Healthcare delivery
Can the NHS deliver the ‘three healthcare shifts’?
MPs recently asked the senior leadership of NHS England whether the NHS is well placed to implement the Government’s three healthcare shifts, in an evidence session to the Health and Social Care Committee. The three shifts include: moving care from hospitals to the community, embracing digital transformation, and shifting from treatment to prevention. Louise Frampton reports.
An evidence session to MPs – featuring top NHS England leadership – recently coincided with the publication of a damning report by the Public Accounts Committee (PAC), accusing NHS senior leadership of ‘complacency’. The panel were grilled on whether the NHS is “well placed to deliver the government’s three healthcare shifts”, and on the findings of PAC, which suggested that there is a “lack of fresh thinking and decisive action” within NHS England and DHSC. Amanda Pritchard, Chief Executive Officer,
NHS England, opened the session by stating that “NHS England is not complacent about productivity, and it is completely wrong to suggest otherwise.” She criticised the PAC report for its “factual inaccuracies”, to which the Chair of Health and Social Care Committee, Layla Moran MP, sharply responded that this was a “bold claim”.
Responding to PAC report criticism Addressing some of the points raised in the PAC report, which she felt were contentious, Amanda Pritchard stated that NHS productivity is improving, but added that NHS England has been open and transparent about the challenges and its plans to address it. She announced planning guidance was being published imminently (see the panel at the end of this article). On the need for earlier budget allocations,
she agreed that “everyone in the NHS would like to see budgets earlier”. However, she quoted Julian Kelly, Deputy Chief Executive Officer & Chief Financial Officer, NHS England, who had previously made a statement to the Public Accounts Committee. He stated: “We try to give early informal indications of what people can be expecting, but we actually need to know what our budget is in order to be able to give a budget.” She pointed out that budgets are subject to
cross government clearance, adding that there must be proper engagement with ministers
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given the billions of pounds involved. “These are really difficult decisions for government,” she continued. “As soon as we have had cross government clearance, we have released planning guidance on the same day.” She also tackled the accusation by PAC that the shift to community has ‘stalled’. Although the shift to community was impacted by the pandemic, she argued that far from stalling, in 2023/24, investment in primary care and community services increased much faster than overall Integrated Care Board (ICB) spend. In addition, this year, there has been extra funding for an additional 1,000 GPs. “There is no shortage of fresh thinking in the
NHS. We are working closely with government to drive innovation forward, as part of the development of the 10-year plan. It is going to be a really ambitious plan to build an NHS fit for the future,” Amanda exclaimed. “Importantly, no one is waiting for the 10-year plan to get on with the job of delivering reform. As the Secretary
of State has said, these shifts are not radical or new – but actually delivering them would be.” She said that in advance of the 10-year plan,
NHS England has set out to “go further” in building on existing initiatives, as well as radical new initiatives. For example, the elective reform plan sets out how more convenient care will be provided, closer to home. Community diagnostic centres have now been established and the aim is to transform patients’ experiences of care through the use of the NHS App.
The shift to community As the focus of the session returned to discussion around the Government’s three shifts, Amanda Pritchard commented that the work on delivering a shift to community over the past few years has been around putting the basic infrastructure in place – such as urgent community response, virtual wards and single points of access for services. There has also been investment in primary care, particularly
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