'Unite behind the NHS’s next and best era'

NHS leaders should not be punished for having ambition if the stretching targets that have been set for the health service this year are not met due to factors that are largely outside of their control, the chief executive of the NHS Confederation will warn today.  

In a keynote address to over 6,000 health and care representatives at its joint annual conference with NHS England, NHS Confederation chief executive Matthew Taylor will say that leaders have set expectations for the year at the outer limits of what is achievable and that significant progress is being made, for example in reducing the longest waits for care.  

But he will warn that the spectre of further industrial action threatens to derail progress and that this will make what is already a very stretching task even more challenging. He will reiterate the NHS Confederation’s long-standing call for the government and BMA to agree a compromise deal rather than risk further upheaval.  

In his speech, to be delivered today (Wednesday 14 June) at the NHS ConfedExpo conference in Manchester, Mr Taylor will call on the government to use the milestone of the NHS’ 75th anniversary to cement a consensus about how to place the NHS on a more sustainable footing for the next decade and beyond.  

He will argue that this could be the basis for an NHS that combines prevention and personalisation with equity and inclusion. If this opportunity is not seized, it could lead to an ever-growing divide between the ‘healthy haves’ and the ‘unhealthy have nots’, he will warn.

Mr Taylor will set out the NHS Confederation’s five-point action plan for stabilising the service. At the heart of this should be a renewed focus on public health and the need to fully embrace the under-utilized opportunities of biomedical and digital technology to help people to better understand and track their own health.  

A report published by the NHS Confederation on the eve of the conference, in partnership with Google Health and featuring new research by Ipsos, shows there is appetite among the public to use technology more to self-manage long-term conditions, live healthier, and access more tailored treatment.  

Based on a survey of over 1,000 people, it found that more than 7 in 10 respondents would use technology, including wearable and health monitoring devices, to help better manage and monitor their health. Additionally, respondents said they would be willing to share the information and data gathered with their doctors and other medical professionals, thus potentially reducing the time the NHS would need to spend recording this information itself.

In his speech, Mr Taylor will argue that this offers hope for empowering patients and reducing pressure on the NHS.

“NHS leaders want to shift the dial and reorient their focus onto prevention, but they are dealing with huge operational pressures, high demand and the ongoing disruption from industrial action. They want to be part of a positive vision for how the health and care system can be transformed to meet the challenges ahead,” he is expected to say.  

The five “critical factors for success” that Mr Taylor will set out in his speech are:

1. A government strategy for national health, not just policies for the NHS  

“We need a strategy for national health, not just policies for the NHS given that most policy that impacts the health of the nation is made outside the NHS. But in recent times, central Government has backed further away from joined up action on health. Our ultimate goal must be to return to rising healthy life expectancy for all sections of the population. We will not get that without a national health strategy and instead the NHS will be left picking up the pieces from a nation getting poorer and sicker.”

2. Sustained and sufficient investment in the NHS

“We need sustained and sufficient investment. We need to acknowledge that we have fallen behind other countries in funding and particularly capital investment, without which it becomes almost impossible to achieve the innovation and productivity gains we all want. Moreover, we need to see that NHS spending is investment contributing to the national and local economy in ways that include helping more people get back to work. Our work with Carnall Farrar revealed that every £1 invested in the NHS results in £4 back to the economy.

On the promised workforce plan for the NHS, Mr Taylor is expected to add: “we are pleased that the plan is imminent as this issue has been ducked by successive governments. But we need to see the detail before knowing whether it will provide the funding and changes needed to plug the major staffing vacancies that continue to blight the NHS.”

3. An upstream shift in resources from acute hospitals and into community-based services, primary care and prevention

“We need to proportionately shift resources upstream into community-based services, primary care and prevention. We have recognised this needs to happen for a long time, but in recent years public health funding has been cut and there are fewer full-time equivalent trained GPs, while at the same time we have many more hospital consultants. What limited capital we have available is barely invested in community, mental health or primary care.  

“The shift requires two things: a clear and measurable commitment to increase the proportion of new investment going upstream and second, to support and scale up solutions that can reduce the number of people needing to go hospital.”

4.Build on Rt Hon Patricia Hewitt’s review to let local leaders lead and empower local communities  

“We must invert the pyramid. All too often in the NHS accountability means what we owe to the tiers of hierarchy above us: NHS England to the Department of Health and Social Care, integrated care systems to NHS England, NHS trusts to integrated care systems. Instead, while each level has its important role, each needs to judge itself by how it empowers and enables those it sees. The research is clear: national organisations and systems that are focused, consistent and truly strategic add more value; organisational leaders with more autonomy achieve more and are more innovative; more trusted staff perform better; and most importantly, patients with a stronger sense of agency and control get better outcomes and feel better about their experience.”

5. A new social contract with the public

“So much of what we must do and can do, from virtual care to patient-initiated follow-up, from anticipatory care to new diagnostic programmes, all relies on public trust and engagement. We are in danger of a downward cycle where the public loses faith and we find it harder and harder to provide the care we want to provide. We must reverse that cycle. The sustainability of the NHS and our capacity to grasp the opportunities that science and technology are bringing depends on a more ambitious relationship between the health service and patients. One in which we offer more and expect more.”

Mr Taylor is expected to conclude by saying:

“The challenge before us now is to use the historic moment of the NHS turning 75 to unite behind a shared vision of the NHS’ next and best era. An NHS benefitting from improving public health, an NHS adequately and sustainably funded, an NHS that is taking care and prevention to the people and their communities, an NHS that empowers and enables, an NHS based on an ambitious and honest partnership between the service and those it serves. Ultimately, one that can once again make our NHS the envy of the world.”   

The keynote address will be delivered live at the conference at 2pm on Wednesday 14 June 2023. All quotes will need to be checked against delivery. A livestream will be available here.