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Leaders call for major rethink on NHS

Manifesto calls for major shift of care to community

Adrian O'Dowd

Monday, 10 October 2016

A fundamental shift of provision of care from hospitals to the community is central to a radical new vision for how the NHS should be run, published at the weekend.

The manifesto* published in The Lancet, is written by a leading group of clinicians, scientists, social entrepreneurs and peers including Professor Maureen Baker, chair of the RCGP, Lord Nigel Crisp, the former chief executive of the NHS, and Professor Dame Sue Bailey, chair of the Academy of Medical Royal Colleges.

The UK’s approach to health needs radical rethinking, said the authors, who also included representatives of the Academy of Medical Sciences, Royal College of Nursing, Royal College of Midwives, NHS Alliance, and expert advisers to Public Health England and NHS England.

Brexit and the “troubled state” of the NHS meant it was time for a rethink on the UK’s approach to health, said the authors.

“The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future,” says the manifesto.

“At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector.”

Despite this, new scientific developments and digital technology offered large and unprecedented opportunities for improving health, they argued.

One of the manifesto’s main calls for action was for the “transformation of the health and care system from a hospital-centred and illness-based system to a person-centred and health-based system” to be accelerated and funded.

“This will require a massive increase in services in homes and communities and new ways to empower front-line staff, enabled by technology, to manage the complex needs of patients across different services and organisations,” said the authors.

At the same time communities, employers, educators and other organisations could do more to develop healthy and resilient communities where people could thrive.

The UK was a world leader in health, biomedical and life sciences and these should be at the heart of the UK’s future industrial strategy, said the authors.

Lord Crisp said: “The NHS faces severe financial constraints, and leaving the EU is likely to exacerbate many problems including staffing.

“We need a new approach to health that recognises on the one hand the enormous contribution health and biomedical sciences make to the economy, and on the other that every part of society has a role to play in improving health.”

Dr Richard Horton, editor-in-chief at The Lancet, said: “It’s time to write a new contract between the UK’s NHS and society.

“The relationship between government and the medical profession is broken. Morale among young doctors is at an all-time low.

“It’s therefore urgent to set out a new, positive vision for health and the health service - a modern NHS that delivers the best care for patients wherever they live, supports world-class scientific research, is supported by all sectors of society working to create a healthier nation, and takes on a global leadership role in advancing the objective of universal health coverage.”


* Crisp N, Stuckler D, Horton R, et al. Manifesto for a healthy and health-creating society. The Lancet, October 2016. DOI: 10.1016/S0140-6736(16)31801-3

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