NHS reform and the future of the health service
Yesterday at the University of East London techUK was invited to the Health and Social Care Secretary Wes Streeting’s address on the progress delivered as well as a series of announcements of future NHS reform.
His opening message was an invitation to believe that change and improvement is possible and already in progress. He referenced the many improved metrics that the health service has been able to deliver in the past months, including: falling waiting lists, lower A&E waiting times, faster ambulance response times, and growing patient satisfaction.
On the abolition of NHS England, the Secretary of State acknowledged the personal toll on staff and pressure on health leaders. While the process has been difficult, he maintained that change is necessary, leading him to announce more improvements and changes scheduled for the coming months and year.
Key announcements
1. Intensive recovery programme
Streeting was direct about the limits of the current progress measured so far. It is evident that a cluster of high-performing trusts is masking chronic underperformance elsewhere in the country. This lead him to announce the Intensive Recovery Programme, which will target the worst performing providers nationally. The programme will deploy top leadership into struggling trusts and, where necessary, pursue structural interventions, including breaking up trusts entirely, to restore basic standards of care.
2. Major reform of the GP contract
Streeting confirmed that a significant overhaul of the GP contract is imminent. The ambition is to position primary care providers as the leaders of neighbourhood health and support the broader shift from hospital-based to community-based care.
3. A new model for integrating health and social care
In what Streeting described as the most radical reform in the history of the NHS, the government will design a first wave of integrated health organisations that hold the health budget for an entire population and are responsible for all health services within it. This directly addresses the current dissonance where providers have little incentives to invest in prevention, since the financial benefits are detected elsewhere. Alongside this, two new health devolution deals with the mayors of Greater Manchester and South Yorkshire will test whether local political leadership can deliver better health outcomes than the conventional NHS model.
Beyond these three flagship announcements, Streeting also confirmed:
the forthcoming publication of a Women's Health Strategy update;
a new policy from April giving patients the choice of whether and when to attend follow-up appointments;
the timeline of the launch of NHS Online to next year;
the defunding of ineffective treatment pathways across the ten most common specialties;
and lastly, the progress on the Advanced Foundation Trust status which will grant high-performing trusts greater financial freedom, with eight candidates currently under assessment.
The overarching tone was one of cautious confidence where progress is real and measurable, whilst it still remains uneven. For Industry members, the speech reinforced the government's commitment to the three shifts set out in the 10 Year Health Plan and signalled that the next phase of reform will rely heavily on change management, integrated care models, efficient tech adoption, and patient empowerment to move the system from recovery to transformation.
