COMMENT XXXX


Changing the way we deliver health and care


Dame Gill Morgan, chair of the Foundation Trust Network, which is changing its name to NHS Providers, gives an update on the organisation’s programme over the course of the next Parliament.


It’s


rare for the NHS to be out of the headlines. From immediate winter pressures to the longer-term challenges of promoting wellness and preventing illness, there is a continuous national conversation about the NHS. Like the weather, everyone has a strong opinion on our prized national institution.


The NHS is, as Professor Don Berwick astutely described, a “world-leading example of commitment to health and health care as a human right”. People are as protective of it as they are critical. They want the best from the public service they turn to when they are in pain, vulnerable and worried – they want to trust it, they want it to give them hope.


The NHS creates unparalleled social and economic value. It is a constant presence in everyday life, in sickness and in health – not least as it employs over a


Development Authority and Public Health England – politicians have helped build up a strong narrative around the NHS of the future.


There is, once the hyperbole is removed, a surprising degree of consensus across all political parties. They advocate integration of health and social care, a greater focus on prevention, better access to primary care, seven-day services and, at last, true parity of esteem for mental and physical health.


Disconnect


“There is, once the hyperbole is removed, a


surprising degree of consensus across all political parties.”


million people, and has a major role in local and national business through procurement, capital investment, and research and development.


Politicians understand the resonance of the NHS, and the impact it has on their electorate’s voting intentions. Working with the NHS’s leadership and statutory bodies – most visibly NHS England, Monitor, the Care Quality Commission, the NHS Trust


20 | national health executive Nov/Dec 14


These are imperatives for new ways of delivering care that build on local strategies and implementation. But this is where there is a disconnect between the overall narrative and the reality.


While nationally there is a shared ambition for radical change,


at a local level politicians


frequently insist that their services stay the same as they’ve always been, denying their constituents health and care services that are suitable to deliver 21st century care in favour of the status quo, irrespective of evidence.


Local services meeting national standards doesn’t mean that the NHS works the same way in every town and village. It doesn’t mean that local services will never change or that we should accept today’s standards as the best


they can be.


The problem: ensuring we have an NHS and social care system which matches 21st century health and care needs.


There are more people, living longer, with more numerous, complex and serious health conditions. A one-size-fi ts-all NHS doesn’t do justice to these needs. An NHS stuck in the formaldehyde of the 20th century will eat money, never quite managing to help people enough.


The solution: money, time and space


Everyone knows that the right people need to be in the right place at the right time to provide the right care for patients and service users.


Everyone in the NHS – from board to ward – knows what they would do to make things better if they could. That’s why they joined the NHS – to make things better. But today’s pressure leaves little room for anything save keeping heads above water.


How do we move forward, both changing and preserving this key public service?


Unavoidably, a large part of the answer does come down to funding. Political acceptance of this is dawning. There is a quiet acknowledgement that without adequate funding, care standards or the current range of services cannot be maintained. But we are some way away from a full realisation of


© Peter Byrne, PA Wire


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