The NHS 10-year plan is an opportunity to transform our nation’s health and wealth
This is a one-in-generation opportunity to tackle health inequalities and innovate so that Britain can support its ageing population.
The government’s 10-year plan for the NHS is a once-in-a-generation opportunity to shape the future of our national health service and the starting point should be to do what it says on the tin.
The current NHS is not a national health service in the truest sense, as it focuses more on sickness than health. This is a chance to re-purpose it into a health and wellbeing service.
One of the biggest challenges is to ensure equality of access to healthcare; I have no doubt that tackling health inequalities is at the forefront of Health Secretary Wes Streeting’s mind.
The good news is that modernising the NHS and future-proofing it for the decades ahead may not require huge investment, which the country cannot afford. Redirecting resources is more important, prioritising the provision of one-stop community services and making good on the commitment to reform.
A national health innovation service
Reform needs to be far-reaching and requires a new mindset. We are currently losing staff with innovative minds and skills because bureaucracy and time constraints stifle new ideas.
We need a national health innovation service – an arm of the NHS where employees can take new ideas rather than going through their line managers and never hearing back. The NHS must be a temple not just for the delivery of healthcare services but for innovation.
We need to promote research champions. I want to see healthcare professionals incentivised to innovate, rather than simply to deliver services, just as we can incentivise patients to do more to look after their own health by giving them better tools.
The NHS has one of the largest health databases in the world. I want to see a greater commitment in the Plan to use the database as a tool for research and innovation. The NHS should be a place where entrepreneurs are encouraged and thrive.
Communicating the why, not just the how
The three pillars of the government’s plan are changing the focus from treating illness to preventing it; from delivering care primarily in hospitals to delivering it in communities; and from analogue to digital systems.
No-one could argue with these objectives, but the government needs to communicate the why as well as the how. The golden thread is the impact that ill-health has on the economy; it holds back growth. Research recently conducted by the Create Health Foundation, which I founded, revealed that one in seven women have been forced to quit a job because of a health condition.
Moving from treatment to prevention
Reforming the NHS is not an end in itself; it is an essential pre-condition for improving our living standards and enhancing family life. We will only achieve this if we focus our efforts on health activation, improvement and education as the three pillars for prevention.
The NHS app can play a significant role in this; it has more than 34 million registered users and monthly logins rose by 69% year on year to March 2024, but it is mainly used to view GP health records, order repeat prescriptions, or manage hospital appointments.
The government has announced a £50 million investment to facilitate the delivery of 270 million messages through the app this year, an increase of 70 million compared to the previous financial year and this is welcome news, but it should do more to educate patients about their conditions, providing targeted, reliable and timely information.
We should also use digital technology to allow people to book their own appointments and for their information to be transferred to other parts of the NHS. I have no doubt the NHS app can facilitate this.
NICE also has a bigger role to play. At present, it mainly provides guidelines about treatment; its remit should be extended to embrace prevention. Education should start in schools; I launched the UK’s first fertility education module pilot in 2016 and there is a strong case to include it in the national curriculum.
Education goes hand in hand with raising awareness of NHS services to ensure they are used properly. There are two aspects; the first is tackling health inequalities by ensuring that disadvantaged and minority communities know where they can find help, for example ensuring the NHS website is regularly updated in multiple languages.
Secondly, diverting funds from secondary care into community care – the second reform pillar – will only be effective if patients are aware of the new services on offer. Women’s health hubs were launched in 2023 to provide early diagnosis and community services, but our research shows that seven out of ten women did not know about them and only 7% had visited one.
The concept of community health hubs is good because they encourage early diagnosis and earlier referrals. But they must be physical spaces, and they must be properly equipped to provide one-stop diagnosis; screening can happen at the same time as diagnosis. They must also provide services that meet the needs of the local communities they serve; one size does not fit all.
Tackling the underlying causes
Building an NHS for the future requires broader thinking and the involvement of different departments of government. For example, the role of local government is often overlooked, but it has responsibility for social care, which is integral to the reform agenda. It also has a role in local education, which should not be forgotten. And it has planning responsibilities, which are important for approving medical centres and ensuring that there are no delays and they are prioritised.
All of us who work in the NHS know that far-reaching reform has never been more desperately needed. We also know that it is unsustainable for more than 9.2 million working age adults to be economically inactive.
Unless we address social determinants of health such as housing, employment, heating and living conditions for families, which are risk factors for poor health, we cannot achieve upstream prevention.
We will need to work with the voluntary sector, local government and relevant government departments to end health inequalities and achieve better outcomes from our healthcare. We can’t continue to wonder why we’re not achieving the outcome we want to see unless we address the underlying social conditions.
The prize, if we get the 10-year plan right, is a more productive workforce that can support our ageing population. The wealth, as well as the health, of our nation is at stake. I look forward to the 10-year plan tackling health inequalities, bringing care to communities and promoting health innovation.
Geeta Nargund is a Senior NHS consultant and Founder of Create Health Foundation.
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