the most seriously ill and injured to seek alternatives to 999 and A&E.

…or indeed your finance teams needing to deal with the cost of delivering the safest possible cover.

 

We do now have welcome clarity on how the Government want us to deal with those costs.

And as a consequence, we’ve been able to release hundreds of millions to give to systems…

…so you can prioritise patient safety and urgent and emergency care going into winter.

Even so, we know we will still have to make difficult choices…

…both nationally and locally…

…to balance the books.

 

And I highlight the challenges of industrial action not to take sides…

…but to recognise your work in dealing with it…

…to recognise the toll it has taken on colleagues, as well as on patients…

…and to reflect a hope that I suspect you share, that the current talks are successful.

 

Nor, in highlighting that additional challenge, do we seek to hide behind it.

There were challenges before industrial action.

And they will still be there, even without further strikes.

 

I’ve always been honest about those challenges.

But I’ve never said they are insurmountable.

 

Not because I’m speaking with blind faith.

But seeing how the NHS steps up…

…how you step up…

…to deliver for patients in the most trying circumstances.

 

And that’s what you’ve done.

That’s what the NHS has done.

The NHS has never delivered more than it did in its 75th year.

Record numbers of GP appointments, cancer checks, and people getting mental health support.

Just compared to our 70th year, your work meant that…

…almost 2,500 more people received an urgent cancer check…

…and 100 more people started cancer treatment.

 

And it’s not just cancer.

Your hard work also now means over 8,500 more people access key diagnostic tests…

…over 800 people start elective care…

…and almost 7,000 more people have checkups.

And all of that’s every single day.

 

In mental health, 10,000 more people accessed community appointments…every day.

 

Whether through 111, 999, A&E, urgent community response teams or mental health crisis teams…

… thousands more people are accessing urgent and emergency care, every day.

And that’s before we get into the huge numbers of people who get help from GP teams, pharmacies and community services.

 

The NHS, delivering more and more for patients, every day.

 

And as we look ahead into winter we know will be incredibly tough…

…you are once again pulling out all the stops to keep services resilient.

 

Thousands of extra beds…

…a rapid increase in virtual ward capacity…

…even deploying AI and at-home monitors to help the most vulnerable stay well at home…

…and that is just since last winter.

 

Real progress.

Real delivery.

But it’s still not enough.

We still have much more to do on access…

…but also on quality, and on experience.

 

The tragic case of Martha Mills was a case in point.

The story told by Martha’s mother…

…of watching her daughter deteriorate, but not being listened to…

…I suspect that affected us all.

 

We already knew we needed to do more to ensure the voice of patients and their loved ones is heard in clinical care.

That’s why we are already working with exemplars…

…like colleagues at Royal Berkshire…

…to test and spread ways of embedding the right to a second opinion.

 

It’s also why we were developing the Paediatric Early Warning System with clinicians and patient groups…

…now being rolled out…

…with a clear focus on asking parents and recording how parents think their own child is doing.

 

We have to continue that progress, and we will.

But there are other areas too.

Maternity and neonatal services a clear example.

Mental health and learning disability services another.

 

In both, and in other areas, increasing capacity is important.

But we must also improve quality.

Not just quality of care, but quality of life.

And you are delivering.

 

I saw that vividly on a recent visit to the Cosy Café in Dudley.

There, the team at Black Country Healthcare are working hand in glove…

…with voluntary organisations, and with patients themselves…

…to support people with a learning disability and autistic people to lead the lives they want to lead.

 

It’s avoiding hospital admissions and acute care.

But more importantly it’s delivering real change for people.

 

A man I met there a guy called Nathan told me was moving into his own flat…

…that he was hoping to learn to drive…

…and that he’d gone nine weeks without harming himself.

Previously unthinkable.

But now he’s doing it…

…thanks to support he’d got from that joined up, person-centred service.

 

You’re also delivering in other areas of care.

Chris Whitty’s report on Friday was the latest reminder that more people living longer is a good thing.

But it’s also one of the greatest challenges we will face over the coming years.

The answer isn’t just having capacity in the right place…

…it’s about how we deliver quality.

Quality of care.

But more importantly, quality of life.

And the NHS cannot do that alone.

 

A couple of weeks ago I went to spend time with the team at the Jean Bishop Centre in Hull.

They bring together a range of services for older people in their area living with frailty.

That’s NHS, social care, voluntary sector, and even fire and rescue services…

…all working together with the goal of helping local people lead happier and healthier lives in old age.

 

And it’s working.

They’re seeing the need for acute care go down…

…with 18 per cent fewer A&E attendances and 25 per cent fewer emergency admissions.

 

So we can’t and won’t relent in the focus on recovery…

…that’s UEC, that’s electives and that’s cancer, and on primary care.

They must be the priority right now…

…because these are the things we know really matter to people now.

 

But we know we must also have an eye on the longer term.

We all want to see a country which is healthier, physically, and mentally.

One where people are given – and take – more control over their own health and care…

…in the way that those teams in Dudley, and in Hull, are doing.

 

As the NHS always has, we’ll always harness the best medicines and innovations that help deliver that goal.

