NHS shake-up to cut bureaucracy and improve care

NHS shake-up to cut bureaucracy and improve care

Health and care services will work more closely together under proposals to reform the system in England, the government has said.

Health Secretary Matt Hancock will set out plans to create a “more innovative and responsive” NHS.

He said he wanted to target “burdensome bureaucracy”.

Ministers believe it will put the NHS in a better position to cope with an ageing population and a rise in people with complex health conditions.

One-in-three patients admitted to hospital as an emergency has five or more health conditions, such as diabetes, obesity and asthma, up from one-in-10 a decade ago.

Those working in the health service said many of the rules in place were time-consuming, frustrating and stressful.

The proposals – which would overhaul many of the rules put in place by the 2012 Health and Social Care Act – include scrapping the tendering rule.

This made it complicated for councils and different parts of the NHS to set up joint teams and pool budgets.

Some had to set up separate bodies to bid for contracts.

Under the changes, to be set out in a white paper on Thursday, councils and NHS services will be able to set up bodies that can make decisions about how to join up services.

Nigel Edwards, of the Nuffield Trust think-tank, said this was a “re-wiring behind the dashboard” and should not be too noticeable to patients.

While not a “magic bullet” it could help different parts of the system work more closely together, he added.

The ageing population requires different services to work hand-in-hand, sharing expertise and staff to make sure people get the joined-up care they need.

If that sounds like NHS-speak, let’s take a typical patient with whom the NHS deals. She is in her 70s, has heart disease, the early stages of dementia and lives alone.

She needs regular contact with her heart specialist, support from community nurses and, ideally, some company from befriending services which are run by the voluntary sector with support from councils.

If she needs to go into hospital – perhaps after a fall – in an ideal world she will be treated quickly and then the hospital staff will be in touch with community services to arrange the support to allow her to come home.

In a world where budgets are linked to individual services, where different organisations are encouraged to compete and tender for work, the pooling of resources and staff is not so easy.

The white paper will cite examples of good practice, such as an care team at the Royal Derby Hospital which sees nurses from the community, council care services and hospital staff working together to plan the discharge of patients.

Mr Hancock said: “The NHS and local government have long been calling for better integration and less burdensome bureaucracy – and the pandemic has made clear the time for change is now.”

Writing in the Times Red Box, Mr Hancock promised the new laws would “bust bureaucracy that gets in the way of people doing their job”.

He said the plans would see the NHS join up “more seamlessly” and help it and local government work side-by-side.

NHS England chief executive Sir Simon Stevens said it will create a “flexible can-do spirit” across the health and care system.

Chris Hopson, of NHS Providers, which represents NHS managers, said it would end “an unnecessarily rigid NHS approach to procurement”.

The Local Government Association welcomed the plans but said they did not provide the funding to put care services on a “sustainable and long-term footing”.

Shadow health secretary Jonathan Ashworth questioned the timing of the reorganisation in the midst of the pandemic.

He said ministers needed to point out how this would helped the growing numbers of people facing long waits for treatment and ease the pressure on services that were “stretched to their limits”.

Leave a Reply