David Hare is Chief Executive of the Independent Healthcare Providers Network.
Much has changed during the last 20 years and in healthcare, in particular, there have been some extraordinary breakthroughs in medical science – including the development of artificial organs; effective treatments for HIV/AIDs; targeted cancer therapies; minimally invasive surgery: the list goes on.
But in how healthcare is organised it is remarkable how much of what was said back then still resonates now. Take this statement from then Labour Health Secretary, Alan Milburn, in 2002:
“While its [the NHS’] values are right its structures are wrong. Too much of it still has the feel of the 1940s – both for those working in it and those using it. Queuing is endemic. Staff are run off their feet. Capacity problems mean shortages of staff and equipment and services are slow and unresponsive. Patients are disempowered with little if any choice.”
Fast-forward 20 years ,and anyone working in the NHS or seeking NHS treatment will recognise much of what Milburn said. Not least with recent NHS performance stats showing yet another record waiting list of 7.2 million.
The Labour government of the 2000s went on to introduce major changes to the way that healthcare was delivered in England and had much success. NHS waiting lists fell and public satisfaction rose. Of course increased funding helped – but it wasn’t the sole driver of improvement.
Opening up NHS service delivery to a plurality of providers, funding mechanisms that ensured money followed the patient, focused targets to avoid an ‘everything but nothing’ approach to management. These were complementary changes which added to a successful programme of reform.
Today, much of that agenda is still visible but the Government was right to signal last week, through the launch of its “NHS backlogs” taskforce, that it needs a renewed focus. And in announcing the news of this new initiative to “help unlock spare capacity in the independent sector to bust the Covid-19 backlogs and reduce waiting times”, Will Quince, the Health Minister, made it clear that, in making greater use of independent providers, his aim is to “give patients more autonomy over when and where they are treated.”
While some ConservativeHome readers may be aware that the right to choose an NHS or private provider for your first hospital outpatient appointment has been a legal right since 2009, only half of the population have ever reported knowing about it. Moreover, the NHS’ annual survey that used to capture public awareness hasn’t been undertaken since 2015, so it’s incredibly difficult to keep track of whether patients’ are being made aware of that right. This is important, since being given a choice of provider can make a real difference.
Research conducted by IHPN in conjunction with the Patient’s Association found that just a 30-minute drive by car to an alternative provider of NHS care, public or private, can shave 14 weeks off your waiting time, lowering it from 22 weeks to just eight.
And the current legal right to ask to be swapped to an alternative provider if you have been waiting for longer than 18 weeks is something which very few are aware of, but could make a huge difference to anyone facing a lengthy delay for treatment.
This could have a real impact not only in ensuring that individuals themselves can get faster treatment, but also in ensuring a more efficient use of resources within the healthcare sector. This also includes through patients being able to choose to receive their NHS treatment in an independent hospital.
Despite the presumption of many that independent hospitals are located primarily in the leafy home counties, our research found that almost 90 per cent of people in England live within a 30 minute drive of an independent provider that delivers NHS care, and that people living in the most deprived areas of England are just as likely to live near an independent provider as the general population.
Unsurprisingly, patients themselves want these rights and to be more in control of their healthcare. Polling conducted for us by Savanta found that three quarters of people believe they “should have a right to choose where I receive my NHS treatment”, with a similar proportion saying they would be happy to travel more than 30 minutes outside of their local area to get treatment more quickly.
It certainly isn’t the case that opening up patients’ choices and making better use of all available capacity and capability both NHS and private will suddenly magic away the pressures facing the health service. Workforce pressures are everywhere, funding will always be an issue and the effects of the pandemic will be felt for years to come.
But if we are to improve access to care – the one thing which the British publicly consistently report as being their top NHS priority – then we need to learn the lessons of the past.
This is why the Government was right to commit to looking at how to turbo-charge its use of independent healthcare providers (and tackling any barriers to this whether cultural, financial or operational) to drive down NHS backlogs and put patient choice back at the heart of the way the NHS operates. Because, unsurprisingly, by putting power in the hands of patients, the public will make the best possible choices for themselves, and in turn, for the health system itself.
