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11.07.13

NHS England warns of need to centralise

The NHS could ‘sleepwalk’ into another Stafford hospital type scandal unless there is radical change over the next five years, chief executive of NHS England Sir David Nicholson has warned.

A new report, ‘The NHS belongs to the people: a call to action’ sets out the need to centralise hospitals, create larger joint GP centres and close a £30bn funding gap.

Later this year, NHS England will publish more detailed plans on how hospitals will be centralised, and how stroke, cancer and vascular surgery should be carried out in fewer, but larger centres.

GPs will work in larger group practices offering a wider range of services under their new contract.

Sir David warned about “not muddling through and sleepwalking into this”, with further failures of care likely and added: “I think it is really really urgent that we take the decisions.” He is due to retire next year.

Recent attempts to reorganise children’s heart surgery were met with fierce opposition from campaigners, and the JCPCT Safer Surgery Review was cancelled following a judicial review which found its decision about which units to close ‘unlawful’.

Chief executive of the NHS Confederation, Mike Farrar, commented: “The NHS is under unprecedented pressure and is experiencing unprecedented demand. Addressing these issues requires unprecedented thinking. But it does not mean we should abandon everything from the past. The traditional values of care and compassion must be at the heart of the NHS of the present and the future.

“NHS England is right to call for an honest and realistic debate between NHS staff, the public and politicians about what needs to change. When that debate has been had, it is crucial that those in charge of the NHS make the changes a reality.”

Chris Ham, chief executive of The King’s Fund said: “The call to action signals a welcome willingness to initiate an important and wide-ranging debate about the future of the NHS and social care. Fundamental change is required to respond to the needs of an ageing population, changing burden of disease and rising patient expectations.

“The Government’s recent NHS reforms failed to address these challenges. This time politicians and policy-makers must deliver – this means having the courage to transform services, rather than making further bureaucratic and structural changes.

“The significant financial and service pressures facing the NHS and social care will continue for some time yet, so it will be important to be honest with the public about the implications of this in the run up to the next General Election and beyond.”

A Department of Health spokesman said: “The NHS has always had to respond to patients’ changing needs and expectations. As lifestyles, society, technology and medicine continue to change, the NHS needs to change also.

“However, NHS England are clear that this will not mean cutting, charging for or privatising services. And this does not change the fact that any changes to local services must have the support of GP commissioners, be backed by clear clinical evidence, involve local people and support patient choice.”

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