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The NHS must construct a 15 year plan to shift money out of hospitals and into investment in communities, a new report argues today. Get Well Soon: Reimagining Place-Based Health demonstrates that the health service in its current form is not sustainable, and sets out a new plan for shifting the system to focus on preventing illness, shorten stays in hospitals and help people live independently for longer.
A new 15 year plan would need to overcome the short term operational and political pressures that prevent a focus on transformation. It would build on the Five Year Forward View to create a longer-term blueprint for a future system for health and wellbeing that is fit for purpose.
The recommendation emerges from the Place-Based Health Commission, chaired by Lord Victor Adebowale and including stakeholders from all the major players in the health and wellbeing system. The commission was run by NLGN and Collaborate.
As well as a new 15 year forward view for the NHS, the commission recommends a route map towards place-based health by 2030 including:
Our focus is making the best use of existing funding, but any new resources for health announced by government should be designated to support a transition to place-based health
Metro mayors and council leaders to be in charge of pooled budgets and other financial models that ensures places rather than institutions are held to account for health outcomes
A renewed focus on people’s wellbeing to drive a reduction in health inequalities.
The commission’s findings show that it is only by full scale transformation from a monolithic institutional service to a place-based approach to person-centred health and care that we can secure the future of our health system and ensure our population are happier and healthier.
Such a transformation will not be easy. At present, short term political considerations vastly outweigh the long term good of the system. This can only change if the NHS learns to lift its vision to the long term horizon. The commission recommends taking a “15 year forward view” to release the NHS from short term reaction and electoral cycles.
This would act as a blueprint to create an agreed vision of place-based health across all institutions currently working in a separate and fragmented way. These organisations coming together to deliver things differently will be essential to making sure the NHS and all its broad spectrum of partners – from local government, housing providers, schools, community pharmacies and charities – achieve a shared vision for health and social care.
Chair of the Place-based Health Commission Lord Victor Adebowale said:
“This report is an excuse remover and challenges decision makers to go beyond five years, setting out why such thinking should start with place. It’s clear we can no longer afford to continue to do what we’ve always done and get what we’ve always got, as it’s proving very expensive. The report’s recommendations are clear; if we focus on place, rather than institutions, we’ll have healthier communities and a more effective health system.”
Report co-author and Deputy Director of NLGN Jessica Studdert said:
“Change to the NHS is essential if it, and the people it serves, are to flourish. Moving from a service for sickness to a system based around promoting wellness is essential to the future of this vital institution. This can only be done if it is allowed to plan for the long term and decisions are taken out of short term electoral cycles and beyond day-to-day operational pressures.”
Collaborate Executive Director, Dr Henry Kippin, said:
“The NHS, social care and other local partners must use Sustainability and Transformation planning (STP) processes as a springboard to achieve more effective collaboration across care settings and organisational silos. But building the right relationships between commissioners, providers and partners will not happen by accident. The Commission is right to highlight the cultural – as well as structural – challenge this poses. We must grasp the opportunity to work across organisational lines and redesign better care for people and places”.
Ruth Cooke, CEO at Midland Heart said:
“The report underpins the very real need for a whole system approach to health and care. We see the significant value that joined up services can bring with our innovative work to help individuals home after a stay in hospital. A longer term plan is essential in ensuring greater savings in the midst of budgetary challenges and will ultimately mean that individuals receive the right care, when and where they need it most.”
Responding to the Place-Based Health Commission Report, Mike Adamson, chief executive of the British Red Cross, said:
“It is no secret that this country is facing a social care crisis. With an ageing population, we need to act so that our services can meet the growing need. We must make sure that people are at the centre of their own care and move away from a one size fits all approach to treatment and support. Place-based health is about fully integrating prevention and care into local services, by coming together they can help people better take control of their health and wellbeing.”