David Hare is Chief Executive of the Independent Healthcare Providers Network.
Much has changed during the last 20 years and in healthcare, in particular, there have been some extraordinary breakthroughs in medical science – including the development of artificial organs; effective treatments for HIV/AIDs; targeted cancer therapies; minimally invasive surgery: the list goes on.
But in how healthcare is organised it is remarkable how much of what was said back then still resonates now. Take this statement from then Labour Health Secretary, Alan Milburn, in 2002:
Fast-forward 20 years ,and anyone working in the NHS or seeking NHS treatment will recognise much of what Milburn said. Not least with recent NHS performance stats showing yet another record waiting list of 7.2 million.
The Labour government of the 2000s went on to introduce major changes to the way that healthcare was delivered in England and had much success. NHS waiting lists fell and public satisfaction rose. Of course increased funding helped – but it wasn’t the sole driver of improvement.
Opening up NHS service delivery to a plurality of providers, funding mechanisms that ensured money followed the patient, focused targets to avoid an ‘everything but nothing’ approach to management. These were complementary changes which added to a successful programme of reform.
Today, much of that agenda is still visible but the Government was right to signal last week, through the launch of its “NHS backlogs” taskforce, that it needs a renewed focus. And in announcing the news of this new initiative to “help unlock spare capacity in the independent sector to bust the Covid-19 backlogs and reduce waiting times”, Will Quince, the Health Minister, made it clear that, in making greater use of independent providers, his aim is to “give patients more autonomy over when and where they are treated.”
While some ConservativeHome readers may be aware that the right to choose an NHS or private provider for your first hospital outpatient appointment has been a legal right since 2009, only half of the population have ever reported knowing about it. Moreover, the NHS’ annual survey that used to capture public awareness hasn’t been undertaken since 2015, so it’s incredibly difficult to keep track of whether patients’ are being made aware of that right. This is important, since being given a choice of provider can make a real difference.
Research conducted by IHPN in conjunction with the Patient’s Association found that just a 30-minute drive by car to an alternative provider of NHS care, public or private, can shave 14 weeks off your waiting time, lowering it from 22 weeks to just eight.
And the current legal right to ask to be swapped to an alternative provider if you have been waiting for longer than 18 weeks is something which very few are aware of, but could make a huge difference to anyone facing a lengthy delay for treatment.
This could have a real impact not only in ensuring that individuals themselves can get faster treatment, but also in ensuring a more efficient use of resources within the healthcare sector. This also includes through patients being able to choose to receive their NHS treatment in an independent hospital.
Despite the presumption of many that independent hospitals are located primarily in the leafy home counties, our research found that almost 90 per cent of people in England live within a 30 minute drive of an independent provider that delivers NHS care, and that people living in the most deprived areas of England are just as likely to live near an independent provider as the general population.
Unsurprisingly, patients themselves want these rights and to be more in control of their healthcare. Polling conducted for us by Savanta found that three quarters of people believe they “should have a right to choose where I receive my NHS treatment”, with a similar proportion saying they would be happy to travel more than 30 minutes outside of their local area to get treatment more quickly.
It certainly isn’t the case that opening up patients’ choices and making better use of all available capacity and capability both NHS and private will suddenly magic away the pressures facing the health service. Workforce pressures are everywhere, funding will always be an issue and the effects of the pandemic will be felt for years to come.
But if we are to improve access to care – the one thing which the British publicly consistently report as being their top NHS priority – then we need to learn the lessons of the past.
This is why the Government was right to commit to looking at how to turbo-charge its use of independent healthcare providers (and tackling any barriers to this whether cultural, financial or operational) to drive down NHS backlogs and put patient choice back at the heart of the way the NHS operates. Because, unsurprisingly, by putting power in the hands of patients, the public will make the best possible choices for themselves, and in turn, for the health system itself.