The King’s Fund has identified three big challenges for the NHS in England:
- Sustaining existing services and standards of care
- Developing new and better models of care
- Tackling these challenges by reforming the NHS
The Kings Fund states that the NHS faces unprecedented financial and operational challenges: deficits among NHS providers are large and growing; performance is suffering, with targets for waiting times being missed; and in all areas of the NHS staff are under pressure from rising demand alongside constrained resources.
These challenges are amplified by cuts to social care and public health and by the requirement for the NHS to deliver £22 billion of productivity improvements by 2020/21.
The Kings Fund suggests that focusing on better value offers opportunities to improve productivity. In individual organisations, better outcomes can be delivered while minimising costs by engaging clinical teams in reducing variations and changing the way care is delivered. The main focus should be on improving clinical practice, building on past experience in areas such as generic prescribing, day surgery, and reduced lengths of stay in hospitals, as well as acting on the themes identified in the Carter review.
Locally, organisations should work together in place-based systems of care to decide how to use the resources available and to break down barriers between services. Opportunities for delivering better value include providing integrated care for older people, children and people with long-term conditions and supporting people to die in the place of their choice, with health and social care budgets being pooled to deliver truly integrated care.
In the long term, as the Barker Commission has set out, we should look to moving to an integrated system for health and social care with a single local commissioner of services. The aim should be to bring public spending on health and social care up to 11–12 per cent of GDP by 2025. The Commission argued that this was both affordable and sustainable if hard choices are made about how to fund the additional resources.
There is an immediate need to ensure that workforce numbers are sufficient to meet demand. Urgent action is needed to tackle staff shortages and to make the NHS an attractive career choice.
Read the report here