NHS unveils drastic overhaul proposals in Five Year Forward View report
The NHS has laid out radical new proposals as it unveiled for the first time a clear plan on how it intends to close the £30bn funding gap expected to open up by 2020.
The plan, which is the work of six national bodies, was laid out in the Five Year Forward View by NHS England chief executive Simon Stevens, who said a "substantial" change was needed to bring about the improvements.
Under the proposals, the NHS will focus on tackling the root causes of poor health, giving patients more control over their own care, dissolving the traditional barriers between different types of care and increasing investment in new care models. Significantly, the report argues that it does believe the funding gap could be closed within the five-year period.
However, Stevens stressed that the changes will only work if the government takes action on demand, efficiency and funding.
"The NHS is now at a crossroads – as a country we need to decide which way to go," Stevens said. "The Forward View represents the shared view of the national leadership of the NHS, setting out the choices – and consequences – that we will face over the next five years.
“It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure the future that we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so."
In order to achieve this, health and social care will become more tailored to the needs of local communities by giving greater responsibility to councils and the delivery of local solutions.
Local authorities will be offered the choice of a number of new care delivery options for which they will be given the resources and support to implement them.
Some of the most radical options being made available include GP surgeries taking on a number of services currently offered by hospitals, the creation of integrated out-of-hospital care with a number of other services such as mental health and social care, and the redesign of urgent and emergency care.
Much more attention will also be given to prevention and education to reduce the growing burden of long-term health conditions, which currently account for 70% of the £100bn annual health service budget.
Diabetes UK estimate that the NHS currently spends about £10bn a year on diabetes alone, with nearly 3m people England diagnosed with the condition and a further 7m considered at risk of developing it.
Conditions associated with alcohol and tobacco use will also be prioritised.
"Effective and adequately-funded local government is fundamental to the sustainability of the health services," said counsellor Izzi Seccombe, the chair of the Local Government Association's Community Wellbeing Board.
"Without effective public health services promoting prevention, the NHS will continue to have to deal with a rising tide of disease and ill-health related to smoking, alcohol and obesity. Without adequately funded adult social care services, Accident and & Emergency admissions to hospital will continue to rise. It is crucial that funding for adult social care is protected going forward."
In order to support these changes, NHS leadership will need to "act coherently together, and provide meaningful local flexibility in the way payment rules, regulatory requirements and other mechanisms are applied", the report explained.
In order to do this, it will back diverse solutions and local leadership, as opposed to undertaking further national structural reorganisation.
A greater focus will also be given to efficiency, which the plan predicting that with sufficient investment, the NHS's historical annual net efficiency gains of around 0.8% could reach between 2-3% for the rest of the decade.
Stevens added: “The NHS continues to be highly valued by the British people. But what’s great about the NHS cannot disguise what needs to change in the NHS."