Hard times for health
There should be some good news for health, as Conservatives pledged the £8 billion by 2020 asked for in the Five Year Forward View. However, this is the minimum needed to ‘keep the show on the road’, and pressure across the system suggests that the £22 billion of cuts the service has to find to meet the funding gap will only grow. There is a risk that there will be cuts not only to the Department of Health but to a range of support that has an immediate effect on health and wellbeing: social care, public health, social security and other support for people with disabilities and long term illness, early years support and more.
As we have made clear to the Chief Secretary to the Treasury, a spending review that doesn’t address the chronic underfunding of social care, mental health, public health and the voluntary sector that provides so much support to the health system, will make it yet harder to close the funding gap in the NHS. The auguries are not good.
Person centred care: unaffordable luxury or the solution?
It’s in this context that we - National Voices and our members - are trying to change the way that the health and care systems work. Since 70% of NHS resources are consumed by people with long term conditions, and since there will soon be 3 million people with multiple conditions, the current model of reactive, episodic care is not the right one for the future, whatever the resource envelope.
We want to see an NHS that is more person centred, that starts with asking what support a person needs and brings all parts of the system together to help them achieve that. We need a modern health system that invests in evidence-based interventions that help prevent people getting sick in the first place, stop their condition becoming acute once they are sick, and gives them the tools to manage health problems in a way that works for them.
Asking for something new at a time when existing services are at risk is not easy. But person centred care cannot be an add-on: it’s essential. Not only because health care should be about the person, not the organisation, but because it helps us target scarce resources more effectively, reduce waste and duplication through better integration between different services and because it can help keep people out of hospital for longer.
The challenge is to persuade commissioners that person centred care is good value,evidenced, and can help target scarce resources by ensuring treatment meets the needs of the patient and they have the skills and confidence to utilise it. We must also develop the ways we measure the impact, and find new and better ways to demonstrate the value of investing in person centred services. The work that Voluntary Voices is doing as part of Realising the Value is an important step forward in this respect.
Making care more person centred doesn’t have to be expensive - it can be as simple as practitioners asking ‘what matters to you’ rather than ‘what’s wrong with you’, and sharing decision making. But the onus is on us to show on a national and local level that person centred care is not only better for patients but is part of the solution for a health service fallen on hard financial times.