A report published today (Tuesday 21 July 2015) by the independent consumer champion Healthwatch which focuses on the patient experience has been welcomed by the NHS Confederation.
The report, entitled ‘Safely Home’, has been praised for its focus on individual patient experience and good system-wide healthcare coordination.
“Every patient has a story about their care and the vast majority are positive, but when it goes wrong it’s often because of gaps and boundaries which exist across the health and care system”, said Phil McCarvill, deputy policy director of the NHS Confederation. “Our members are already making progress in connecting different health services and delivering individualised, person-centred care, and will be keen to reflect on Healthwatch’s findings.
“The scale and complexity of the NHS can sometimes make the experience of care feel less tailored to individual’s needs. Delivering compassionate, dignified care must be the top priority of everyone who works in the NHS and change is needed wherever patients’ experience falls below that standard. There’s no one-size-fits-all solution so we need local leaders to continue working with key partners, such local authorities and the voluntary sector, to shape services and ensure the delivery of care in the right way, the right place and at the right time.”
The NHS Confederation has confirmed that it will work closely with Healthwatch and other partners to develop this agenda.
Mr McCarvill continued: “The NHS Confederation’s Commission On Improving Urgent Care For Older People is already working with partners across the health and care system to develop practical activities that help personalise care and connect services.
“Making services more joined-up is also helping to bring mental and physical care closer together, which is a priority as the NHS strives to improve its support and identification of poor mental health.”
Joined up models of care being developed by the NHS risk overlooking the full potential of community health services which are vital for their success according to a discussion paper launched today (Tuesday 21 July 2015).
The paper – ‘The art of the possible – what role for community health services in reshaping care?’ – states that community services’ focus on whole person care makes them “ideally placed” to help lead and deliver new care models.
Based on the views of community services leaders, the paper (compiled by the NHS Confederation) contains practical suggestions on the role community services can play in new care models.
Suggestions in the 15-page paper include: (i) community health staff taking on more care planning for people with long term conditions rather than GPs being expected to do it all; (ii) developing new arrangements for patients to have access to a wider range of professionals and specialist services through GP practices; (iii) community providers and GP practices combining their knowledge of local community and voluntary sector organisations and networks to develop new approaches to local health and wellbeing issues; (iv) joint initiatives between community services and care homes, for example offering ‘intermediate care’ within a care home so that residents suffering an acute episode of illness can avoid hospital admission; and (v) using community services to their full potential to ensure health and care systems, and smaller hospitals, are viable – including delivering more care in community settings and rotating more staff across acute and community settings.
“We need truly joined-up, community-based models of care if we are to meet the demands of a 21st century health and care service”, said NHS Confederation Community Health Services Forum chair Matthew Winn.
“Community services and primary care are natural partners. We could create a stronger and more sustainable community-based offer for patients if we build on the strengths that each possess. Bringing together the two parts of the NHS that see and support the entire population at different points of people’s lives would be incredibly powerful.
“Everyone involved in developing new care models – commissioners and providers – will need to take a strategic approach to maximising the expertise, innovation and resources in community health services and release the possibilities of working in an integrated way with general practice.
“To create new care models we must not start with organisational structures but instead use the views and insights of patients and the public, and engage community health care and general practice staff, to design a new future.”
Today’s budget in which the Chancellor of the Exchequer George Osborne confirmed that the NHS will receive an extra £8bn by 2020/21 has been given a cautious welcome by healthcare leaders.
Daniel Mortimer, chief executive of NHS Employers, said: “We welcome the Government’s commitment and confirmation of additional funding for the NHS.
“Patients and employers want to see improved and better seven-day services, and what we urgently need to consider is the workforce and pay and contract reform required to support this, especially for medical staff.
“In continuing with the work to reform terms and conditions of service in and across the NHS, we now look forward to the publication of reports and the observations from the pay review bodies. Following publication we will be urgently seeking to speak with our trade unions, to ensure we continue to work in partnership to progress pay reforms and service improvement across the NHS.
“Our discussions will now need to be set against the context of today’s announcement from the Government of continued public sector pay restraint and we recognise that these discussions are now likely to be more difficult.”
Further comments came from Rob Webster, Chief Executive of the NHS Confederation, who said: “The £8bn highlighted in today’s budget document needs to come in staged increases and we would emphasise this should reflect the bigger cost pressures expected in the first half of this Parliament. There is an opportunity for a multi-year funding deal to be aligned with planning in the NHS, for example around pricing, contracting and allocations. Through NHS Employers, we will look at the impact of the budget on our workforce.
“The additional funding will also need to account for investment in transformation, to support double-running and other costs that will be needed to move to new models of care. What cannot be forgotten though is the impact that social care cuts are having on the NHS. We need urgent action to look at how we address the gap in social care funding, currently estimated at £4bn by 2020.
“We also look forward to continuing to work with the Treasury and the Department of Health in addressing these urgent questions as part of the spending review due in autumn. Through this process we hope to secure a sustainable settlement for health and care, which allows our members to get on with the bigger challenge of delivering change in service delivery, to better meet the needs of people in the 21st Century.”
NHS organisations and the government need to take “rapid action” to avoid winter pressures in A&E, the NHS Confederation warns in a briefing paper released today.
The NHS Confederation’s parliamentary briefing – due to be discussed in the House of Commons on Wednesday 24 June – warns that many patients who attend A&E could have their needs better met outside of hospital if sufficient capacity existed.
The briefing also highlights pressures in A&E are symptomatic of issues across the whole system affecting a raft of services including ambulance services, general practice and community and mental health and cannot be dealt with in isolation.
These issues were referenced in a recent NHS Confederation member survey which found that 99 percent of respondents thought cuts to social care funding were increasing pressures on the NHS as a whole, particularly on hospital services.
Dr Johnny Marshall, director of policy at the NHS Confederation, which represents 85 per cent of NHS providers and commissioners, said: “NHS organisations need to take rapid action now if they are to change services to make sure all patients have access to good quality urgent and emergency care services. Many local organisations are already making significant progress on this but local leaders need further support from the Government and national bodies, particularly NHS England, if we are to be successful across all parts of the country.”
The NHS Confederation briefing also covers recent changes to waiting time standards, links between health and social care, as well as a commission on improving urgent and emergency care for older people (set up by the NHS Confederation).