Lords call for independent body to assess health spending

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A Lords Select Committee inquiry into the long-term sustainability of the NHS has echoed a number of recommendations put forward by the NHS Confederation.

The committee’s report, published on 5 April, recommends a ten-year financial settlement and calls for the creation of an independent office for health and care sustainability.

Such an office would look at what health and care services are needed for the UK over the next decade and beyond.

The Confederation has long called for both measures, making the case most recently in written and oral evidence to the committee.

'Objective assessment'

Confed chief executive Niall Dickson said: “Instead of the sterile arguments that have characterised NHS and social care funding, we could have an objective assessment from an independent body which would report to Parliament on how to meet the needs of a changing population. 

“It also seems inevitable, as the committee asserts, that spending on health and care will need to rise at least as fast as GDP in the coming decade if we are to provide good quality care to all our citizens.” 

He added: “We are obviously delighted that the committee has accepted both our recommendations around future spending needs and the creation of the independent office for health and care sustainability.”

The key recommendations include:

  • Responsibility for adult social care at a national level should be transferred to a new Department of Health and Care. 
  • A new, independent Office for Health and Care Sustainability should be established to look at health and care needs for the next 15-20 years and report to Parliament on the impact of changing demographic needs, the workforce and skills mix in the NHS and the stability of health and social care funding relative to demand.
  • The Committee asserts that, beyond 2020, a key principle of the long-term settlement for social care should be that funding increases reflect changing need and are, “as a minimum, aligned with  the rate of increase for NHS funding.”
  • NHS England should engage with GPs to examine alternative models including direct employment 
  • NHS England and NHS Improvement should be merged to create a new body with simplified regulatory functions and strong local government representation. 
  • The government should commission an independent review to examine the impact of pay on morale and retention of health and care staff. 
  • The government should do more to incentivise the take-up of new approaches and make clear that there will be funding and service delivery consequences for those who repeatedly fail to engage. 
  • National and local public health budgets should be ring-fenced for at least the next ten years. We also need a new nationwide campaign to highlight the dangers of obesity. 
The report also claims that the lack of a comprehensive long-term strategy to secure appropriately skilled, well-trained and committed workforce is ‘the biggest internal threat to the sustainability of the NHS.’ 

It recommends that the government takes steps to retain overseas-trained staff working in the NHS and social care, and provides reassurances about their future. View NHS Employers' round-up of workforce issues identified in the report.

The NHS Confederation submitted written evidence to the inquiry in September 2016. This was followed in October by Confederation chair Stephen Dorrell appearing before the committee in October 2016.

Find out more

Access the committee's report from the Parliament UK website.

Download the NHS Confederation's written evidence.

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