Eight things the new government should prioritise for the NHS

Eight things the new government should prioritise for the NHS

1.Commit to the five year forward view

“The government should back the funding pledges of an additional £8bn by 2020/21 as a minimum and cover immediate shortfalls in funding for 2015/16. The new secretary of state should work to three main objectives for the NHS – maintain or improve quality, transform care for the future and achieve financial balance. Better quality care often results in lower cost, but quality of care should win out if trade-offs are to be made. The secretary of state should work constructively with frontline staff and managers rather than adversarially and commit to no administrative reorganisation.” 

Dr Jennifer Dixon, chief executive, Health Foundation

“It will be crucial that the next government maintains a stable and certain environment in the NHS that enables clinical commissioning groups (CCGs) to continue to transform care and improve health outcomes for their local populations. We must trust the clinical expertise that CCGs have and give local NHS leaders the space and flexibility to find local sustainable solutions that meet the needs of their communities ... We would also call on the next government to fund the Five Year Forward View – every party has welcomed its intentions as a sensible approach to securing the future of the NHS, and keeping it free at the point of need, but politicians have to commit to resourcing it.” 

Julie Wood, director, NHS Clinical Commissioners

“The Five Year Forward View called for a radical upgrade in prevention and addressing the causes of lifestyle-related illnesses, such as diabetes and obesity, and the new government must be committed to this agenda. We are still faced with huge gaps in health inequalities, with people living in the richest neighbourhoods living on average seven years longer than those living in the poorer neighbourhoods and this cannot continue ... The new government needs to act quickly to turn around our struggling NHS and we believe huge potential exists in a wider untapped workforce which includes firemen, hairdressers, podiatrists and pharmacists.” 

Kate Sanger, spokeswoman, Royal Society for Public Health

2. Keep the NHS free at the point of care

“Competition and deregulation for private interests will restrict patient services and welfare cuts are likely to create a greater demand from the public’s need to access care. Without action we will soon have a health system which fails to provide for patients and is fundamentally neglecting the interests of those that it is there to serve. It seems that among the false rhetoric surrounding health tourism, politicians have forgotten that universality is one of the founding principles of the NHS.” 

Lucas Scherdel, national director, Medsin UK


“The NHS has suffered badly from the instability caused by constant reorganisation, and funding policies that have made it harder for hospitals, GPsand community services to work together to improve patient care. The next government must commit to a long-term vision that brings joined-up care to patients wherever they are. They must also increase funding quickly to safeguard the NHS from an impending financial crisis, and reassure the public that the NHS will remain free at the point of delivery.” 

Prof Jane Dacre, president, Royal College of Physicians

3. Avoid another top down reorganisation at all costs

“ Ministers must avoid the temptation to tinker with NHS structures and instead create the space for local health leaders to reshape services around people’s needs. People’s needs are different now to when the NHS was first established in 1948, and we need services that reflect these changing needs. Most obviously, we have an ageing population and in just 10 years’ time, it is estimated that 18 million people will have at least one long-term condition. The debate has focused on how the Treasury will need to find at least an additional £8bn as set out in NHS England’s Five Year Forward View, to help fill the £30bn funding gap. This level of investment would require at least £22bn in efficiency savings and probably more.” 

Rob Webster, chief executive, NHS Confederation

4. Invest in mental health

Black Mental Health UK’s top manifesto demands are: 

Outlaw the use of prone restraint of vulnerable people detained on mental health wards in line with international human rights law. End the practice of health staff calling police on to locked wards to restrain distressed patients when in crisis, and ban the use of Tasers against those detained under the Mental Health Act.

Invest in black-led third sector community agencies to provide “places of safety” that are an alternative to hospital for those detained under the Mental Health Act. 

Matilda MacAttram, director, Black Mental Health UK

5. Ensure safe staffing levels

“We desperately need more GPs – we have a severe shortage right across the country and this is now a genuine threat to patient safety and the wider NHS ... General practice is a fantastic, rewarding and varied career and it is essential that the new government works with us to promote this message and attract new medical graduates into general practice. GPs keep the rest of the health service sustainable by delivering care to our patients out of hospital, where it is more cost-effective, close to home, where they want it most – but we need more resources and more GPs so that we can continue to do so. Along with more GPs, the new government must make sure that general practice receives 11% of the NHS budget over the course of the parliament.” 

