News / King’s Fund sets out NHS challenges

The ‘agenda for action’ draws on a lecture given by Chris Ham (pictured), Kings’ Fund chief executive, in December and on other work by the fund. The challenges include:

• sustaining existing services and standards of care
• developing new and better models of care
• tackling the challenges by reforming the NHS from within.

To sustain existing services, the fund said that a focus was needed on ‘better value’. Better outcomes could be delivered while minimising costs by engaging clinical teams in reducing variations and changing the way care is delivered. It said work should build on earlier work to improve generic prescribing, increase day surgery and reduce length of stay, while also acting on themes identified in the Carter review of productivity.

It also reiterated calls to move to an integrated system for health and social care and to ensure workforce numbers are sufficient to meet demand.

The fund said that transformation would require a ‘radical shift to more fully involve individuals in their own health and care’. Greater priority must also be given to public health and prevention. A national workforce strategy was needed to ensure the future workforce was aligned to the new care models outlined in the Five-year forward view.

The fund said that, rather than relying on targets, performance management and regulation, the service needed to ‘reform from within’. This would mean giving a higher priority to valuing and developing leadership.

A quality improvement strategy was also essential, the fund said, if the NHS is to deliver better value through changes in clinical practice. All boards should commit to quality improvement, work with partners to share learning and train clinicians and managers in quality improvement skills.