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| How to save the NHS: experts offer their big ideas | How to save the NHS: experts offer their big ideas |
| (25 days later) | |
| Alan Milburn, former health secretary | Alan Milburn, former health secretary |
| There is nothing inevitable about a winter NHS crisis. The government has short-changed the NHS and the chickens are now coming home to roost. It is obvious that a long-term funding settlement is needed both for health and social care. It must be allied to a new determination to harness technological advances to make the NHS sustainable. | There is nothing inevitable about a winter NHS crisis. The government has short-changed the NHS and the chickens are now coming home to roost. It is obvious that a long-term funding settlement is needed both for health and social care. It must be allied to a new determination to harness technological advances to make the NHS sustainable. |
| Advances in genomics will allow the NHS to shift emphasis from diagnosing and treating illness to predicting and preventing ill health. The development of precision medicine will increasingly allow each patient to be treated individually. New mobile and bio-devices will enable us to check – and take greater control over – our health in a way that was not previously possible. | Advances in genomics will allow the NHS to shift emphasis from diagnosing and treating illness to predicting and preventing ill health. The development of precision medicine will increasingly allow each patient to be treated individually. New mobile and bio-devices will enable us to check – and take greater control over – our health in a way that was not previously possible. |
| Big data and predictive analytics have the power to transform how we care for people – not least by allowing healthcare professionals to manage workload and patient flow, so helping tackle the problem of delayed discharge of patients from NHS beds into social care, currently a big problem for hospitals. | Big data and predictive analytics have the power to transform how we care for people – not least by allowing healthcare professionals to manage workload and patient flow, so helping tackle the problem of delayed discharge of patients from NHS beds into social care, currently a big problem for hospitals. |
| These kinds of innovations promise a revolution in how healthcare is delivered. The job of government is to provide the resources and reforms that will enable the NHS to harness them for the common good. | These kinds of innovations promise a revolution in how healthcare is delivered. The job of government is to provide the resources and reforms that will enable the NHS to harness them for the common good. |
| Chris Ham, CEO of the King’s Fund | Chris Ham, CEO of the King’s Fund |
| Hospitals are struggling to cope because of rising demand for care from a growing and ageing population. Some of this demand could be met more effectively by greater investment in care in people’s homes and the community. Social care as well as health care must be given priority and shortages of district nurses, GPs, home care staff and others tackled as a matter of urgency. | Hospitals are struggling to cope because of rising demand for care from a growing and ageing population. Some of this demand could be met more effectively by greater investment in care in people’s homes and the community. Social care as well as health care must be given priority and shortages of district nurses, GPs, home care staff and others tackled as a matter of urgency. |
| Pressure on hospitals will only be relieved if they are working as part of well-functioning local systems of care. Silos must be broken down, and health and social care joined up around the populations served. This means integrating care to enable patients to be admitted to hospital quickly and discharged appropriately. It also means investing in prevention to tackle people’s needs before they become crises. | Pressure on hospitals will only be relieved if they are working as part of well-functioning local systems of care. Silos must be broken down, and health and social care joined up around the populations served. This means integrating care to enable patients to be admitted to hospital quickly and discharged appropriately. It also means investing in prevention to tackle people’s needs before they become crises. |
| The more fundamental reform that’s needed is a new health and social care settlement fit for the 21st century. The Barker Commission set out a blueprint in its 2014 report, arguing for a single health and social care budget funded mainly through taxes. Successive governments have ducked this issue and the 70th anniversary of the NHS is the right time to put care services on a sustainable footing for the future. | The more fundamental reform that’s needed is a new health and social care settlement fit for the 21st century. The Barker Commission set out a blueprint in its 2014 report, arguing for a single health and social care budget funded mainly through taxes. Successive governments have ducked this issue and the 70th anniversary of the NHS is the right time to put care services on a sustainable footing for the future. |