Dr Maureen Baker, chair, Royal College of GPs

“The next government should commit to improve patient care through ensuring safe staffing levels across all settings and listening to staff, to value nursing by giving staff the fair pay they deserve, and to invest in health and care by guaranteeing no more cuts to the workforce. The RCN calls on MPs to formulate policies for the future of nursing based on these priorities, which have patient care at their heart.” 

Dr Peter Carter, chief executive and general secretary, Royal College of Nursing

“Illness does not respect time or boundaries. Yet, we know mortality and complication rates are significantly higher for patients admitted on Fridays and the weekend. Therefore, the implementation of the same standards of care seven days a week will be vital for patients to reduce variability in outcomes. This must be a priority for the new government ... The government must also prioritise improvements to urgent and emergency care. In surgery there is wide variation in death rates for emergency and trauma patients. This must change ... We need to attract more staff into emergency medicine and review how we can make emergency care more clinically and financially sustainable.” 

Clare Marx, president, Royal College of Surgeons

6. Review current wages

“We want to see a commitment to end the midwife shortage in England which we estimate to be around 3,000 full-time midwives. Also, there is a pressing need to improve mental health services for pregnant and postnatal women. Investing in midwives and in the services for women and their babies will save the NHS money in the long run. We would want to see any government committing to abide by the recommendations of the NHS Pay Review Body. It is essential that NHS staff are paid a fair wage and that their pay at least keeps up with the cost of living.” 

Sean O’Sullivan, head of policy, Royal College of Midwives

“Quality services, capable of adapting to changing population needs, rely on a motivated workforce which receives fair pay. A government serious about transforming our health system needs to commit to ensuring an independent pay review body for the NHS and to support NHS staff in restoring lost income. Transforming out-of-hospital care must be a key priority for the next government. Our health and care system needs to change to meet the needs of our ageing population, and an increasing number of patients with long-term and complex conditions. This can only be achieved through better use of the whole range of healthcare professionals, so that the right patient sees the right professional at the right time.” 

Prof Karen Middleton, chief executive, Chartered Society of Physiotherapy

7. Bring joined-up care to patients

“To give some hope for the future sustainability of the NHS, healthcare policies need to move away from flashing blue lights and multi-bed hospitals and instead focus on individuals’ lifestyles and care in the community. We need to ensure people avoid becoming ill in the first place or that, when unwell, they have their conditions well managed to avoid medical emergencies and hospitalisations which put patients in danger and cost the NHS large amounts of money.” 

Edmund Stubbs, healthcare researcher, Civitas

“The key NHS priority for any incoming government will be to ensure excellent health and social care for older people. Getting care right for this hugely important group of patients is a critical part of modernising the NHS, and ensuring that it can look after patients of all ages. To achieve this, the new government will have to make firm commitments on ending the current divide between health and social care (the former is universally free, the latter means-tested) and ensuring that both are adequately resourced. They must also focus on measuring outcomes of care which matter to older people and their carers, and building systems of care around patients living with multiple conditions including frailty and dementia.” 

Dr Andrew Williams, consultant geriatrician, Royal Bournemouth general hospital

8. Plan for the long term

“The next government should prioritise transition funding to allow new models of care for long-term conditions, integrated electronic personal healthcare records, early intervention for mental illness and teenage wellbeing to be established. They should then set out the choices we face on future funding or service prioritisation.”

Julia Manning, chief executive, 2020 Health

“The short-term political game playing with the health service that has dominated the election campaign must end. Instead, the focus should switch to the long-term challenges facing the NHS, namely how to meet rising demand from an ageing population with more complex needs. In addition to addressing the major funding pressure on services, there needs to be greater emphasis on delivering more joined up health and social care. The chronic shortage of doctors in general practice and emergency medicine, and the rising pressure frontline staff are under, which is increasingly leading to burnout, must also be dealt with ... An open and honest debate involving patients, frontline NHS staff and the public on how to undo the significant damage that has been done to the NHS by the Health and Social Care Act must occur without making more structural change for the sake of it.” 

Dr Mark Porter, chair, BMA Council 

By Sara Naraghi,

The Guardian, Friday 08 May 2015

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