The NHS is the country’s largest employer, creating jobs for around 1.25 million people and ranking as the world's best healthcare system, ahead of comparable systems on measures including care process and equity.
However, the NHS is changing. Our population is aging, demand for health and social care services is increasing, and innovative technology is creating opportunities for better, more personalised care and support. Patients, service users and the public now need and expect different things from the health service.
In response, the NHS is transforming to provide care that is closer to home where possible, better joined-up across community, primary, secondary and social care services and more responsive to individual needs. For the NHS to continue developing its care and services to meet changing needs, it needs support from the government in four key areas, as set out in our manifesto on building the NHS of the future.
1. Investment in people
Staff are the bedrock of the NHS. With over 100,000 vacancies in the health service, recruiting and retaining enough people with the right skills in the right places is the number one challenge facing the NHS frontline. Rapid solutions to a range of workforce issues – such as training, pension taxes and staff pay, terms and conditions – are vital.
Growing the future NHS workforce must be supported. We need to increase the number of staff through investment in training more people with the skills needed for the care needs of today and the coming years, as well as developing a flexible immigration system that ensures the NHS can continue recruit the staff it needs.
We also need a focus on workplace culture and how to make the NHS a great place to work. This includes creating more flexible and appealing career pathways and ensuring that policies such as the apprenticeships levy fulfil their aims and support the NHS in building a committed workforce and increasing supply.
Staff are the bedrock of the NHS. With over 100,000 vacancies in the health service, recruiting and retaining enough people with the right skills in the right places is the number one challenge facing the NHS frontline. Rapid solutions to a range of workforce issues – such as training, pension taxes and staff pay, terms and conditions – are vital.
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2. A structural and technological upgrade
The NHS can only be as good as its facilities, equipment and technology allows. With a maintenance backlog of nearly £6.5bn, an urgent upgrade is required.
We need to see a broad approach, with investment across mental health services, digital transformation, primary care and wider service transformation, such as moving care closer to home, multidisciplinary working and diversifying the role of ambulances. The current NHS capital budget needs to be at least doubled and sustained to meet these needs – that would bring us into line with other comparable countries.
We also need a more transparent process for allocating capital and a digital strategy that supports the NHS to improve how it delivers care and ensures patients get the maximum benefit from digital technology.
We also need a more transparent process for allocating capital and a digital strategy that supports the NHS to improve how it delivers care and ensures patients get the maximum benefit from digital technology.
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3. Locally-led services
Greater collaboration between health and social care organisations in local communities presents a major opportunity to improve care and support for patients and service users.
Getting this right will rely on holding trusts and local systems to account through proportionate and efficient regulation, balancing central support for closer working between health and social care services against the freedom of local health and care organisations to make decisions in the best interests of their communities.
The NHS should maintain good governance practices as local health and care systems evolve, with any changes to law to be developed together with NHS staff and board members.
4. Whole-system investment
Some of the key opportunities to improve care quality and population health outcomes fall outside the NHS' core budget. This includes sufficient funding for public health and prevention services and the wider determinants of health such as education, housing, transport.
A sustainable, long-term funding model for social care is also essential. There is broad consensus around increasing social care funding and creating a fair and accessible system which protects the most vulnerable. Without addressing the social care challenge we risk devaluing every pound of investment in the NHS.
A sustainable, long-term funding model for social care is also essential. There is broad consensus around increasing social care funding and creating a fair and accessible system which protects the most vulnerable. Without addressing the social care challenge we risk devaluing every pound of investment in the NHS.
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To build a 21st century NHS, we need the right number of people with the right skills in the right places equipped with the modern facilities and technologies, with investment that supports people to live well in their communities.
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