Healthcare delivery
theatre lists to get through a week of planned operations in a day and create seven-day-a-week surgical hubs.
3. Reform the GP contract to focus on wider health outcomes, ensure prompt appointments and restore continuity of care. Encourage more super-practices and create community health centres.
4. Write off student loans for doctors, nurses and midwives who stay in the NHS. Debt should be cut by 30 percent for those staying three years, 70 percent for seven years and 100 percent for ten.
5. Introduce no-blame compensation for medical errors with settlements determined according to need to, ensure families get quick support and encourage the NHS to learn from mistakes.
6. A National Care System giving the right to appropriate support in a timely fashion. Equal but different from the NHS, it should be administered locally and delivered by a mixture of public and private sectors.
7. Guarantee that all children and young people requiring mental health support can get timely treatment and rapid follow-up appointments. Publish data on waiting times for all mental health services.
8. Tackle obesity by expanding the sugar tax, taxing salt, implementing a pre-watershed ban on junk food advertising and reducing cartoons on packaging to minimise children’s exposure to unhealthy food.
9. Incentivise NHS staff to take part in research and put the case for research to their patients by giving 20 percent of consultants and other senior clinicians 20 percent protected time for research.
10. Establish a Healthy Lives Committee empowered by a legally binding commitment to increase healthy life expectancy by five years in a decade.
Commenting on the report, Nuffield Trust Chief Executive, Thea Stein, said: “In an election
year, the final report from the Times Health Commission should provide food for thought. The breadth of the report illustrates that, across health and care services, we need innovative and bold action. The Commission puts a lot of stock in the role of new technology to bring about improvement, but serious questions remain about how we fund and properly invest in the talented people we need to provide these vital services to patients and the public. “The Commission is right to point to the
need to act on workforce concerns, and we are pleased that the Commission, and public polling, has backed the sensible and realistic proposal to gradually write off the student debt of healthcare professionals, put forward by the Nuffield Trust last September. The government’s plan to increase clinical training places are ambitious, but without a realistic plan to keep people within the workforce, the benefits will not be felt as hoped. We continue to argue that writing off the debt is affordable, credible and the benefits will be felt immediately. “The failure to implement limited proposed
reforms to social care funding is the latest delay to taking steps to pull the care sector back from the brink. The proposals set out by the Commission propose a new system based on principles of sustainable funding, a consistent and clear offer, stable provision of services and a strong and valued workforce. “The Commission also proposes much needed
ideas to improve the perception of social care careers by encouraging medical students to spend some time during training in these care settings. The funding model suggested still requires politicians to step up and make the tax and funding decisions needed and sadly this remains the biggest barrier to any progress. “While many of these ideas are of individual merit, political leaders will remain faced with the difficult question of how to bring the changes needed together, while health and care services
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and their workforce remain under severe pressure. That inevitably includes how to fund the change and accepting the need for long- term investment rather than expecting quick fixes.” Sarah Woolnough, Chief Executive of The
King’s Fund, also commented: “Many of these solutions have been known about for years, but not implemented. Successive governments have focused on short-term solutions to immediate challenges, not fully grasping the wider opportunities to improve the health of the nation. The impact of these decisions is clearly visible in the challenges now faced by our healthcare system with people struggling to access the care they need when they need it, and in the overall health of the population. While public support for the NHS remains rock solid, public satisfaction with the health service is at its lowest since it first began to be tracked 40 years ago. “There is precedent to show that when the political will exists, and a long-term approach is taken, significant improvements to health and health care services can be made. To improve the nation’s health, politicians should focus on making health and care a more attractive place to build a career, bolstering out-of-hospital care, such as primary, community and social care services, and helping people live healthier lives through a focus on preventing illness.”
Refocusing health and care According to the King’s Fund, “the answer to over-crowded hospitals is not more hospitals.” Instead, the health and care system in England must be radically refocused to put primary and community care at its core if it is to be effective and sustainable.3 The King’s Fund’s latest report, ‘Making care
closer to home a reality’, argues that the failure to grow and invest in primary and community health and care services is one of the most
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