A recent study has been completed by the King’s fund, which focuses on how the current health and care system is broken, and how the government could fix it. It is common knowledge that the social care system is in need of change, and was a significant issue brought up during the election period back in June and July.
This report sets out suggestions to be implemented to make our healthcare system more effective.
Overview:
There needs to be a shift in focus away from hospital care, to primary and community care to ensure everyone receives adequate support that is quick, effective and before conditions worsen. This doesn’t mean hospitals should be closed, or services should be moved; there needs to be a wholesale shift to focus on primary services, with the intention of freeing up other sectors so the hospitals can function more smoothly.
Why was this study done in the first place?
As life expectancy increases, specialist care to treat individuals living with multiple conditions will increase. This means more staff, more facilities, and more money. Without a shift, hospitals will only be under more stress. Whereas, community care could be improved to increase the chances of conditions being prevented or managed earlier on. Therefore, lowering the chances of needing more complex care and lessening the burden on hospitals.
How was the data collected?
The King’s fund collected perspectives from people across the health care sector, both those who provide services, and those who draw on services. In addition, they reviewed existing research and evidence from the past 30 years, both in England and internationally.
Findings:
‘Financial and workforce growth is not aligned to a vision of care focused on communities.’ There are a number of reasons for this, such as:
- A lack of agreement in the purpose of change- Cost saving, reducing hospital demand, providing better services, etc.
- There is a cycle of invisibility, where staff from primary care sectors are overlooked and difficult to quantify. These services are constantly forgotten about when they should be taken just as seriously as those working in hospitals.
- There is a hierarchy where serious conditions and complicated treatment plans take priority; the majority of funding is allocated to hospitals, so many primary care services cannot work effectively.
What’s next?
The health and care system is complex, and so are the solutions. As mentioned, a wholesale shift is needed- it will be complicated, and long, but must be completed in its entirety to have a significant difference.
- All policies must align with this vision, as partial implementation will not be enough.
- It must be maintained over a long period of time- this shift will not work as a short-term fix.
- The workforce needs to be equipped to deal with change- we need more people working in primary care services, and their position in society needs to be recognised as just as valuable as those in hospitals. This will require workforce planning, further training, and reward systems introduced.
- Teamwork between different sectors of care needs to be improved- connections between community care services, GP’s and hospitals needs to be strengthened to ensure treatment is provided quickly and effectively. You can read about how the UK is currently struggling with this here.
- Local areas should be given greater responsibility in order to reflect and meet the needs of their community.
Actions that should not be taken include:
- Partially implementing plans as this will be ineffective
- Significant structural reorganisation, as this is not necessary and may reinforce hospital-centric care
- Expecting short-term financial savings- the impact will not be overnight.
September Update:
Midway through writing this summary, The Darzi review was published, criticising the current state of our NHS, with a significant focus on A&E waiting times.
The report brings attention to the broad and deep performance issues within A&E departments nationally. For example, not a single hospital operating a major A&E department in England is currently meeting the performance standard, introduced in 2004. This states that 95% of patients in A&E must be seen, treated and admitted/discharged within four hours of arrival.
In addition, the review team received a huge number of submissions that includes a lot of information about wider hospitals services, and so emphasises that it is not just A&E that needs reform. However, the report lacks in information on what is happening outside of hospitals, so there is a risk that policy change will continue to focus on these services, despite change needed across the whole health and care system.
Even so, the report helps build the case for radical change. For instance, the NHS has attempted to gradually increase that A&E target by 2% each year, however the sector seems to be getting worse and worse, evidencing how incrementalism is not the answer.
“We don’t need an independent review to know that NHS performance is bad and that the government has received a troubled inheritance. What we need is a mandate for change. With a diagnosis this serious, the treatment surely needs to be radical.”
Us at Broomfield Care:
At Broomfield Care, we work together with local GP’s, hospitals, and the council to ensure each individual’s care is right for them, and aligns with recommendations made by medical professionals.
