The government should mandate the rebalancing of NHS funding towards primary and community services and overhaul existing hospital-focused performance targets in order to deliver its reform plans for a sustainable NHS, according to a new report from The King’s Fund.
The health and care charity is calling on the government to rebalance NHS spending towards primary and community care to make sure those services are able to provide the care and treatment the public need to stay healthy.
This could be achieved through returning hospital spending to below 50 per cent of the NHS budget over the medium-term.
The report authors also call on ministers to review the current, hospital-focused targets regime that they find hinders progress towards a more sustainable NHS that reduces people’s need for hospital treatment in the first place.
Beccy Baird, Senior Fellow at The King’s Fund and co-author of the report, said: “The structure and focus of the NHS has failed to keep pace with changes in disease and ill-health.
“English hospitals are well-placed to support the most acutely unwell, but too often they are treating patients that could have had their condition better managed in the community.
“An increasing number of us are living with long term health conditions that require regular, ongoing support.
“Boosting out-of-hospital services can help avoid the need for hospital treatment, meaning better care for patients and better value for tax-payers.”
The King’s Fund has argued that the 76-year old NHS is stuck in 1948 with a model of care based on patients getting sick, being patched up and sent home.
Latest figures show that 1 in 4 people in England live with one or more long term conditions, many of which will never be cured and instead will require constant management and support.
To meet this shift in patient need, the NHS needs to focus far more on the services in the community, such as GPs, district nurses, pharmacies and occupational therapists, that support people to stay well and independent, not just those that treat them when they are acutely unwell.
The Labour government has committed to shifting the focus of the NHS towards primary and community services as one of its three ‘big shifts’ which will be delivered through the NHS 10-year reform plan due to be published this spring.
This new report builds on previous research by The King’s Fund which found that successive governments have failed to deliver this ambition of moving more ‘care closer to home’ over the past 30 years.
Researchers at the charity studied past failed attempts to shift focus to primary and community services, analysed national and international research into what others have done to shift how health services are delivered, and interviewed national policy-makers and frontline healthcare leaders.
The new report sets out what this government needs to do differently to succeed this time, outlining the key policy ‘levers’ available to the Secretary of State for Health and Social Care if he is to deliver this change.
Baird said: “For ministers to succeed where their predecessors have failed, they will need to take bold action.
“History tells us that warm words and soft ambitions won’t cut it – delivering this change will require hard targets, including the mandated rebalancing of funding towards primary and community services.
“Rebalancing NHS funding away from hospitals may sound counter-intuitive, and may even face some public criticism, but the truth is that the long-term solution to our over-crowded hospitals lies in boosting out of hospital services.”
