A new report from The King’s Fund has called for fundamental changes in how health services are commissioned, paid for and regulated to deliver the vision set out in the NHS five year forward view.
The Forward View, published in October, sets out how NHS services will need to change in future. It has been endorsed by all three main political parties and will set the agenda for NHS reform in the next parliament. However, without significant changes to policy and new approaches to leadership in the NHS, The King’s Fund argues that it risks suffering the fate of previous policy documents which have failed to deliver on their ambitions.
The report argues that dealing with growing financial and service pressures could crowd out the time and space needed to implement long-term changes to NHS services. It argues that delivering these changes will require leadership of the highest order, with much resting on whether the coalition of NHS bodies assembled behind the Forward View can be kept in place.
The report makes a number of recommendations to align national policies with the agenda for change outlined in the Forward View.
- An integrated approach to commissioning is needed, with a much greater emphasis on pooling budgets currently held by NHS England, clinical commissioning groups and local authorities.
- New ways of paying for NHS services should incentivise the delivery of integrated care instead of encouraging admissions to hospital as under the current system of Payment by Results.
- The Care Quality Commission's work should focus on assessing how well care is integrated across local systems of care rather than just inspecting individual NHS organisations.
- A national strategy for quality improvement and leadership development is needed to ensure the NHS becomes a 'learning organisation' focused on improving quality of care.
Chris Ham, Chief Executive of The King’s Fund and lead author of the report, said: ‘The NHS five year forward view offers a compelling vision for how NHS services need to change but risks gathering dust on the shelf unless fundamental changes are made to the way health services are commissioned, paid for and regulated. While NHS leaders will understandably be tempted to focus on dealing with short-term pressures, the reality is that improving operational performance and implementing the changes to services outlined in the Forward View are two sides of the same coin – both must be priorities if the NHS is to confront the challenges it faces.’