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The NHS belongs to the people: a call to action


NHS England sets out call to action to staff, public and politicians to help NHS meet future demand and tackle funding gap through ‘honest and realistic’ debate.

NHS England has today called on the public, NHS staff and politicians to have an open and honest debate about the future shape of the NHS in order to meet rising demand, introduce new technology and meet the expectations of its patients. This is set against a backdrop of flat funding which, if services continue to be delivered in the same way as now, will result in a funding gap which could grow to £30bn between 2013/14 to 2020/21.

A new publication, The NHS belongs to the people: a call to action' sets out these challenges facing the NHS, including more people living longer with more complex  conditions, increasing costs whilst funding remains flat and rising expectation of the quality of care.  The document says clearly that the NHS must change to meet these demands and make the most of new medicines and technology and that it will not contemplate reducing or charging for core services.

Speaking today, Sir David Nicholson, Chief Executive of NHS England said:

"The NHS was set up to provide high quality care for patients, free at the point of need. The NHS has stayed true to this aim and to do so in the future, we must embrace new ways of working. The NHS, like every other healthcare provider in the world, is facing these challenges. Too often, the answers are to reduce the offer to patients or charge for services. That is not the ethos of the NHS and I am clear that our future must be about changing, not charging. To do so we must make bold, clinically-led changes to how NHS services are delivered over the next couple of years.

"The focus needs to shift from buildings and onto patients and services. The  NHS was 65 years old last week and throughout its history our services, staff  and treatment has evolved as medicine, technology and evidence has changed.  Our success in extending life means people living longer, but with more conditions and illnesses such as dementia that were not common twenty years ago. New technology means earlier diagnosis and better treatment, but this costs more and we are not reaching everyone we need to.  The NHS can increasingly deliver care at home, yet too often patients have to travel are around buildings.

"We are facing demands, opportunities and investment unimaginable when the NHS was created in 1948. New data is available now to highlight where we get it right – and as importantly, where we get it wrong. We are setting all this out today – including the funding gap – to encourage the public and doctors and politicians to have an honest and realistic debate about how they want their local NHS to be shaped. With the new independence of NHS England and the establishment of  GP-led commissioners, we can find local answers to meet these challenges .”

Commenting on NHS funding, Sir David continued:

"Our analysis shows that if we continue with the current model of care and expected funding levels, we could have a funding gap of £30bn between 2013/14 and 2020/21,which will continue to grow and grow quickly if action isn’t taken.  This is on top of the £20bn of efficiency savings already being met.  This gap cannot be solved from the public purse but by freeing up NHS services and staff from old style practices and buildings. ”

The document sets out a number of latest facts on the NHS, including demand, the changing  demographics of the patients being treated and the growth in long term conditions.  These include:

  • The NHS treats around one million people every 36 hours
  • Between 1990 and 2010, life expectancy in England increased by 4.2 years
  • The difference in life expectancy between the richest and poorest parts of the country is now 17 years
  • Around 80 per cent of deaths from major diseases, such as cancer, are attributable to lifestyle risk factors such as smoking, excess alcohol and poor diet
  • One quarter of the population (just over 15 million people)  has a long term condition such as diabetes, depression, dementia and high blood pressure – and they account for fifty per cent of all GP appointments and seventy per cent of days in a hospital bed
  • Hospital treatment for over 75s has increased by 65 per cent over the past decade and someone over 85 is now 25 times for likely to spend a day in hospital that those under 65
  • The number of older people likely to require care is predicted to rise by over 60 per cent by 2030
  • Around 800,000 people are now living with dementia and this is expected to rise to one  million by 2021
  • Since it was formed in 1948, the NHS has received around four per cent of national income
  • Modelling shows that continuing with the current model of care will lead to a funding gap of around thirty billion between 2013/14 and 2020/21
NHS England along with other national partner organisations will be providing support to local GPs, charities and patient groups to hold meetings to discuss these issues. These meetings will provide the mechanism for patients and the public to have a genuine say in how the NHS of the future will look.
All feedback from these meetings, as well as national events and online contributions via NHS Choices, will be published and used to help shape a longer term strategy for the NHS.  This will need to be in place by early 2014 to feed into commissioning plans for GP-led Clinical Commissioning Groups in 2014/15 and 2015/16.

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