The minister of state for care and support has told charities he is positive about the role of civil society in health and social care reform.

As the government today responds to the Francis Report, which suggested a change in culture of the NHS, Norman Lamb told delegates at the Acevo Health and Social Care Conference that the voluntary sector has a powerful role to play in the wholesale culture change of the NHS.

Lamb said that four key things needed to change in the NHS and that the voluntary sector could help. He highlighted prevention, saying too often investment was concentrated at the repair end and not preventing illnesses. He added the NHS has to start involving people in their care, and provide more joined-up services and services which are less exclusive.

During questions from the audience, Lamb said that commissioners of NHS services were “hopeless” and often commissioned on price, not quality of care. Acevo chief executive Sir Stephen Bubb also made this point during the debate, saying that commissioners were “appalling”, “anally retentive” and risk-averse.

In response to questions, Sir Stephen and Lamb said changes to the NHS would be difficult as much of the public view it as a “national religion”, which should not be tampered with.

But delegates warned about jumping on the bandwagon of criticising the NHS and commissioners. “There is political difficulty in diverting resources from the acute end of care to prevention,” one delegate said.

Sir Stephen agreed, saying that it would be a brave politician who would call for an extreme change in services, such as the closure of a hospital. But he said structural change had been achieved; citing the example of mental health charities which had achieved change in care for mental health patients by campaigning for the closure of asylums and the development of community care.

Report calls for move away from hospital care

The conference today coincided with the release of the first report by the Acevo-led taskforce on preventative health, led by former health permanent secretary Sir Hugh Taylor and made up of leaders from the charity sector, NHS and local government.

The report calls for a shift away from hospital-based care and towards more preventative services to keep people healthy and allow them to manage their conditions at home and in the community.

It warns that failure to embrace this agenda will lead to “the end of the NHS as we know it”, given flatlining budgets and rising demand for care from an ageing population.

The report’s recommendations include:

• An ‘NHS Investment Bank’ to support the shift of care out of hospitals and into the community
• The establishment of social impact bonds in the NHS, bringing private capital to pay for preventative services, with the NHS paying investors back when results are achieved
• New partnerships between hospitals and the charity sector, including joint vehicles and ‘prime provider’ models
• A new training regime for GPs to help them understand the value of preventative services, including through secondments to charities
• Changes to the way GPs are paid, to encourage them to make more use of preventative services in the community
• ‘Patient charters’ between the NHS and patients, setting out two-way responsibility deals between patients and doctors

Sir Hugh Taylor, who is also chair of Guy’s and St Thomas’ NHS Foundation Trust, said: “There needs to be a step-change in the way the NHS operates, with far more done to keep people healthy and enable them to manage their conditions.  If we cannot make that happen, the NHS as we know it will be pushed to breaking point, with our health service struggling to cater to the nation’s growing health needs, alongside crippling budget constraints. We have long known that the NHS needs to do more to prevent ill-health as well as cure it – now we need to make it happen.”

 

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