The road ahead: Simon Stevens outlines NHS roadmap at The Future of Health

We are doing well but we can do better, was the broad message of the day from chief executive of NHS England Simon Stevens at the Future of Health event on Friday, 21 November. 

By Sarah.Aston

24 Nov 2014

Speaking at the event, Stevens outlined in broad strokes what NHS England’s 'Five Year Forward View' will look like and what is needed to take the NHS forward.

“The argument that we start with is that the NHS is not only good, it is better than it has ever been,” Stevens stressed before adding: “But the reality is, as experienced by many people using the service and many of us working within it, actually it feels like a service under enormous pressure right now.”

Stevens called for a drastic change in the way the NHS approaches its patients: “We know that actually we need to change and that more of the same is not going to be sustainable over the next five to seven years.”

First on the self-improvement agenda for the NHS boss is eliminating “pre-historic fragmentation” and empowering local authorities to work with the NHS to improve overall delivery.

So far, delivering joined up services and working with local authorities to reduce the pressures on the NHS have received a mixed response. Earlier this month, the National Audit Office report 'Planning for Better Care Fund' criticised the Department of Health for failing to adequately plan for the delivery of the Fund, which aims to introduce locally led integrated care services, and suggested that local authorities were not confident that they could deliver the savings expected by government.

To ensure success in this area is “a big journey” Stevens acknowledged, making it clear that the improvement of the delivery of joined up services is something “that we’ve got to take together over the next five years”.

“We are going to put standards in place for mental health in the way that there has been for getting a hip operation or your cataracts done.” Simon Stevens

Part of the journey has been made, but there is still a long way to go. For instance, the creation of Clinical Commission Groups (CCGs) through the 2012 Health and Social Care Act has given local GPs direct responsibility of commissioning, but has also created a so-called postcode lottery with regard to provision for major conditions like diabetes.

In response to further questioning around attempts to eliminate the geographic discrepancies in provision, Stevens discussed the difficult balancing act between acknowledging the inevitable differences in local approaches to health and the need to create standards of care.

For Stevens, although healthcare will feel different depending on where you are, standards around waiting times and treatment need to be standardised. By way of example, Stevens said, from April 2015 new standards are being introduced across the country for mental health: “We are going to put standards in place for mental health in the way that there has been for getting a hip operation or your cataracts done.”

The need to improve mental health has been a point of focus for Stevens this year. Speaking at a recent health select committee hearing, Stevens criticised the small amount of NHS budget spent on mental health and said that he was willing to be ‘held to account’ over the NHS’ intention to increase spending by 2020.

Outlining the roadmap for the NHS, Stevens was not hesitant to acknowledge where the NHS needs to improve but was keen to highlight the improvements that have already been made.

Introducing greater transparency in the NHS, working with patient groups and local communities and pursuing a preventative strategy have all helped the NHS to improve, Stevens was keen to stress. Where we are, he emphasised, is in a good place but the 'Five Year Forward View' will take the NHS further. 

Stevens concluded: “There is no reason at all why we should be beginning to doubt the sustainability of the model of care which has served this country well and for which all the signs are that people in this country rightly continue to attach very great importance.”

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