Despite being under increasing pressure, the NHS can look forward with optimism, with proposed changes leading to a radical overhaul of the way healthcare is managed.
These are critical times for the UK health sector. The changes that are likely to take place within the NHS over the next five years or so are probably more significant than anything that has happened to it since it was founded in 1948.
The health service is under greater than ever pressure. An ageing population and a big increase in the number of people living with long-term conditions, such as diabetes and heart disease, means demand for care provided by GPs, hospitals and community health teams is rising significantly.
Long-term conditions already account for 70 per cent of the NHS budget and this is set to increase. At the same time, financial constraints are unlikely to ease. The UK government has committed more funds for the NHS, linked to gains in productivity through a transformation in the way the health service works.
Amid the economic uncertainty that has followed the UK’s decision to leave the European Union, it has become clear that this financial settlement is unlikely to be renegotiated.
Shaping the future
In 2014, Simon Stevens, chief executive of the NHS, published his blueprint for the new NHS, the NHS Five-Year Forward View. Although this notionally established the direction of travel for the health service through to 2020, the reality is that the changes proposed by Mr Stevens are intended to shape the NHS through the next decade and probably beyond.
At the heart of the Stevens plan is a radical upgrade in prevention and public health. This requires hard-hitting national action on obesity, smoking, alcohol and other major health risks.
The ambition is to develop and support new workplace incentives to promote employee health and cut sickness related unemployment. There will be stronger public health-related powers for local government and elected mayors.
Patients will gain greater control of their own care, including the option of shared budgets combining health and social care.
“Emergency care services will be redesigned to integrate between A&E departments, GP out-of-hours services, urgent care centres, NHS 111 and ambulance services”
The 1.4 million full-time unpaid carers in England will get new support, and the NHS will become a partner with voluntary organisations and local communities. The NHS has promised decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, and between health and social care.
The future will see more care delivered in the community, with some services in specialist centres, organised to support people with multiple health conditions, not just single diseases.
Across the NHS, urgent and emergency care services will be redesigned to integrate between A&E departments, GP out-of-hours services, urgent care centres, NHS 111 and ambulance services. Smaller hospitals will have new options to help them remain viable, including forming partnerships with other hospitals further afield and partnering with specialist hospitals to provide more local services.
Midwives will have new options when it comes to taking charge of the maternity services they offer, and the NHS will provide more support for frail older people living in care homes. England is too diverse for a one-size-fits-all care model.
In some devolved areas, such as Manchester, budgets and responsibility for health and social care will be transferred to local authorities, who will develop models that suit their population.
Elsewhere, local health communities will be encouraged to choose from a small number of radical new care-delivery options, and then given the resourcesand support to implement them. This approach could, potentially, accelerate the fragmentation of a countrywide health service, which has already seen new models of care emerge in Wales, Scotland and Northern Ireland.
Technology will play a crucial role in the evolution of the health service into the next decade
After a number of ostly and ignomonious false starts, there is a determination across the NHS to harness the power of digital technology to improve delivery of care while gaining operational efficiencies.
The tech industry has enjoyed huge success in creating consumer health products, but these are not comprehensively linked to the health and social care sector. The new National Information Board hopes to put this right by bringing together organisations from across the NHS, public health, clinical science, social care and local government and public representatives to develop systems collaboratively, instead of imposing them centrally.
So, against a challenging background for the NHS and social care, there are opportunities for the healthcare industry in developing products and services that support Stevens’ vision of an affordable and sustainable health service. Whether it is helping patients manage their own care at home, or helping care professionals navigate their way across the increasingly complex health landscape, the outlook is bright.