The NHS continues to see exponential growth in the demand for services.
Launched in 2015, the NHS Five-Year-Forward View sets out a clear direction of travel meeting both current and future demands of patients. While the proposed plan readily acknowledges that the NHS has seen dramatic improvements within the last 15 years, it also acknowledges the intense pressure the NHS is under and proposes a new vision of opportunities to improve health, quality of care and financial stability.
In March 2017, the Department of Health published the Next Steps on the NHS Five Year Forward View. The latest report outlines achievements and progress, as well as those required changes for the future. It highlights the tremendous progress:
- on cancer survival rates
- the addition of 8,000 extra doctors and nurses
- the first ever waiting time standards for mental health treatment being introduced and met .
On the other hand, it also spells out where progress has stalled. With increasing pressures on A&E departments and acute hospital wards, and increasing demands on available services, clinical and medial resources continue to be stretched. This all lowers patient satisfaction rates and can lead to an increase in poor patient outcomes.
Along with efficiency cuts this all points towards a storm fast approaching. Healthcare delivery is only predicted to get tougher before the dust settles. Many bet on technology to save the day, and technology is a key enabler of excellent patient services. For example, modern integrated information systems can:
- allow for better collaboration between health and care practitioners
- assist in service design and management
- reduce medication and treatment errors
- reduce time to treat
- increase overall efficiency
- increase information security
- increase patient safety
Such enhancements can deliver an overall increase in positive patient outcomes.
But technology alone cannot be the only solution. It is clear that staff are one of the NHS’ greatest resources. Qualified clinical and medical staff, strong support staff and well-resourced back office departments all assist in creating the efficiencies to deliver truly excellent patient care. This, along with properly costed funding and the correct systems and change programmes, together will save the service.
At the core of all this, the NHS is a patient centric organisation, changes to service delivery and other functions should ultimately impact positively on the patient. Many organisations struggle with this, it is not always evident how changing a back-office solution directly impacts patient care, for example.
However, without maintaining a patient centric view to all programmes, the NHS risks implementing work streams which are – ultimately – of little benefit. The Five Year Forward View must be considered in this context. Working closely with suppliers, all organisations will be putting in place change programmes to achieve the aims and objectives of the plan.
As patient centred services increase, we place greater reliance on the patient to take an active part in their wellbeing and healthcare. This is an ultimate benefit to the overall health and care economy – informed and educated patients looking after their own conditions, with the assistance of the health and care systems as required, reduce the burden on the service.
For this to be successful, all programmes should be carefully aligned to a patient centric view and greater education and information must be made available to the patient community. There are several programmes being enacted in the NHS to assist with this, and these must be correctly funded and implemented if we are to make the changes required.
Access to patient portals, increased patient education programmes, better access to healthcare information for all clinicians, greater information sharing across the health and care communities are all examples of work streams which require a fully patient centred focus in order to be effective.
Clinical and medical staff, by the very nature of the work they do, are patient focussed. Sometimes, there are issues for other support teams in recognising the patient centricity of what they do. But all members of the NHS need to be patient focussed, and this challenge has to be met.
Collaboratively working between health and care partners, and greater understanding by suppliers of the need for this patient centric view, will lead to better health and care economy outcomes. Until these partnerships are patient centric, there will continue to be failures in the delivery system and precious funds will be wasted.
The challenges facing Health and Social Care cannot be underestimated. It is only by working together, across the whole health economy, and in true health economy partnerships that the right levels of change and education can be enacted to ensure the NHS survives.
In 1948, the NHS was launched with three core principles:
- that it meets the needs of everyone
- that it is free at the point of delivery
- that it is based on clinical need, not ability to pay
This is still possible as long as we evolve to account for the shifting social, economic, political, environmental and medical ecosystem. By ensuring future work streams – which are part of the Five-Year-Forward view – take notice of these changes and challenges, we can deliver the correct programmes to calm the storm. It is up to all of us to work together to ensure the NHS succeeds.