Every healthcare system in the western world is grappling with the same problem: limitless potential demand for care within a post-recessionary economic system of constrained supply. Squaring that circle is impossible, which is why frameworks for evolution, transformation and radical innovation in care models are moving centre stage.
Last week’s release of the NHS Five-Year Forward View sets out the vision for the future of NHS England, and it is difficult to disagree with the main thrust of the transformational changes outlined. It represents the collective view of NHS national leadership; highlights the fundamental health and care challenges to be faced; argues for patient empowerment, taking more control over their own care and treatment; proposes incentivisation and lifestyle intervention programmes; and aims to unleash system efficiencies through the co-design and implementation of eight major new care models; while advocating local reconfiguration with the championing of new joint commissioning models between NHS and local government. All of this is to be done through aligned national NHS leadership; supporting a modern workforce, exploiting the information revolution and accelerating useful health innovation and personalised care. Massive change management challenges now need to be addressed, as well as the considerable planning issues of how to achieve that vision.
And of course there is a £30bn annual black hole by 2020/21 to be addressed as well. Three options are examined revolving around net annual efficiency ambitions of 0.8% (cutting it to £21bn), 1.5% (£16bn) and 3% (zero).
Procurement receives no mention whatsoever. Encouragingly, though, there is no appetite for wholesale structural reorganisation. Change plans will need to be adaptive and collaborative. Now is the time for procurement leadership to align themselves with this vision, build internal alliances with clinicians and develop the road maps required for 3%+ annual improvement.
by Jon Hughes