The new report, titled NHS financial sustainability, says that civil servants in the health department lack the drive to deliver the Government’s mission to build an NHS fit for the future, warning that “it appears that no one at the top of DHSC and NHSE has been preparing the NHS for the future, for example by putting together a revised strategy or plans as part of the recovery following the pandemic when it was clear that the Long Term Plan 2019 was no longer valid.”
One of the five “Missions” set out by the new Government for this Parliament was “Building an NHS that is fit for the future”. The recent consultation on a 10 Year Health Plan for England, due to be published shortly, set out three key shifts which would underpin their vision: analogue to digital; hospital to community; and-ill health to prevention.
The report says that the creation of a ten year plan is a “golden opportunity to take significant decisions for the longer-term benefit of the nation’s health and the sustainability of the NHS” but comments that there “seems a lack of readiness amongst senior health officials to take the radical steps needed”.
It specifically highlights that NHSE’s payment mechanisms can mean that local systems do not receive financial recognition when they prioritise hard-to-reach patients, citing GP surgeries receiving payment for every child vaccination with no recognition of the activity that does not result in a vaccination. This reflects the information our London practices reported to us in May 2024 when we surveyed them on the challenge of meeting QOF targets in this domain.
The report also reflects that DHSC does not view providing more resources for prevention as a substantive part of the prevention shift, instead considering that a shift towards prevention might be achieved through longer-term legislative and culture change to tackle issues such as obesity, physical activity and poor air quality alongside a shift in the way GPs advise patients.
It is also critical of the minimal work achieved towards the delivery NHSE’s long-held ambition to move more care from hospitals to the community, which the report says has “stalled”, going on to say that there should have been more investment and progress in mental health and community services, particularly GP surgeries and dental services. Concluding that the resource to deliver the three shifts, and particularly the shift to prevention, has been “slow”.
You can read Londonwide LMCs response to the 10 year plan consultation here.