Never far from the spotlight, the NHS is under even more scrutiny as it turns 75. This is understandable as a lot has changed since it was founded in 1948, with a recent report showing a complex picture: overall satisfaction with health services has fallen to its lowest point in 40 years, but support for the founding principles of the NHS – notably equitable access – remains strong.
With a general election in the offing, I have spoken to trust leaders up and down the country about what they think is needed from the next government to put the NHS on a sustainable footing. It’s clear to me that a holistic approach will be key: politicians must think about the changing needs of society and look at health as a cross-government responsibility in order to pave the way for a health service that endures.
With adequate government support, the NHS can have a bright future ahead. It is resilient and innovative. Despite recent challenges including sky-high workforce vacancies and ongoing strike action, it has made remarkable progress transforming services and developing new ways of working to better support patients and staff.
Trusts are improving the delivery of care by working closely with other trusts and local organisations. Together, they can better assess the needs of their local communities and make sure patients can receive care in a setting that is appropriate for them through expanding community services and making services more efficient.
However, there is only so much collaboration can achieve by itself. For the NHS to continue to innovate and reform, there are many issues that need to be addressed by the government, including long term-investment in staff and capital as well as reform of social care.
Amid prolonged industrial action, better investment is needed in the workforce. The new long-term workforce plan is welcome but only forms part of the solution. We also need resolution on pay and a focus on improving staff wellbeing and making the NHS a great place to work to ensure the NHS can recruit and retain the staff it needs to deliver for patients.
Quality and safety also need to be actively upheld and promoted as central to care delivery. Trusts and staff need to be empowered and supported – not just to better manage day-to-day pressures, but to continually focus on how to improve the way they deliver care in the future. Trusts are clear of the value of a continual improvement approach, but tell us they need proper support to embed this into their culture.
Investment in health infrastructure can bring significant and wide-ranging benefits. Trusts need major operational capital investment to drive improvements to service capacity, increase productivity, improve the safety and experience of patients and staff, and prevent further deterioration of the NHS estate. Giving trusts access to adequate strategic capital will deliver the transformation needed to improve patient flow and deliver integrated, high-quality care across the whole system.
Better support for social care must be at the top of everyone's agenda. The failure to place social care on a sustainable footing has a detrimental impact on patients, communities, staff, and the wider health and care system. Historic underinvestment in social care has a serious knock-on effect on the NHS – hospitals struggle to discharge patients who are well enough to recover at or closer to home, which in turn badly affects timely hospital admissions, including in A&E and the handover of patients from waiting ambulances.
If the next government can harness these key areas and provide support where it’s needed, the health service could prosper for decades to come. To coin a phrase: the NHS will always be there as long as there are folk left to fight for it. In today’s highly challenging environment, this feels more important than ever.
