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Blog from Chief Nursing Officer about local proposals to improve health and care

Writing for a national newspaper, Jane Cummings, Chief Nursing Officer at NHS England said:

The National Health Service is one of Britain’s proudest achievements. And today its staff do a superb job treating record numbers of patients. Quite rightly, people to want to protect our NHS when it is under pressure – but in doing this, they also need to allow it to change and improve.

Since 1948, the NHS has adapted itself constantly, and it must continue to do so as the world and our health needs will continue to change. We are now able to treat people with new drugs and clinical care that were not available in the past. As life expectancy increases, so do the ailments of old age, and there are now more people with chronic conditions such as heart failure and arthritis.

There are also big opportunities to improve care by making common-sense changes to how the NHS has worked historically. Improvements that matter, such as making it easier to see a GP, speeding up cancer diagnosis and offering help faster to people with mental ill health.

This is why the NHS and local councils have come together in 44 areas covering all of England to develop detailed proposals for health and care.

Each area has produced a sustainability and transformation plan for the next few years. With services feeling the strain, collaboration between organisations will give nurses, doctors and care staff the best chance of success.

Attempting to improve care for 55 million people, bringing together over 440 NHS organisations with 152 local authorities is a complex task. Proposals have now been published for every part of England. They are all at different stages and now patients, the public and NHS staff must help to develop and shape them.

Let me give you some examples. In Surrey, a £30 million investment in primary care services is proposed, giving people more access to GP appointments in the evenings and at weekends, and longer appointment times where necessary.

In Somerset, simple changes to the way care services work will reduce the number of people stuck in a hospital bed when they do not need to be, recognising that most patients in hospital today are frail, needing as much social as medical support.

In south-east London, the NHS wants to develop a £30 million cancer centre at Queen Mary’s Sidcup to complement the new £160 million purpose-built centre at Guy’s Hospital, providing an additional 16,000 radiotherapy and 4,600 chemotherapy treatments a year from early 2017.

In some areas, the NHS is asking people to think about where best to invest resources and to consider making choices.

For example, the NHS wants to do more to help people stay healthy – reducing heart disease, cutting smoking and stopping alcohol abuse.

Advances in medicine mean it is now possible to treat people at home who previously needed a stay in hospital. And the most seriously ill often need to be treated in centres where specialist help is available around the clock.

In London, this approach has saved the lives of 100 stroke sufferers a year and across the country the chances of surviving a major trauma have risen 50 per cent.

In Devon, the local NHS wants to invest in home-based care, but it struggles because resources are currently tied up in hospital beds. Many patients stay in those beds for too long, because home care is not available, often becoming more ill as a result.

With more care provided at home, the NHS can spend more cash on patients rather than maintaining old and expensive buildings. And more people can be better looked after, with care personalised to their needs.

Whatever the merits of these plans, choices like these will always be controversial because we are talking about changes to strongly supported services that have served communities well for years.

So this is not a moment to sit on our hands, nor to instigate big-bang changes. What we need is decisive but well-debated, locally owned improvements, doing things for which nurses doctors and other health and care workers have argued for years.

While there will always be a vigorous debate about how much money the nation invests in the NHS and in social care services, that does not change our responsibility to patients, which is to squeeze the maximum value and the best possible care from every penny that is made available to us.

That means changing outdated models of care so that patients don’t fall into the cracks between different parts of the system and ensuring that we provide care based around their needs, and not those of NHS organisations.

Everyone in the NHS wants to ensure that every person in this country can get high-quality care whenever it is needed. By continuing to adapt to a changing world, the NHS will build a better service for future generations.

Jane Cummings

Professor Jane Cummings is the Chief Nursing Officer for England.

In this role, she is the professional lead for nurses and midwives in England and she will oversee quality improvements in patient safety and patient experience.