The Committee is expected to question Mr Stevens on a variety of matters affecting the NHS, including the financial performance of the NHS, prevention and public health, the NHS workforce and staffing, urgent and emergency care, mental health services, and the post-Francis Review progress on changing culture in the NHS.
Ahead of the session, the Committee has received a brief statement from NHS England on progress with the NHS Five Year Forward View, published last October. The text of that statement can be found below.
Overview of progress on the Five Year Forward View
When the NHS came together to produce the Five Year Forward View our ambition was to reframe the terms of debate: to set out a shared view of the challenges ahead and the choices we face about the kind of health and care service we want in 2020. Working with patient groups, clinicians, local government and national partners, we tapped into a widespread consensus on the need for change, and a shared ambition for the future.
It’s a future that empowers patients, their families and carers to take more control over their own care and treatment: a future that dissolves the artificial divide between family doctors and hospitals, between physical and mental health and between health and social care. One that no longer locks expertise into outdated buildings, with services fragmented, patients having to visit multiple professionals for multiple appointments; one organised to support people with multiple conditions not just a single disease.
We now have a consensus about the challenges ahead, a commitment to at least £8bn of additional funding and support for the changes needed to shape the future NHS. Our shared challenge is to close three gaps in health care: the health and wellbeing gap, the care and quality gap, and the funding and efficiency gap. In the months since the Forward View’s publication, we have made progress in all three areas.
Closing the care and quality gap
As a catalyst to create new ways of delivering care that are better suited to modern health needs, we have initiated a ‘Vanguard’ programme to develop, implement and learn how to replicate the new care models outlined in the Forward View. 269 localities came forward with their ideas on how to design new models of care, and following a period of peer assessment, 29 were selected to form the initial cohort. We have since initiated two further Vanguard groups. The first invites expressions of interest from hospitals across England to develop new ways of collaborating and sharing resources. The second seeks areas covering five million people to become Urgent and Emergency Care Vanguards. The successful areas will be announced shortly.
Our aim is not just to improve services in the Vanguard areas, but to develop models that can be replicated elsewhere, so that all patients can benefit in the future. However, there are a number of local health and care systems where the conditions for transformation do not yet exist. In these challenged areas, we will implement a ‘Success Regime’. The first cohort includes North Cumbria, Essex and Northern, Eastern and Western Devon. These areas will benefit from short-term improvement in current performance, support for medium and longer term transformation, and a greater focus on leadership capacity and capability.
We have also established independent taskforces on Cancer, Mental Health and Maternity services, to identify further opportunities for improving these specific services.
Closing the health and well-being gap
To meet the needs of patients in a sustainable way, the NHS can no longer simply respond to the forecasts of ill health and increased costs; the NHS must become a pro-active agent of change, taking bold action in partnership with individuals, local government and third sector bodies to ‘bend the curve’ on predicted trends. To drive this increased emphasis on prevention, we have established a national prevention board, chaired by Public Health England, and with an early focus on diabetes prevention.
The Diabetes Prevention Programme, together with Diabetes UK, aims to halt the predicted rise in this disease, by delivering at scale lifestyle interventions that have been shown to help individuals at high risk of developing Type 2 diabetes. Seven local demonstrator sites have been developing the early stages of the programme and over the next few years we roll out the programme out across England.
Closing the funding and efficiency gap
The Forward View highlighted that if we continue with the current model of care and historic trends continue, it is likely we will face a substantial funding gap between projected health spending requirements and available resource. So the NHS needs a combination of new investment and new efficiency to create the headroom to manage increased demand and continue to improve care. To achieve these savings there are three main areas where the NHS is taking action:
Preventing and managing demand – reducing, wherever possible, the need for health care in the first place by supporting people to keep healthy, through actions like the Diabetes Programme.
Maximising the value of our £115bn spend – driving up productivity and reducing inefficiencies so that more of our budget is spent on patients who need our care, with early action to reduce agency spend and consultancy services.
Redesigning services – investing in new ways of providing joined up care in a more clinical and cost-effective way for patients and their carers through the development of New Care Models.
We have established an NHS Five Year Forward View Board to bring together the CEOs of the national NHS bodies to ensure oversight and delivery of the vision. Because the scale of the required changes cannot be driven by the centre nor delivered by the NHS alone, we have also launched a programme of engagement, led by the NHS Confederation, NHS Providers and other partners such as the LGA, National Voices, the Academy of Medical Royal Colleges and the Royal College of GPs. The results of our engagement and the Spending Review process will inform the service’s national and local planning processes in autumn, providing the foundation for the next phase of delivery.
- Tomorrow’s oral evidence session will be open to the public and will take place in the Thatcher Room, Portcullis House. The session will also be broadcast live on www.parliamentlive.tv and on BBC Parliament.