Thanks to our unique ability to do deals on a national scale…

…we’re already leading the world in eradicating Hepatitis C…

…and ending new cases of HIV.

 

We’ve rapidly rolled out direct oral anticoagulants to half a million people in 18 months to prevent thousands of strokes.

 

We’re offering tens of thousands of women now the chance to reduce their risk of breast cancer…

…by taking a drug previously used for treatment, and repurposing it for prevention.

 

And our pilots have provided the evidence to support wider use of closed loop systems for people living with type one diabetes.

 

And Samira’s already mentioned it, today we’re setting ourselves a new and ambitious target.

… to be one of the first countries in the world to eradicate cervical cancer.

 

School teams have already delivered protection from HPV to millions of young people…

…directly preventing an estimated 450 cancers.

 

By continuing to make it easier to access and catch up on vaccines…

…and continuing to make progress on screening…

…we can eradicate the threat of HPV by 2040…

…sparing thousands more women the pain and worry of cancer.

 

It’s truly momentous to be able to set out such an important and life-saving ambition today.

To eliminate cervical cancer would be an incredible achievement.

 

And through a combination of our HPV vaccination programme…

…and our highly-effective cervical cancer screening programme…

…it could become a reality in the next two decades.

 

As ever, the public can play their part too.

Achieving our goal needs as many people as possible taking up the offer.

So our message to the public is: please don’t delay – this could save your life.

 

The future will hold other exciting possibilities…

…and we want to deliver those, too.

 

New drugs for Alzheimer’s – a great example of that hope.

And that’s why we are preparing now for their potential approval.

 

But as Chris Whitty’s report reminded us…

…more people living longer means more people developing dementia.

And whether or not people can benefit from new treatments, diagnosis is the gateway to support for them and their families.

 

A dementia diagnosis can be and many of you will have experienced this with your families, incredibly daunting.

But an early diagnosis can ensure that they get the support they need as quickly as possible.

There are many things we can do to support people…

…and importantly there is support for their families and carers too.

 

We know that the pandemic hampered identification efforts.

So we have been delivering a catch up programme for dementia diagnosis catch-up drive…

…including piloting proactive assessments in care homes.

And it’s working.

 

Thanks to the efforts of NHS staff, tens of thousands more people are now getting a diagnosis than this time last year.

Opening doors to further support for patients and their families who suffer from this heart-breaking disease.

 

Like Laura Hudson…

…a mental health nurse from King’s Lynn.

She used the tool behind the outreach pilots.

And she got her mum, Pam…

…herself a former nurse…

…the diagnosis which gave them peace of mind that she will get the care she needs…

…it makes a real difference for both of them.

 

So we will press on with those efforts and outreach work to detect dementia earlier because behind every number there is a Pam

And I am determined that…

…by next year…

…we will once again reach our ambition of diagnosing two thirds of people with dementia…

…so they don’t have to go through it alone.

 

But as the example of dementia shows…

…while delivering innovative tests and treatments will always be part of the NHS success story…

…it always will be people who will make the biggest difference.

 

Thinking about all the things we know we need to do…

…all the opportunities that system and partnership working presents…

…in all cases, the key to success is people.

And that’s why the publication of the NHS Long Term Workforce Plan was such a seminal moment in the history of the NHS.

 

In taking that unprecedented opportunity, we made a real statement of our ambition for the future.

And in securing Government backing for the Plan, we secured an important vote of confidence in the NHS…

…in what we want to deliver for patients…

…and in our ability to deliver it.

 

And when I say ‘we’, I mean ‘we’.

NHS Providers provided a strong voice in the debate.

But it was all of you.

 

You helped push for this plan.

You helped design the plan.

You helped convince the Government to back it.

 

And the publication of the Plan was therefore a major achievement for everyone here.

But it was just the beginning.

 

We worked together to design it.

We must work together to deliver it, too.

But that work has already started.

 

Many elements of the Plan…

…the new training places, routes, and roles…

…they’re important for the future…

…and the work is underway now to make them real.

 

But they’re not going to deliver the boost to the workforce we need right now.

That’s where the Retain part of the Plan comes in.

It’s those actions that we can make progress on, right now.

And you are already delivering.

 

The NHS leaver rate is already down…

…from 9.4% in August 2022, to 8.1% in August this year.

 

And while that might not sound like much.

But that’s around 14,000 fewer people leaving.

 

14,000 more people…

…with skills, training, and experience…

…staying in their roles.

 

That’s people like Jeanette, a housekeeper I met at Hull Royal Infirmary.

52 years in the NHS, and she isn’t done yet.

 

She knew literally every inch of Ward 12.

Knew how to get things done…

…as thoroughly and efficiently as possible.

Her experience helping others develop…

…and helping the team deliver for patients.

 

That improvement in retention is also driving growth in our clinical workforce…

…up 5% in the last year in trusts alone.

In real terms, over 32,000 more full time equivalent clinicians…

…in our services and providing patient care.

 

Real progress.

But we can do more.

And you are showing the way.