| Shirley Cramer, chief executive of the Royal Society for Public Health | Shirley Cramer, chief executive of the Royal Society for Public Health |
| Public health and prevention are the key to the survival of the NHS. Investing in population health and preventing disease is highly cost-effective – by reducing future demand on NHS services, preventive measures have the potential to save the NHS billions of pounds. | Public health and prevention are the key to the survival of the NHS. Investing in population health and preventing disease is highly cost-effective – by reducing future demand on NHS services, preventive measures have the potential to save the NHS billions of pounds. |
| The ban on smoking in public places is just one example, having been estimated to save the NHS more than £380m a year. Indeed, £1 of investment in public health interventions is found to have a £14 return in savings to the public purse. In the 21st century, most of the big killers, such as lung cancer and heart disease, are preventable. Diabetes alone costs the NHS £10bn a year – money that could be saved by investing in tackling obesity now. | The ban on smoking in public places is just one example, having been estimated to save the NHS more than £380m a year. Indeed, £1 of investment in public health interventions is found to have a £14 return in savings to the public purse. In the 21st century, most of the big killers, such as lung cancer and heart disease, are preventable. Diabetes alone costs the NHS £10bn a year – money that could be saved by investing in tackling obesity now. |
| Failure to invest in public health will inevitably lead to falls in life expectancy, widening inequalities and a drastically increased strain on the NHS in the future. While the long-term nature of the investment in public health is not appealing for politicians who want to see immediate benefits, the future of the NHS depends on overcoming this short-sightedness. Public health and prevention are vital to a sustainable health service and, of course, to better health and wellbeing for all. | Failure to invest in public health will inevitably lead to falls in life expectancy, widening inequalities and a drastically increased strain on the NHS in the future. While the long-term nature of the investment in public health is not appealing for politicians who want to see immediate benefits, the future of the NHS depends on overcoming this short-sightedness. Public health and prevention are vital to a sustainable health service and, of course, to better health and wellbeing for all. |
| Jack O’Sullivan, director of his own health innovation consultancy | Jack O’Sullivan, director of his own health innovation consultancy |
| We need to change the relationship between ordinary people and the NHS because the most dynamic bit of healthcare, the bit that’s the most successful, is self-care. Patients are not just a problem, they’re a resource. Think of all the patients who got fitbits for Christmas. I don’t get the sense the NHS properly engages with the self-care revolution. | We need to change the relationship between ordinary people and the NHS because the most dynamic bit of healthcare, the bit that’s the most successful, is self-care. Patients are not just a problem, they’re a resource. Think of all the patients who got fitbits for Christmas. I don’t get the sense the NHS properly engages with the self-care revolution. |
| Most people see a health professional for about an hour in a year and the other 8,000 or so hours people are looking after themselves. The idea is that instead of the system where you go to a GP and the GP tries to fix you, you build up a relationship where the GP helps you and coaches you to keep well and with that you save the NHS a lot of money. It tackles the cost and care crisis, it changes the NHS from being just a sickness service to a proper health service. | Most people see a health professional for about an hour in a year and the other 8,000 or so hours people are looking after themselves. The idea is that instead of the system where you go to a GP and the GP tries to fix you, you build up a relationship where the GP helps you and coaches you to keep well and with that you save the NHS a lot of money. It tackles the cost and care crisis, it changes the NHS from being just a sickness service to a proper health service. |
| We [O’Sullivan wrote a paper with former health minister Lord Warner in 2014] are suggesting there would be a £10 a month charge [for using the NHS] but there would be exemptions, you wouldn’t lose access to your GP if you couldn’t afford it. You might say why charge? The first reason is it’s expensive to coach well and the other thing is it would make people feel ‘I am entitled to go to the GP even though I’m healthy’. | We [O’Sullivan wrote a paper with former health minister Lord Warner in 2014] are suggesting there would be a £10 a month charge [for using the NHS] but there would be exemptions, you wouldn’t lose access to your GP if you couldn’t afford it. You might say why charge? The first reason is it’s expensive to coach well and the other thing is it would make people feel ‘I am entitled to go to the GP even though I’m healthy’. |
| As told to Haroon Siddique | As told to Haroon Siddique |