The NHS’s 70th anniversary has been a brilliant opportunity to reflect on the achievements of the National Health Service, and also to look ahead at the challenges it faces in the future and what we need to do to address them.
To mark this milestone, NHS Providers, along with the Royal College of Physicians, NHS Clinical Commissioners, National Voices and Ipsos MORI brought together leading health and care experts and commentators to debate how the NHS can survive and thrive for another 70 years.
Simon Keen, senior media and communications officer at NHS Providers, shares ten reflections on the top talking points from the second debate held in Liverpool:
- Despite these challenging times support for the NHS and its basic principles remain high. Ipsos MORI found that 84% of the public would be willing to pay more tax towards the health service if it led to improved performance. So as welcome as the five-year funding settlement is, the public will expect to see improvement as a result of any tax increase used to fund it. Polling commissioned for this debate series also showed that concern about mental health services had doubled within the last year. This is good news and a testament to the work to improve parity between mental and physical health. However there is still much to do.
- An audience member made the stark point that the NHS would not survive another 70 years unless we address the social care question now. How we should pay for our care as we get older is a political hot potato – but, with our ageing population it needs to be addressed. Without a commitment to fund social care we risk devaluing every pound invested in the NHS. Alex Fox, our panellist from Shared Lives, suggested the new funding could offer breathing space to reframe this relationship.
- Alongside the funding settlement, the government has committed to protecting prevention and other key budgets. But we should be looking at prevention as an investment which could offer some ‘quick wins’. As a starting point, we need to tackle inequalities around access to the prevention services for minority groups. This is something we must urgently tackle regardless of resources.
- To address both social care and prevention, we have to recognise the vital role that the voluntary and community sector plays. We need to change our approach to this sector in order to meet the needs of patients and communities in the future. The current approach is leading to unviable short contracts. Our panel argued that we should see these sectors as ‘design partners’ in service delivery.
- Despite this, we know that tough decisions will need to be made about the priorities for the additional funding. Just filling the gaps and recovering performance against key targets will eat away at much of, if not most of, the additional funding. Anita Charlesworth, our panellist from The Health Foundation, warned that there is a risk that the money will be spent in the system as it always has been without the public seeing tangible results. Health and care leaders and the front line must play a central role in helping to shape the ten-year plan and address the priorities that will improve the way people access services and the care they receive. These conversations must be honest and open with the public. As Ben Page, of Ipsos MORI, said - someone will have to make these tough “choices about the NHS, and those decisions won’t please everyone”.
- Alongside the ten year plan, we are expecting the government to publish a comprehensive workforce strategy. The challenge of recruiting and maintaining the right workforce with the right skills mix is now bigger the number one issue facing the NHS. An ageing workforce, the stress of increasing and complex demands, bullying, inflexible working patterns and a lack of diversity in leadership are all contributing to the problem. A comprehensive workforce plan needs to plan for and invest in the future workforce and ensure the NHS is seen as a great place to work. Estephanie Dunn, our panellist from Royal College of Nursing, warned that to do this we need to “move away from a one size fits all approach” to workforce planning.
- But where will the staff we need for the future come from? Recruitment of doctors, nurses and carers from overseas will remain a key part of the staffing mix but we need to invest in the domestic supply as well. Changing the culture of the NHS is an important step in addressing retention for overseas staff but also making nursing or a career in health and care an attractive choice for young people.
- What will the services of the future look like? How will they be accessed? To answer these questions, patients should be at the heart of service design. We need to move beyond consultation and towards genuine co-production with the public and service users argued Alex Fox. The public, when fully engaged, is more likely to support and understand the need for change. The current approach is too limited and does not involve people in the discussions at an early stage where they make can make a real impact. The services of the future must be built in a more humanising way.
- Technology will play an increasingly crucial role in the delivery of health and care services of the future. It was a timely discussion with the recent appointment of a new health and social care secretary keen to move technology in the NHS further up the agenda. The role of technology in improving efficiency and enabling the integration of health and care services is likely to be a key component of the ten-year plan. It was noted by our panel that although technology has much potential, it should not replace people and cannot replace caring relationships. The key is working together.
- Finally, the second debate was held in the fantastic city of Liverpool. It was great to host the event outside of London and welcome a broad range of views and challenges that the audience and our panel brought the debate. We were pleased to bring together a diverse audience of professionals and leaders working in the health and care sector and contribute to the wider national debate about the future of the NHS as it celebrate its 70th anniversary.
Couldn't make the debate? You can watch the event in full below.
Read our exclusive polling results commissioned for the NHS at 70 debate series.