Letter to new Secretary of State for Health and Social Care: member priorities

Dear Secretary of State,

I am writing to congratulate you on your new role as Secretary of State for Health and Social Care. There is an opportunity to transform the NHS for the better and to build the health of the nation, and we look forward to working with you and your team.

As you know, we are the only membership body that supports and speaks on behalf of the whole healthcare system across England, Wales and Northern Ireland – that includes NHS trusts, integrated care systems, primary care providers and voluntary, community and social enterprise providers. We also proudly host NHS Employers.

This means we have a broad perspective of the priorities, opportunities and challenges facing all parts of the NHS as well as how its different components can work together and be better supported to bring about improvements for the communities they serve. We are keen to use this insight to support you and your team as you make a start tackling the challenges facing health and care.

In preparation for the next government and drawing on the insights of our members, we have set out what we feel are the most critical priorities that are needed to place the health and care system on a sustainable footing. Much of this is based on detailed work we have undertaken with our members starting with the question, “what could health leaders do, working with a new government, to improve patient outcomes?” We are glad to see much commonality in your pledges for this policy area. Our members stand ready to work positively with you to deliver them.

We very much welcome your early call and planned meeting with the BMA junior doctors committee this week and your pledge to ‘reset’ relations with NHS staff. Our members know industrial action can simply not continue if the government is to meet its first step for change on the NHS of cutting waiting lists. NHS staff are central to the success of the service, and we are pleased to hear you pledge to support the NHS Long Term Workforce Plan.

Related to this, we are increasingly concerned by the opposition to the current GMS contract for 2024/25 with the BMA’s GP committee balloting its members on whether to stage collective action. We welcomed many aspects of this year’s GP contract but the 1.9 per cent uplift allocated falls considerably short of what is desperately needed across general practice. The prospect of collective action by GPs risks having a significant impact on patients with fewer GP appointments every day and driving up A&E attendances.

We are encouraged that your manifesto acknowledges this with the move towards a ‘Neighbourhood Health Service.’ Health leaders are keen to see more care delivered closer to home as this is often both better for them and a more efficient use of resources. Our research with Carnall Farrar found that every pound invested in primary and community care could return £14 in gross valued added.

We welcome the mission-approach to government set out in the Labour Party manifesto and were pleased to hear over the weekend that the Prime Minister will chair each of the five mission boards. Our members know that 80 per cent of what affects health happens outside the NHS, and therefore they are keen to see the health mission scope be truly cross-government. This is needed in order to shift the focus from simply treating illness to promoting health and wellbeing, reducing inequalities and tackling the wider determinants of health, and supporting the public to be active partners in their own health.

Integrated Care Systems (ICS) have a key role to play in this locally, given their membership is made up of NHS services, local authorities, the VCSE sector and beyond. As you know, ICSs are two years old as statutory bodies. In our annual ‘State of ICSs’ report, we will soon be highlighting their key achievements and challenges. Our members have welcomed before your intention to avoid top-down structural reform to the health service, and we would ask you to retain this commitment for the whole of the parliament to minimize unnecessary disruption.

There is, as we are sure you are aware, an urgent need to address the funding gap that has emerged in the NHS this year, with some estimates putting this at around £3 billion between what is available and what systems are being asked to deliver in 2024/25. This is before any potential additional costs of new pay awards for junior doctors and other NHS staff are factored in. In order to make an impact ahead of a winter which could otherwise be very difficult for staff and potentially dangerous for patients, we believe this needs to be considered as part of any fiscal event this autumn.  

In the medium to longer term, our members also feel it is critical that there is investment in capital - including buildings, equipment and digital - to improve productivity and patient care. This goes beyond the encouraging commitments you have made relating to the ‘Fit for the Future’ fund. Specifically, they are calling for capital funding to increase to at least £14.1 billion annually, a £6.4 billion increase from the current level of £7.7 billion in order to boost productivity and reduce waiting lists. We are currently working on recommendations for how this extra funding for capital can be raised and would be keen to meet with you to share this later in the summer.

The NHS remains one of the UK’s most valued institutions and its staff are among the most trusted but as you know, the decade of underinvestment in the 2010s, compounded by the impact of an unprecedented pandemic, rising demand and an ageing population, have left NHS and social care services under extreme pressure. We understand why you used the term “broken” to describe it on your appointment.

You have taken office at a time of both opportunity and threat towards the health and care service. Our members stand ready to support your government to boost NHS productivity, efficiency and staff experience, and ultimately improve patient care and population health.

We would welcome a meeting to discuss how we can continue to work together. Your team can contact our external affairs team (externalaffairs@nhsconfed.org) to arrange that.

Yours sincerely, 

Matthew Taylor
Chief Executive
NHS Confederation 

Lord Victor Adebowale CBE
Chair
NHS Confederation