Chris Ham: reflections on my first weeks at the Fund

My first few weeks as the Chief Executive of The King's Fund have been dominated by the election campaign.

The launch of the Fund's review of NHS progress over the past 13 years stimulated a great deal of media interest. The review received front page coverage in the Observer on 11 April and on the same day I found myself in the BBC studios doing TV and radio interviews. In the following three days we summarised the plans set out in the three main parties' manifestos, and briefed various journalists on the Fund's response.

Our review of the NHS shows that major progress has been made in improving performance since 1997, especially in reducing waiting times for treatment and investing in cancer and cardiac services. However there is still unfinished business, including taking prevention seriously, tackling health inequalities, and reorienting the NHS to meet the needs of people with long-term conditions. If the NHS was in intensive care when Labour came to power, it is now in active rehabilitation, but much remains to be done to restore it to good health.

The three main parties have much in common in their plans for the future, but there are also differences. The Conservatives' plans attracted interest because of their commitment to fund new cancer drugs not yet approved by NICE. Labour has promised that all NHS trusts will become foundation trusts by 2014 and successful trusts will be able to take over those that are under-performing. The Liberal Democrats want to create elected health boards to commission care.

In an editorial for the BMJ on 7 April, I argued that much more emphasis needs to be given to planning services across local systems of care if the NHS is going to improve performance in future. This requires providers to work with each other and with commissioners to reduce duplication and waste, and to ensure that continuity of care is given priority. Creating the right levers and incentives to enable systems of care to emerge will be one of the biggest challenges faced by the next government.

The King's Fund will be contributing ideas to this debate in the coming months.

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