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In recent weeks, most health policy discussion has rightly focused on the health White Paper consultations. As we debate the implications of the proposed new structures it is crucial to be thinking about what kind of care we want these structures to help deliver.
Not long ago, barely a day could go by without someone invoking Rahm Emanuel's 'never waste a good crisis' line or talking about the opportunity presented by the 'burning platform' to deliver radical change to transform care. A report, How to deliver high-quality, patient-centred, cost-effective care, out yesterday from ten major health charities reignites that line of argument.
With support from The King's Fund, the charities have made a collective case that whether you look at care for people with cancer, stroke, lung disease, multiple sclerosis, mental health problems, diabetes, or, importantly, care for people with multiple conditions, there are great opportunities to make services both more patient-centred and more cost-effective, through things such as more extensive use of care planning and better supported self-management.
An important underlying message in the report is the contribution of the voluntary sector in the delivery of these sorts of services. Commissioners wanting to provide co-ordinated, personalised, cost-effective care will want to ensure they look to the voluntary sector as an important source of services that patients want and need. And the voluntary sector in its turn will need to support commissioners with the information and evidence they need to do this.
While many of these services can demonstrate cost-effectiveness and value for money, the savings made are usually realised over time and are dispersed across organisations both within and outside the NHS. The recent reports about Iain Duncan-Smith's spending review negotiations with the Treasury over welfare reform are a high profile example of how difficult it is to make the 'invest now to save later' argument at the moment. But taking a long-term view of the services that will meet patients' needs both now and in the future is the only sustainable way to deliver the government's goal of excellent patient-centred care.