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NEWS
Health bosses call for ‘decisive action’ and £8bn in Five Year Forward View
Decisive action must be taken to transform the provision of NHS care for patients, otherwise in five years’ time there will be a growing gap in healthcare delivery and funding, health bosses say.
The Five Year Forward View – instigated by NHS England – argues that more needs to be done to tackle the root causes of ill-health. The 41-page report says delivering a better future for the NHS will need action on three fronts: demand, efficiency and funding.
Focusing on prevention and looking after patients with long- term conditions outside of hospital could save 3% of the NHS budget by 2020, the report says. But even if the NHS achieves this ambitious target it will still have a deficit of £8bn – meaning more funding will be needed.
Simon Stevens, chief executive of NHS England, said: “To secure
the future we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so.”
On new models of care, the
‘Forward View’ wants more alignment nationally to provide meaningful local flexibility in the way that payment, rules and regulatory requirements are applied, plus more money for workforce development, technology and innovation.
The NHS must break down the barriers between GPs and hospitals, between physical and mental health, and between health and social care. Proposals include more GP federations that provide previously hospital-only services; new mixed care settings where primary, secondary, community, social care and mental health services are all provided; and proper support for hospitals whose services are backed by
evidence, are affordable and have commissioner support.
King’s Fund chief executive Chris Ham said the Forward View “throws down the gauntlet” to politicians to back fundamental changes to health services.
“But attention will rightly focus on the funding options,” he said. “Even if the very challenging estimates for productivity
improvements outlined here can be achieved, an additional £8bn a year in funding would be needed by 2020.”
The Forward View was produced by NHS England, Public Heath England, Monitor, the NHS Trust Development Authority, CQC and Health Education England, advised by patient groups, clinicians and independent experts.
Leeds children’s heart surgery safe, Newcastle stoked safety fears – independent report
An independent review into children’s heart surgery at Leeds General Infirmary has found that the hospital’s heart unit is safe and provides excellent care, while also criticising doctors at a ‘rival’ centre in Newcastle, who cast doubt on the quality and safety of the Leeds service at a time when the two were battling to avoid closure.
NHS England called in Verita, an independent investigative agency, to carry out the final reviews of
the children’s heart unit at Leeds, which has been at the centre of controversy since NHS England data appeared to show that death rates among babies born with heart defects who needed complex surgery were higher than they should be. Surgery was temporarily shut down in April 2013 while investigations began.
Adding to the alarm were
comments from doctors and a letter sent from the chief executive
at Newcastle’s Freeman Hospital to NHS England. Both hospitals had been reviewed as part of an attempt to rationalise children’s heart surgery in
England and
ensure surgeons operated on enough patients to remain expert in the difficult operations. Leeds was fighting against the closure of its unit, which would have meant most patients went to Newcastle instead, ensuring its survival.
But the report found that many of the claims made by Newcastle were untrue and driven by vested interest.
The report also concluded that the ‘Safe and Sustainable’ cardiac review, under which some units would have had to close, created a “climate of fear”.
Dr Mike Bewick, deputy medical director of NHS England, said: “Not only have we learned about service in Leeds, we have learned
14 | national health executive Nov/Dec 14 lessons of relevance nationally.”
In September, NHS England launched
a new consultation
paper on the future of children’s and adults’ congenital heart disease (CHD) services, in an attempt to move forward after a decade of debate over which hospitals’ surgical units should stay open and which should shut. That consultation December.
closes on 8
NHS England’s Specialised Commissioning Oversight Group said in a recent update on the CHD review: “‘Safe and Sustainable’ took four years and had a net cost of £6m, but in the end the conclusions were not implemented because of concerns about the process. We are mindful of this and – despite the clamour for a quick solution – have resisted the temptation to take short-cuts in our process, our engagement or in our own internal assurance.”
© Anna Gowthorpe and PA Wire
© Owen Humphreys PA Wire
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