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MPs: NHS must be ‘re-imagined’

pharmafile | March 20, 2013 | News story | Sales and Marketing | Dorrell, NHS

Increasing cost pressure on the NHS will lead to a breakdown in health and social care services unless commissioning becomes truly ‘joined up’.

That is the view of the House of Commons health select committee, whose report on public expenditure on health and care services this week warned of the need for the NHS to be ‘re-imagined’.

“It’s unlikely that public expenditure on health and social care services will increase significantly in the foreseeable future,” said committee chair Stephen Dorrell MP.

“This means that the only way to sustain or improve present service levels in the NHS will be to focus on a transformation of care through genuine and sustained service integration,” he added.

Among the committee’s key recommendations are that the Health and Wellbeing Boards in various areas should be given responsibility for ensuring that there is a more joined up approach to commissioning both health and care services.

The King’s Fund welcomed the report, saying the committee has “hit the nail on the head” by calling for fundamental change.

The think tank’s chief economist John Appleby said: “In focusing on the need to develop integrated care, the committee has identified the right starting point.”

He wants better use made of existing resources by bringing together health and social care budgets locally and moving towards a single, strategic assessment of the funding needs of the NHS and social care in future spending reviews.

Dorrell says joined up commissioning is vital because it would ensure that resources “are no longer treated as ‘belonging’ to a particular part of the system, but become shared resources to use more efficiently”.

This will deliver more flexible and responsive local services, he suggests. “Moving to this approach must not, however, result in less overall funding for care services,” Dorrell warned.

Another of the committee’s main proposals is that government commitments to protect real-terms funding for healthcare should be extended to cover local authority social care services too.

The funds need to be ring-fenced at current levels in real terms, the committee suggests.

The King’s Fund has looked at the NHS’s funding in several reports. “Our own work shows the financial squeeze is beginning to bite hard in the NHS and efficiencies are becoming harder to deliver, as one-off savings, such as cuts in management costs, start to slow,” Appleby says.

“As the report points out, pay restraint and holding down prices paid to hospitals are no substitute for delivering genuine productivity improvements,” he adds.

The committee found that:

Measures used to respond to the Nicholson Challenge too often represent short-term fixes rather than sustainable long-term service transformations
Changes in tariff payments within the NHS do not constitute ‘efficiency savings’ – they are just internal transfers that only result in efficiency gain if the NHS provider changes the way care is delivered
Under-spending is a problem so the rules on the use of reserves by NHS providers should be abolished to encourage investment in necessary service change
Although pay restraint is undoubtedly key in the short-term, it cannot be regarded as a sustainable form of ‘efficiency gain’.

“It is neither prudent nor just to plan for sustainable efficiency on the basis that NHS pay will continue to fall relative to pay elsewhere in the economy,” the report points out.

Above all, Appleby says, action is required. “Despite high-level political commitment, there has been a lack of urgency in developing integrated care – this now needs to happen at scale and pace,” he said.

“Major reconfigurations of hospital services are also needed to improve the quality of care and increase financial sustainability,” he added.

Adam Hill