New NHS funding should drive patient-centred reforms
‘Devo-Health’ agenda and spread of personal budgets should drive NHS reform
The lion’s share of the extra £8bn of new NHS funding should be invested into a new ‘transformation fund’ to drive patient-centred reform across the NHS, according to a report published today by the think tank IPPR and endorsed by former Health Secretaries Alan Milburn and Stephen Dorrell.
IPPR recommends that the new ‘transformation fund’ invests in new models of care to drive change across the country. The report says the fund should be additional to that already allocated in the NHS’s core budget. The report agues that the fund should be independently administered by a board of politically neutral experts in health and care transformation, to avoid any perception of political partiality in the allocation of funds and to prevent raids on the fund during future NHS crises.
The new report also argues for a new ‘Devo-Health’ agenda, with a presumption in favour of devolution to England’s 10 core cities (Birmingham, Bristol, Liverpool, Leeds, Manchester, Newcastle, Nottingham and Sheffield, Cardiff and Glasgow) to enable them to redesign NHS services around people’s needs.
IPPR’s report also argues for more NHS money to be put directly in people’s hands by accelerating the spread of personal health budgets. The report says personal health budgets should be an entitlement for all those with long-term conditions by 2020, expanding from around a quarter of a million patients to more than ten million.
The report is published at a time when NHS England estimates rising demand and higher costs will produce a funding gap of £30 billion by 2020/21. The government has committed to raising an additional £8 billion in revenues for the NHS by the end of this Parliament, which leaves the NHS with the need to increase its productivity by a historically unprecedented £22 billion over the next five years. IPPR’s report shows that 70 per cent of healthcare spend in England goes on treating chronic conditions and people with chronic disease account for 50 per cent of all GP appointments. Around 20 per cent of emergency admissions to hospital are thought to be potentially preventable, and many of these involve chronic conditions.
Nick Pearce, IPPR Director, said:
“Empowerment in health and care has tended to focus on giving patients more rights, information and choices so that acute healthcare services are more responsive to them. There has been far less focus on the self-management of chronic health conditions where 70% of the NHS’s resources are spent.”
“Gaining more power and control over one’s health and care is both a good thing in and of itself, and it tends to produce better outcomes for patients, particularly those with long-term conditions which require ongoing self-management. It can lead to better health, more satisfied citizens and much-needed fiscal savings.”
Alan Milburn, former Health Secretary, said:
“For decades policy-makers have focussed on structural and organisational changes as the primary means of driving improvement. Other levers - competition, transparency, incentives - have also been deployed with some success. But a key lever of change has been missed: patient power.
“The opportunity now exists to make patients a key driver of change in the NHS. That will require an unprecedented shift in the culture, attitudes and skillset in NHS institutions and workforces. But if the NHS can rise to that challenge it will help put it on a sustainable path. There is no more important task in the years ahead than for the NHS to stop treating patients as passive by-standers and instead enlist them as active agents of change.”
Stephen Dorrell, former Health Secretary, said:
“Enhancing patient power in the NHS has been a long-cherished ambition. Successive governments have talked the talk but have not walked the walk when it comes to fundamentally changing the balance of power in the NHS. Today patient power remains marginal rather than mainstream in the NHS. The decisions that impact most on patients are still taken by clinicians, commissioners and policy-makers in Whitehall.”
Notes to Editors
IPPR’s new report – Powerful People: Reinforcing the power of citizens and communities in health and care – will be available from: http://www.ippr.org/publications/powerful-people-reinforcing-the-power-of-citizens-and-communities-in-health-and-care
The NHS workforce has grown by 160,000 whole-time equivalent clinicians since 2000.
The most robust evaluations of empowerment programmes focused on peer support and redesigned consultations have been estimated to reduce acute care costs by 7 per cent. Nesta estimates that this, which they describe as a conservative estimate, would save the NHS £4.4 billion a year across England.
Richard Darlington, 07525 481 602, [email protected]
Sofie Jenkinson, 07981 023 031, [email protected]