 

Through our exemplar programme, 23 trusts are implementing action plans to address what their own staff say would make them want to stay.

At Lancashire and South Cumbria, it’s advocates on hand to talk to staff thinking of leaving.

At Guy’s and St Thomas’ my old place, it’s training 4,000 line managers to have those conversations with their teams.

At United Lincolnshire, it’s a focus on supporting flexible working for people juggling work and family life.

 

And it’s working.

Their leaver rates are improving even faster that the rest of the NHS.

If everyone made the same progress, we’d see thousands more staff choosing to stay in the NHS…

…tens of thousands more years’ worth of experience, training and investment retained, for the benefit of patients.

 

So we’ll be keeping our foot on the gas.

And we will be shortly inviting more Trusts to join the exemplar programme.

Levelling up staff experience and retention nationwide.

And ultimately, of course delivering better care for patients.

 

Already, not just a Plan.

A banner under which you and your colleagues are rallying…

…to improve how we look after our staff…

…and by extension those who need us.

 

But there’s more to do.

The Plan is very clear about that.

 

For one, increasing productivity, and continuous improvement.

Vital, both to keep up with rising demand…

…and to give staff the space to transform care for the future.

 

And you’re already delivering that, too.

Through GIRFT, Further Faster, and increasingly NHS IMPACT…

… you are using and sharing data and best practice to deliver better and more efficient care.

And it’s working.

 

At University Hospitals Leicester…

…meticulous action to improve systems and processes seeing their elective waiting list fall by more than 11,000 in a year…

…and a 68% fall in long waits for diagnostics.

 

The Plan also talks about modernising our infrastructure.

Ensuring it supports, not thwarts, the improvements you want to make.

 

That’s our physical estate.

But it’s also our equipment…

…particularly diagnostic scanners…

…where we’ve seen a real focus with the rollout of CDCs.

 

I’ve done a lot of traveling recently, I was in Barnsley a few weeks ago at the Glassworks CDC

I met Ronald there.

 

Ronald needs a blood test every three months.

Previously he’d go to hospital.

Now he loves the fact he can come into the centre of town…

…he can park up…

…get his test done…

…then browse the local shops or go get a coffee…

…just as he would on a normal day.

 

So yes, CDCs are helping us ramp up activity and reduce the backlog.

But CDCs are also making a huge difference for patients like Ronald in terms of their experience.

 

So our physical infrastructure is important.

But increasingly important is our virtual infrastructure.

Our digital platforms and our data architecture.

 

Things that support patients to get what they need more easily.

Like the NHS App.

Which is rapidly becoming the one stop shop for many services.

Thanks to your work, 3.4 million secondary care appointments were booked or managed through the App in September alone.

 

It’s also things that help you plan and deliver care more effectively…

…like Electronic Patient Records.

 

Thanks to the teams at Sheffield Health and Social Care and Hillingdon Hospitals…

…who completed their go-lives over the last couple of weeks…

…you have now delivered on the target for 90% of Trusts to have this capability in place ahead of winter.

 

Delivering that switch isn’t easy.

But it’s worth it.

And it’s worth it, because that’s the underpinning work that will enable us to benefit from new technologies.

 

Technologies like the Federated Data Platform.

Which we’re working hard to finalise that now…

…so we can provide clinicians and managers with powerful tools to bring together the data you hold in different systems…

…and harness it to improve care.

 

Tools of the kind that colleagues across the country have already shown can make a real difference.

Like in North Tees and Hartlepool…

…where their clinical team uses them to support discharge planning.

 

Which means patients going home with the right support faster…

…long stays falling by over a third despite admissions growing…

…and almost 10 hours of clinician time freed up each week.

 

The other major shift will be strengthening our incredible primary and community care services…

…who already account for so much of what the NHS does.

Like in Dudley, like in Hull…

…improving how they work together, and with other services…

…to provide more services closer to people’s homes…

…providing more convenient, more personalised, more preventative care.

 

In integrated care systems we have the platform for that now in every place now in every part of the country…

…and I’ve been delighted to see how well Providers have embraced the system-first approach.

 

So that’s what we want to achieve with the Long Term Workforce Plan.

People…

…working in decent facilities…

…supported to reach their potential…

…with the right tools to work productively…

…with the agency to keep improving how they work…

…and with the partnerships in place to ensure they can deliver what patients need and want.

 

That’s what will help us face the challenges of the next five, 10, 15 years.

That’s what we all now need to work to deliver.

 

And that is not ignoring the immediate challenges.

The focus we need to maintain on recovery…

…on access…

…on quality…

…and on safety.

 

But the success of the NHS over the last 75 years…

…the enduring support of the public…

…has been because people like you have carefully balanced both.

 

Delivering the best possible care they could in the moment…

…but also identifying and delivering improvements that make a difference for the future.

 

And that’s exactly what I continue to see when I come and spend time with you.

Everywhere it is what I also see is real pressures.

But also real progress…

…real promise…

…and real pride.

 

I know it’s tough.

I know it will be tough.

But what you’re doing is delivering for our patients.

What you’re doing is making a difference.

So thank you for that.

And let’s keep delivering together.