Prescription for the NHS is more change

23 Apr 15

Manifesto pledges suggest there will be more money for the NHS whoever wins the election, but there are radically different ideas about how to manage change and meet patients’ needs

The NHS is rarely far from the centre of any general election campaign and this one is no different. Despite retired NHS chief Sir David Nicholson’s warning that the political parties are ignoring its ‘substantial’ financial problems, their manifestos contain some striking pledges which, if adopted, have the potential to transform the health service indifferent ways.

Here’s the Healthcare Financial Management Association’s rundown of what the three main party manifestos promise on health and how they would work if adopted into the current system.

The Conservatives are pledging that by 2020 everyone will be able to see a general practitioner seven days a week and that people over 75 will be guaranteed an appointment on the same day if they need one. There will be a need to increase GP capacity, hence the commitment to train more GPs.

More GPs would mean more timely access to key primary care practitioners, as well as helping to reduce unnecessary and often expensive hospital admissions, boosting the quality of care and providing long-term savings.

All the parties are pledging additional NHS funds – welcome news across the board. The £8bn additional funding pledge by the Conservatives matches the requirements set out in NHS England’s Five year forward view. Together with £22bn of savings from efficiencies and changes to service provision, this would close the £30bn funding gap envisaged for the NHS over the life of the next parliament.

This funding gap takes into account predicted NHS inflation up to 2020, the costs of providing care to an increasing and ageing population, plus the forecasts of the cost of initiatives to improve the quality of care for patients. Any extra funding will be directed towards this overall requirement. But the £22bn of savings is very ambitious and, to be met, will mean the continued transformation of the way that services are delivered.

Like the Conservatives, the Liberal Democrats are also pledging an additional £8bn, although they differ by ringfencing £3.5bn specifically for mental health services. Meanwhile, the Labour Party has committed to an extra £12.5bn over the parliament with which it says it will recruit 8,000 more GPs, 20,000 more nurses and 3,000 more midwives.

There is also talk from the Conservatives of decentralising the NHS, in similar fashion to what has been announced for Manchester. However, if we are to generate the savings that the NHS will need to make over the next five years, this will mean coming up with radically different models of care. It is important that we work towards improving integration and quality of care between healthcare organisations and social care, but the financial implications need to be carefully thought through.

Labour is promising to improve patients’ rights, including the adoption of personal care plans for patients with complex conditions, personal budgets and better information and advice on the management of long-term conditions. But making such aspirations achievable demands a more integrated approach to physical and mental health, as well as social care – a ‘whole-service approach’ to patients’ needs.

The Liberal Democrats say parity between physical and mental health should be a key NHS priority. Such parity does not currently exist, but if achieved could lead to both improved care and potential savings as patients are able to access mental health services more quickly.

The LibDems are also keen on the better use of technology to help the system work more efficiently. Transforming service provision is key to a fit-for-the-future NHS and, given the staff shortages we are experiencing, if better use of technology helps us to provide more effective and sustainable care with staff levels as they currently are, then this is to be welcomed.

There is everything to play for in early May and those working in the NHS, including the HFMA members we represent, need to understand the proposals and work with any changes that a new government will bring.

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