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NHS must be allowed to “evolve”

NHS must be allowed to “evolve”

Self-improvement in healthcare systems must be allowed to be driven by the energy of NHS staff and not through structural reform.

Posted: 8 December 2014

Speaking at the NHS alliance conference last week, Rick Muir, associate director at the Institute for Public Policy Research, said studies had shown improvements in public health systems happened when systems were allowed to evolve over time, instead of when “receiving sudden shocks from on high”.

Muir’s views were echoed by Health Secretary, Jeremy Hunt, who said there was a danger of assuming “by pulling a lever in Whitehall, lots of things are automatically going to change”.

He said changes must be driven by the frontline of the NHS.

Hunt said government ministers and the Department of Health should avoid the previous mistakes of finding the “right model and rolling it out across a system of 1.3m people” and focus on removing barriers for integrated care instead of forcing people into the “straitjacket” of a template.

The £8bn extra government funding demanded by NHS England chief executive, Simon Stevens, to save the NHS is a large but realistic and achievable figure, said Muir.

“Something needs to be done for short term funding,” he said.

“We need to build in some automatic drivers in the system for raising funding and ensure it is as efficient as possible.”

Chair of the NHS Alliance, Dr Michael Dixon, said both bureaucratic and financial pressures on GPs were beginning to cause a “terrible divide” between what frontline clinicians deliver and patients’ expectations and this divide had the potential to cause the NHS to unravel from the bottom upwards.

“As GPs, we need to put silos and fragmentation behind us,” he said.

“I do believe we are dangerously close to the brink, I have never see this happen to the frontline before, but doing nothing is not an option.”

Dr Dixon said new relationships, not new structures were needed and GPs needed to work with colleagues across the primary care spectrum.

Chief executive of Reform, Andrew Haldenby, said the deficit on public finance at the beginning of the next Parliament will total £70bn and urged the NHS to live within its means.

Carlisle Baker-Jackson, Reporter