The Long-term Sustainability of the NHS and Adult Social Care

Please find attached a copy of the House of Lords Report into the sustainability of the NHS published April 5th (The Patel Review)

The key recommendations are

  • A tax-funded, free-at-the-point-of-use NHS is the most efficient way of delivering health care and should remain in place now and in the future. For that principle to remain, however, many aspects of the way the NHS delivers healthcare will have to change.
  • A political consensus on the future of the health and care system is not only desirable, it is achievable and the Government should initiate cross-party talks and a meaningful national conversation.
  • The failure to implement a comprehensive long-term strategy to secure appropriately skilled, well-trained and committed workforce that the health and care system will need is, the biggest internal threat to the sustainability of the NHS.
  • There is an indisputable link between a prolonged period of pay restraint, over-burdensome regulation and unnecessary bureaucracy and low levels of morale and workforce retention. The Government should commission an independent review to examine the impact of pay on morale and retention of health and care staff.
  • The health and social care systems are interdependent but poorly-coordinated. To allow money and resources to be used more effectively the budgetary responsibility for adult social care at a national level should be transferred to a new Department of Health and Care.
  • Policy is now increasingly focused on integrated, placed-based care and so NHS England and NHS improvement should be merged to create a new body with simplified regulatory functions and strong local government representation.
  • There is a worrying lack of a credible strategy to encourage uptake of technology and innovation in the NHS. The Government should do more to incentivise the take-up of new approaches and make clear that there will be funding and service delivery consequences for those who repeatedly fail to engage.
  • Cuts to funding for the public health budget are short-sighted and counter-productive. National and local public health budgets should be ring-fenced for at least the next ten years. We also need a new nationwide campaign to highlight the dangers of obesity.
  • The Government should be clear with the public that access to the NHS involves patient responsibilities as well as patient rights. The NHS Constitution should be redrafted to emphasise this.

House of Lords report on sustainability

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