THE BLOG

Making Citizens Integral to the NHS Debate

04/03/2016 15:20 GMT | Updated 05/03/2017 10:12 GMT

It won't have escaped anyone's notice that there's a big debate taking place about the future of the NHS. Quality, efficiency, safety and of course money is at the heart of much of the lively discussion.

We have a great opportunity to make sure that citizens are central to this debate.

For years, we've talked about the importance of person-centred health and care, co-production, engagement, involvement and the need to activate communities to help plan health and care systems that really meet the aspirations and needs of their local populations. The long term value this will bring is well evidenced and understood so, in the drive for efficiency and innovation, we must make sure that person-centred care does not become an optional 'nice to have'. If citizens are ignored, we do so at our peril.

Significant challenges ahead

This week I met with health leaders at the Nuffield Trust's Health Policy Summit to discuss the many challenges facing the NHS and the progress that has been made in transforming the service since the Five Year Forward View, which was published 18 months ago. The mood was muted - everyone present was acutely aware of the size of the task ahead, the change required and the responsibility to make health and care improvements for citizens.

Doubts were raised by a number of speakers about whether the £22bn needed in efficiencies can be achieved. Elsewhere, Professor Don Berwick has cautioned that the current level of NHS funding is 'risky'. And social care services, a key component in realising the Forward View, continue to be under resourced. The King's Fund estimates that NHS trusts will be £2.3bn in deficit by the end of 2015/16, and there is a real danger that increased monies to the NHS end up plugging this gap rather than being allocated to service redesign. Despite the concerns about money, energy and commitment remained high to achieve the ambition and change outlined in the Five Year Forward view.

With all the talk of change and the desire to make improvements, it is important to remember that change can make matters worse as well better. For less common conditions that are less often in the headlines, we will need to work hard to get our voices heard and ensure improvements that have been hard fought for and gained over the years continue and get the attention and focus they deserve. Neurology is one such area. A recent select committee report concluded that neurological conditions are not a priority for the Government and progress made may not be sustained. Improvement in services must continue and provision for conditions like MS must not be left behind.

Opportunities ahead

The devil can be in the detail. Recently published NHS planning guidance set out that local health and care systems will be required to produce individual Sustainability and Transformation Plans, covering the period from October 2016 to March 2021. Meanwhile, there has been consultation on how the performance of Clinical Commissioning Groups (CCGs) will be publicly monitored.

This means we can now see what will be expected of the NHS over the next five years and how we'll know whether or not it's working.

Innovation and collaboration

In the face of these significant challenges, the commitment to designing, delivering and evaluating services and support differently is welcome and can make a very real improvement to the lives of people who rely on them.

People living with MS need services and support across health and social care to best manage their condition. This can include, but is not limited to, specialist support from neurologists and MS nurses, care closer to home, such as physiotherapy, and social care to support them to remain independent. Currently access to these services can be patchy depending on where you live, while there is also a need for better integration between services.

Ensuring that services are responsive to need and person-centred is essential, but a lot needs to be done to transform this from an aspiration to a reality.

Our hope is that the development of new models of care can lead to better integrated services for people living with MS. Voluntary sector organisations have an important role and contribution to make - at the heart of our work is a commitment to fully understanding the needs of people with MS, and co-producing the services and support we deliver, while encouraging others to do the same. We would ask that the NHS utilise this wealth of expertise and experience in the pursuit of truly person-centred care.