As Parliament returns from the summer recess, the real politics and policy making of this new parliamentary term gets underway. With NHS England and NICE poised to announce a major consultation on how the health system values new medicines and a brutal delisting of established medicines from the cancer drugs fund , the pattern for the next five years is set – a long public debate about what the NHS can afford.
At a Portland policy breakfast this week, we discussed how Government expects the NHS to deliver 4 per cent efficiency savings year on year to 2020, something that has not been achieved on a sustained basis in any other industry sector, anywhere in the world. This daunting efficiency saving is double the savings the rest of the national economy is asked to deliver, comes without any real increase in money, and will take place in the emotionally charged and politically sensitive health sector.
The NHS needs to succeed on two fronts: delivering better quality care for less; and reducing demand for health services by keeping people well. In this context, the recent announcement of a £200 million cut to public health budgets is short sighted. Organisations that can make a positive contribution on improving quality, reducing costs and keeping a lid on demand will have the biggest impact when approaching local and national policy makers.
Alongside the health service, the social care sector is under relentless pressure with budgets falling by 16 per cent since 2010. The Government has pushed the Dilnot reforms into the long grass and proposed changes to immigration rules and the introduction of the National Living Wage that make workforce planning difficult. Local government and social care providers are both voicing concern that the sector will snap under the strain, increasing the likelihood that the NHS will need to step in and provide support that is better delivered to older people in their own homes or care homes.
National political solutions to these problems are in short supply. The Five Year Forward View is the answer put forward by NHS England, and DevoManc is the cutting-edge approach being held up by local government. Strong leadership and close working across the health service and local councils to pool the skills and resources available to deliver care will be essential to meet the challenges ahead.
The political impact of the next five years could range from a major public re-evaluation of what the NHS stands for, to the vulnerability of the NHS and social care services being exposed through a major crisis. Organisations need to be ready to articulate the changes needed to help them provide high quality care, put effective risk management processes in place to spot potential problems and deal with them, and have robust crisis management plans in place to react fast if things go wrong.
Strong communications and political nous will be vital for all organisations involved in health and social care for five years that could redefine these sectors in the UK. Finding a way through the challenges ahead is vital to improve the health of the NHS and social care sectors and ensure they can deliver the high quality and responsive care that we all want for ourselves and our families.
Measurement and evaluation