The NHS at 75 needs to be rebalanced
Sir David Haslam and Professor David Pendleton call for a temporary investment of new money to rebalance the system around primary and social care.
To coincide with the 75th anniversary of the founding of the NHS, the NHS Workforce Plan has now been published promising 300,000 new healthcare workers. This is clearly welcome but the current ills of the health service will require action on a broader front and it remains to be seen whether such a number could be recruited or retained without other significant changes being implemented. Our view is that the NHS needs a reset, not just a recruitment drive, in order to deliver systemic change for its long-term future.
The need for a rebalancing of the NHS was the conclusion reached by the Henley Centre For Leadership 2023 Symposium on the NHS – a diverse group of executives from the health, education, technology, energy, community inclusion and charity sectors who met in June at Henley Business School.
Whenever new or additional funds are announced for the NHS, hospitals tend to receive the lion’s share. They are vital and also popular with MPs and voters alike. Hospitals will always need additional funds and we are clear that they continue to need significant investment but new funds are needed now for primary and community care, at one end of the system, and social care at the other. Primary care provides patient education, prevention and early diagnosis and treatment. It can reduce and even obviate the need for hospital care in a great many cases. Social care and care in the community create more opportunities for patients to be discharged from hospitals without delay. This shift in spending priorities will rebalance the entire healthcare system. By creating better services at the beginning and end of the process, pressure on secondary care can be eased, and the health of nation will improve. These changes must include recruitment and retention of professional staff to deliver services.
What we are proposing will require brave leadership to create a short, intensive programme of investment that is funded with additional money for a limited time period. Our belief is that this could deliver the long-term dream of flattening the ever-rising line of NHS expenditure by reducing demand for hospital treatment and retaining those who provide it. This was always Bevan’s dream but it has proven to be elusive.
The prime minister, speaking in support of the NHS Workforce Plan, described a once in a generation opportunity to bring in more talent to the NHS. However, if we do not reboot the system, the new doctors and nurses will be parachuted into services that are still lurching from one crisis to another, because the core issues have not been dealt with – too much demand and too few resources.
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