NHS England Chief Executive Simon Stevens has this week given wide ranging interviews to both The Daily Telegraph and The Health Service Journal (£) in which he has begun to set out his vision as to what the future of NHS care will look. The headline recommendation from his interview has been for more care to be delivered within community hospital settings, with Stevens reiterating the comments from NHS England Medical Director Sir Bruce Keogh in last year’s review of urgent and emergency care that the current system of care outside hospitals is “too complex”, and that “if you were starting from scratch, you would not design community services like that.”
It is believed that he will use a speech to the NHS Confederation next week to outline new models of healthcare which will include measures to see hospitals take over the running of some GP services, and more close working between specialist and community care, in order to break down barriers between what GPs do in community settings and consultants are doing in hospitals.
Stevens further advocated the potential of “accountable care organisation” models, in which one or a group of providers is given a single budget to serve a specified population, as has been suggested by NHS England officials over the past few months, with these providers responsible for combined hospital, primary care and community services. On current commissioning models, Stevens stated that the “status quo is clearly not working”, but did argue that both CCGs and Health and Wellbeing Boards “have got to prove themselves”, with CCGs “still finding their feet” in terms of making use of competition.
He also reiterated the comments that he made in front of the Health Select Committee last month that he would take a “pragmatic approach” to independent provision in the health service, stating that NHS providers would remain the principal providers of NHS funded care “in the near future” but that, wherever possible, patients’ choices should determine where and how services are provided. He did say that he would give NHS providers the first chance to change when performing poorly, but would not sign up to Andy Burnham’s proposal to make the NHS the ‘preferred provider’ of services.
Finally, on the issue of funding, he commented that the NHS had done extremely well in the past five years of efficiencies, and that the service has a “line of sight” on how it will make around half of the estimated £30 billion worth of savings that would be needed over the next five years.
Pete from PSI: Stevens’ speech next week is likely to apply more flesh to the bones of these two interviews, during both of which he reiterated many of the points made in his appearance in front of the Health Select Committee last month. Many of his comments support the ongoing attempt to move care out of acute hospital settings, with his suggestions on population-based commissioning an evolving, but seemingly popular, idea within NHS England. His approach to NHS providers in the respect of allowing them to ‘prove themselves’ is also a pragmatic and rather sensible one, as this will ensure that the independent sector is seen in the eyes of the public as a necessity in order to help to work with the public sector to improve services.
