With the end of the decade fast approaching, the government has been contemplating the development of the NHS over the past ten years and has published its plans for the next five in NHS 2010-2015: from good to great. Preventative, people-centred, productive. Here we summarise the main points of this roadmap.
As a foreword, Andy Burnham admits that whilst the NHS has made huge progress in recent years, there is still potential to transform the NHS from “good to great.” The NHS is due to receive a substantial budget next year which will be crucial in achieving the aims set out during this new financial era.
The government vision, to create a “preventative, people-centred, productive NHS,” builds on Lord Darzi’s vision set out during the NHS Next Stage Review. It outlines the six challenges that a modern healthcare system faces: ever higher patient expectations, an ageing society, the dawn of the information age, the changing nature of disease, advances in treatments and a changing workforce. The government plans to tackle these challenges by focusing on three main areas: patients and the public, NHS staff, and support for staff and organisations. The principal changes that have been proposed are highlighted here.
Achieving this will depend on encouraging patients to take greater responsibility for their own health...
Patients and The Public
Patients and the public will have a full set of rights, set out in the NHS Constitution. There will be a greater emphasis on patient choice and further services will be available at more convenient times. The primary aim is to reduce the burden of avoidable ill-health by taking the “predict and prevent” approach. Achieving this will depend on encouraging patients to take greater responsibility for their own health via the “big four” lifestyle factors (smoking, diet, alcohol and physical activity). The idea will be to target young people in order to have maximal preventative impact. Policies to improve mental health services and promote public mental health will be outlined in New Horizons: A shared vision for mental health. There are plans in place to enable patients to make self-referrals to a therapist and be seen within two weeks. All 40 to 74 year-olds will have access to NHS Health Checks to prevent heart disease, stroke, diabetes and chronic kidney disease. Greater regulation will allow for safer care. Essentially, patients will be at the centre of care.
...consultants and the most senior managers will not receive a pay increase in 2010/11
The proposed changes will clearly require staff alterations. Help will be provided for underperforming services and to establish new services. The offer of guaranteed employment is under consideration, but this needs to be weighed up with resulting pay restraints. Ultimately, staff satisfaction will be at the forefront of these changes and the level of satisfaction will be measured in a systematic way. Staff will need to collaborate with different teams and set up social partnerships. Provisions will be in place for teams to share acquired knowledge with staff nationwide. As is the case for patients, staff will have their own rights set out in the NHS Constitution. In addition, consultants and the most senior managers will not receive a pay increase in 2010/11. The document supports the protection of the NHS pension scheme for new and existing staff.
Management costs will be cut in primary care trusts
Support for NHS Staff and Organisations
In order to implement the changes set out, the government needs to provide support, incentives and payment rewards for staff and affiliated organisations. Poor quality of care must not be financially rewarded and the services involved will need to show “clear and rapid improvement.” The tariff system will allow for delivery of improvements in quality and productivity. Management costs will be cut in primary care trusts and strategic health authorities in an attempt to free up further capital. Commissioners will be encouraged to collaborate and the NHS will unite with other partners. The significant change for hospital providers is the announcement of a maximum uplift of 0% over the next four years. This will encourage hospitals to consider their costs carefully.
The NHS 2010-2015 plan provides a detailed roadmap of how the NHS will grow during the current economic climate. Much of it highlights initiatives that have already begun, but the focus of the change is to create an NHS where prevention and patient satisfaction is fundamental. We can only wait with anticipation to discover whether the next decade will bring with it the transformation of the NHS from “good to great.”