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The Chief Executive of NHS England has put forward a 5 year plan to improve the standard of care provided by the NHS in England. This blog looks at the changes proposed in the 5 year plan and how this may impact upon the standard of care provided to patients.
The NHS five year plan is said to signal a big shift in the way the NHS in England is managed and organised, and is said to be the most radical since the service was born in 1948.
The Chief Executive of NHS England, Simon Stevens, wants to see barriers removed and an end to the age old divide between GPs with patients, and consultants with hospitals. The aim is not to have more top down re-organisations, but instead the development of new models to suit local need.
The most radical option flagged up in the plan is the development of “accountable care organisations” similar to those in other countries such as Spain and parts of the United States. This essentially means that a single organisation taking responsibility for all of the local population’s health needs.
Mr Stevens believes some communities want to expand the role of GP practices so that they provide a much wider range of care for patients in their locality. For example, practices might employ consultants and senior nurses with the aim of shifting more out-patient work away from hospitals. Alternatively, leading hospitals might open up their own GP surgeries. Smaller hospitals might be preserved if taken under the wing of larger institutions.
NHS England will embrace and fund “new models of care” to look after a specific group of patients, such as those with diabetes or the elderly. One option could see the creation of a so called “multi-speciality community provider” in which GPs could come together with nurses, hospital specialists and potentially also mental health and social care services to provide integrated care outside of hospitals.
Urgent and emergency care services, which look after patients when GP surgeries are shut, will be redesigned so that the array of different services are integrated. That will see A&E units, out of hours GP services, urgent care centres, walk-in centres, the NHS 111 telephone advice line and ambulance services work together better and hopefully more effectively.
The full review says that the NHS have been getting better in the last 15 years, despite its tight budgets, as illustrated by much improved outcomes for people who get cancer or heart problems. However, it warned, “quality of care can be variable, preventable illness is widespread, health and the quality is deep routed.”
I would welcome the improvements set out in the plan particularly as it does mean that health professionals would appear to be working together more closely to meet the overall needs for different groups of society. I see all too often patients who have not accessed the treatment they require, have received poor care from hospitals and GPs and have not received appropriate follow-up care when they have been discharged home from hospital. There is clearly the need for change but how this change will be implemented and overseen is not yet clear.
It is not yet clear how these models will be set up and it is likely it will take time, possibly several years. In the meantime, there may be more need for immediate help for example with overstretched GP surgeries or hospital waiting lists to ensure patients get the standard of medical care they deserve.