With the general election coming at a pivotal time for health and social care, we set out our view of the twelve key challenges and priorities for the next government.
Meeting the financial challenge
The NHS is going through the biggest financial squeeze in its history. Since 2010, its budget has effectively been frozen, increasing by just enough to cover inflation. While this is generous compared to other areas of public spending, the increasing demand for care means that services are under huge pressure.
2: A health and social care transformation fund
Without new funding to make essential service changes, patients will bear the cost as staff numbers are cut, waiting times rise and quality of care deteriorates.
More on a health and social care transformation fund
3: Develop a new settlement for health and social care
The Barker Commission has challenged politicians by calling for a new settlement to end the historic divide between health and social care – responding to this should be a top priority for the next government.
More on a new settlement for health and social care
Transforming services for patients
The NHS has not kept pace with 65 years of demographic, social and technological change and is still largely based on the post-war model of providing episodic treatment in hospitals. It remains a service that diagnoses and treats sickness, instead of one that predicts and prevents it.
4: Deliver integrated care at scale and pace
Services need to be more co-ordinated around the needs of patients – delivering integrated care should become the core business of everyone working in health and social care.
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5: Agree a new deal for general practice
GPs need to work differently – the next government should develop a new type of contract to enable federations of practices to take responsibility for delivering more services to larger numbers of patients.
More on a new deal for general practice
Improving quality of care
The Francis report has unleashed an avalanche of change, including a major overhaul of the hospital inspection regime, a new duty of candour, and a number of initiatives to make more information available to the public about the performance of services. Meanwhile, hospitals have responded to the report by recruiting additional staff to boost staff–patient ratios.
7: Create a new culture of care
Local leaders must be supported to create cultures of care in which patients come first and openness, transparency and accountability are the norm.
More on a new culture of care
8: Put mental health on an equal footing with physical health
With mental health services under increasing pressure, the next government will need to work hard to make a reality of the commitment to put mental health on an equal footing with physical health.
More on the equal footing between mental and physical health
9: Revolutionise the care of older people
A revolution is needed in the care of older people based on a shift away from reactive, hospital-based care to preventative care that is co-ordinated around people’s needs and provided closer to their homes.
More on revolutionising older people's care
A new approach to NHS reform
It is time to initiate a fundamental shift in how the NHS is reformed, learning from what has worked here and around the world. The experience of high-performing health organisations shows the value of leadership continuity, organisational stability, a compelling vision and a clear focus on improving quality of care.
10: Develop a new political settlement to demarcate the role of politicians
The NHS is one of the most centralised health systems in the world – a new political settlement is needed to demarcate the role of politicians and devolve more power and accountability to NHS organisations.
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11: Focus on reform from within
Instead of mandating change from above, the next government should promote ‘reform from within’ based on a long term commitment to improve care and appealing to the intrinsic motivation of staff.
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12: Invest in the right kind of leadership
NHS leadership should no longer be concentrated in a few ‘heroic’ leaders at the top – a more collective approach is needed, with all staff taking responsibility for improving care.
More on the right kind of leadership
More of our work in the run-up to the next general election