News
NHS must root out inefficiencies and reduce costs without waiting
for government
11 March 2010
A report published by the NHS Confederation today says that the
NHS should not wait for government action to respond to the current
financial challenges.
The study, Rising to the challenge: health priorities for the
Government and the NHS looks at the scale of the task facing a new
administration after this year’s General Election and paints a stark
picture of the challenges an incoming Government will face in the
management of the health service.
It argues that the demands of a spending squeeze combined with
lifestyle factors, the UK’s aging population and the increasing cost of
healthcare mean the NHS is facing one of the most difficult moments in
its history.
The NHS Confederation, which represent more than 95% of the
organisations which make up the NHS, has called on whoever wins
the next election to acknowledge the size of the challenge and be honest
about the tough decisions that will be needed.
The report says the NHS has to improve operational efficiency,
including finding ways to reduce staff costs, and redesign services to,
for example remove delays and duplication in services, stop ineffective
and outdated practices, and ensure patients only stay in hospital when
needed.
For the government, it says closer integration of health and social
care is needed, including shared commissioning. It calls for a move away
from World Class Commissioning, the Care Quality Commission, Vital Signs
and other frameworks that reinforce silo thinking. It also says that the
regulatory system is not working and that there is no clear consensus
about its role.
There needs to be more integrated working between primary care and
specialist and diagnostic services, especially for long-term conditions,
and patients need more support to manage their own health.
The report calls for a new GP contract to support reform, greater
choice and integration of services.
A chapter on learning from the past highlights the large number of
reorganisations, mergers and other centrally driven changes the NHS has
gone through and the need to consider the time it takes to adapt to
changes. It warns that while top-down targets can be effective,
inflexibility can be damaging. It calls for a move away from the planned
surgery model of healthcare to one that allows different approaches,
structures, systems and methods to allow for adaptation to local
circumstances.
Steve Barnett, the chief executive of the Confederation, said a frank
debate during the forthcoming General Election along with cross party
co-operation afterwards, was essential if the NHS was to deal with the
coming years. “It is crucial that we have an honest debate about where
the NHS is headed in the next five to ten years and that politicians, as
well as managers, doctors and staff, are frank with the public about how
significant the problems we face are,” he said.
“We have specific problems in public health with issues like
drinking, smoking and obesity, which need action across Government and
society. We also face real challenges in providing better care for
elderly people — which needs a coherent policy for social care — and
some tough decisions to make about how and where we provide healthcare
services.
“The NHS has to play its part in rising to these challenges and
should not be looking to Government for all the answers — both
clinicians and managers need to focus, amongst other things, on rooting
out inefficiencies in the system, reducing costs and redesigning
services.
“Political leadership is required in continuing to build on the
reform programme, including the use of competition and new providers
where appropriate; dealing with major challenges such as integration of
health and social care; and aligning national public health initiatives
with local campaigns and activity.
“Coming to conclusions about these of challenges will be one of the
defining tasks of the next Government, regardless of who forms it.”
The Confederation’s report says reform of the way the NHS does things
needs to continue but also calls for health organisations to be given
the freedom and flexibility to find their own solutions, it says: ‘We
need much more tolerance of different approaches, structures, systems
and methods to allow for adaptation to local circumstances.
It also observes: “In the past, the NHS has suffered from an
over-abundance of initiatives. In these times of austerity, policymakers
may not be able to create new initiatives quiet as easily and must
resist the temptation to do so.
The report is available at:
http://www.nhsconfed.org/Publications/reports/Pages/
health-priorities-for-government.aspx
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