23 October 2014 Last updated at 00:00By Nick TriggleHealth correspondent, BBC NewsA new vision for the NHS service will be set out on Thursday The NHS in England needs extra money and drastic changes to services if care is not to suffer, health bosses say. A five-year plan for the NHS - unveiled by six national bodies - once again highlighted that an annual ￡30bn shortfall would open up by 2020. It said changes, such as breaking down the barriers between GPs and hospitals, would plug a large chunk of the gap. But it said an extra ￡8bn a year would still be needed at the end of the period to maintain quality services. The sum amounts to 1.5% extra a year above inflation for the next five years. The current budget stands at ￡100bn a year. But the plan - called the NHS Forward View - said this would only be enough if the health service became more efficient. To achieve this, the plan called for a rethink about the way services were delivered. Continue reading the main storyIt put forward a range of models - although stressed it was up to each local area to decide which ones to adopt. These include: - Large GP practices to employ hospital doctors to provide extra services, including diagnostics, chemotherapy and hospital outpatient appointments
- In areas where GP services are under strain, hospitals could be encouraged to open their own surgeries
- Smaller hospitals to work as part of larger chain, sharing back-office and management services
- Larger hospitals to open franchises at smaller sites, as Moorfields Eye Hospital has done in London
- Hospitals to provide care direct to care homes to prevent emergency admissions
- Volunteers could be encouraged to get more involved, by offering council-tax discounts
Many of these measures are designed to curb the rise in hospital admissions and impact of the ageing population - the source of the most pressure in the health service. Case study: Working with care homesNurses and doctors from Airedale Hospital in West Yorkshire have set up video link-ups with local care homes. It allows consultations to take place with residents on everything from cuts and bumps to diabetes management. Emergency admissions from these homes have reduced by 35% and A&E attendances by 53%. But the report - produced by NHS England, Public Health England, the regulator Monitor, the NHS Trust Development Agency, Care Quality Commission and Health Education England - also said more needed to be done to reduce the obesity, smoking and drinking rates. It suggested employers should be encouraged to incentivise their staff to become healthier by taking steps such as offering them shopping vouchers for healthy behaviour. Meanwhile, councils could play their part by using their powers in areas such as planning and licensing to limit the opening of junk food outlets and the sale of cheap high-strength alcohol.
Simon Stevens, chief executive of NHS England, the lead body for Forward View, said: "The NHS is at a crossroads - as a country we need to decide which way to go. "It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But the NHS needs to change substantially." He said if the health service did not, the "consequences for patients will be severe" in terms of what could be done to ensure patients received the best care in areas such as cancer and heart disease. Case study: The GP super-practiceWhitstable Medical Practice, in Kent, is one of the new super-practices that are being developed. It offers the traditional GP services alongside a host of services more associated with hospitals. It operates out of three sites and employs nearly 150 staff, providing care for 34,000 people. It runs maternity services, a minor injury unit with X-ray facilities and dedicated diabetes, heart disease and asthma clinics as well as diagnostics and minor surgery. Nigel Edwards, the chief executive of the Nuffield Trust think tank, said: "This report makes crystal clear that the NHS cannot continue with 'business as usual' if it is to meet the needs of a diverse and ageing population." Royal College of Nursing general secretary Peter Carter called the report "rigorous and realistic". In terms of funding, the three main political parties have all committed to giving the NHS extra money in the next Parliament. Although at this stage it is not clear how large those rises are once inflation is taken into account. |
