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Long-term NHS plan must be honest, realistic, achievable and clear

Providers demand end to paradox where NHS faces ‘permanent cycle of debilitating public failure’

Louise Prime

Tuesday, 09 October 2018

NHS leaders have warned of the effects on NHS staff of a “permanent cycle of public failure” as they miss key targets despite working harder than ever, thanks to rising demand and tough savings targets. NHS Providers’ chief executive Chris Hopson told delegates at their annual conference this morning that this paradox must end, as he called for a long-term NHS plan that is honest about demand, sustainable, achievable, clear and based on mutual respect.

Chris Hopson pointed out that over the past six years trusts have made “incredible achievements” in treating record numbers of patients and service users while simultaneously raising standards of care and dealing with the longest financial squeeze in NHS history. He said over that period, ambulance trusts have dealt with a more than 30% rise in call numbers; A&E departments have treated 180,000 more people within four hours; mental health and learning disability trusts have introduced a new world-leading regime of outcome standards, to improve treatment; and there are many examples of community trusts “leading the way in rapidly improving care for patients by bringing together different parts of the health and care systems”.

But he warned that the health service is facing the “incredibly frustrating paradox” of dealing with rapidly rising demand and realising record levels of savings as its frontline staff work harder than ever, while still missing key performance and financial targets; he said this is resulting in a “permanent cycle of debilitating public failure”.

Chris Hopson insisted that the upcoming long-term plan for the NHS must allow the provider sector to return to sustainable success so that both frontline staff and trust leaders can “feel, once again, that their efforts are being properly reflected in a positive public narrative about how well the NHS is doing”. But in order for trust leaders to meet their responsibility to deal with the challenges they face and ensure the best possible care for patients, he added, they need “the right national framework and support so they can deliver an achievable and realistically prioritised operational task and transform their local systems”.

He said this means that the NHS long-term plan must be honest about the scale of growing demand with “realism on the size, scope and nature of the demand challenge our NHS faces” that is “reflected in all our plans, priorities and performance oversight”. He said the plan must quickly tackle growing workforce challenges; set an achievable task for the NHS frontline, with “no unfunded commitments, no over-ambitious assumptions, no aspirational wish lists”. He said it must bring clarity on how services will be transformed and called for an end to “the current confusion and uncertainty on the journey from individual institutions to integrated local health and care systems”. And finally, he said, the plan must create a new relationship between national system leaders and local leaders based on mutual respect. He argued: “It is local leaders to decide what is deliverable and what is not; what is safe and what is not … either we trust them or we don’t.”

Chris Hopson concluded that the government must “ensure the NHS has the capital, public health and training budgets it needs when the next spending review completes its work.

“And, above all, it absolutely must develop a robust long-term solution to social care.”

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