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This week the NHS is 65 and NHS England is 3 months old. In 1948, when the NHS was founded, Europe had not long emerged from a war which brought people together in a common cause. My generation has benefited from the vision and commitment that brought about the NHS. When I first started at medical school the NHS was less than 30 years old (I was even younger!): yet it seemed a natural part of society. As I have worked in the NHS and studied healthcare systems world-wide I have understood what a privilege it has been for me to be able to work in a system where I have never been required to check if a patient could afford the treatment suggested, where care is based on need and not ability to pay.
Now the NHS, in common with health systems worldwide, faces questions that urgently need to be addressed. How can we meet the needs of a population that has a longer life span leading, for many, to frailty and multiple physical and mental health conditions? How can we create a system of health and care that faces the community – making a hospital part of that community rather than central to a medicalised model of healthcare? How can we mobilise the potential of the community, the family and the individual in health and care? How can we support the professions to work collaboratively, as teams, wrapping care around individuals rather than conditions? How can we harness the potential of the digital era to make care more personalised and integrated?
NHS England is 3 months old, it has been born at a time when the NHS needs to radically change, at a time when the NHS needs to be reinvigorated.
For a moment consider the purpose of NHS England and the new commissioning system. Local clinicians working with local communities informed by insight and understanding of local needs focussed on a common purpose: supporting continuous improvement in quality – safe, effective care providing a positive patient experience. A system that puts patient voice on a par with clinical effectiveness. A partnership between people and professionals; not paternalism. For me, despite all the turmoil and structural change and the difficulties we face, as we celebrate the first 65 years of the NHS, it is time to realise the potential, possibilities and purpose of the NHS. It is time to think of the next generation. It is time for a regeneration of the NHS whilst staying true to its purpose and intent.
Martin raises many interesting questions and lots of challanges for all clinicians. In particular I like the “wrapping care around the patient rather than conditions”. Our increasing elderly population with multiple conditions are currently often being mainly treated as conditions leading to multiple appointments and polypharmacy.