Experts warn funding cuts and staffing crisis could undermine bold vision of genomics and hi-tech surgery
NHS leaders are to outline a future in which genomics, cutting-edge surgery and artificial intelligence help save hundreds of thousands more lives and every area of care is improved in return for the government’s major funding boost for the service.
On Monday, Theresa May and Simon Stevens, the chief executive of NHS England, will publish the service’s long-awaited long-term plan, which will pledge to transform the help it provides everyone from premature babies to the growing number of older people over the next 10 years.
The document will set out detailed plans to dramatically reduce the number of people dying from big killers such as cancer, heart attacks and strokes. It will explain how the NHS will spend the extra funding May announced last year to mark its 70th birthday, which will increase its budget in England from £115bn to £135bn by 2023-24.
But experts and doctors’ leaders warned that May and Stevens’s vision risked being undermined and reduced to a set of “groundless aspirations” because of the NHS’s deepening staffing crisis, continued cuts to public health and limits to what the extra investment could achieve. Turning the plan into reality will be “extremely tough”, one leading health expert said.
Stevens said that as the service looked ahead to its 80th anniversary, the document “keeps all that’s good about our health service and its place in our national life. It tackles head-on the pressures our staff face. And it sets a practical, costed, phased route map for the NHS’s priorities for care quality and outcomes improvement for the decade ahead.”
Ministers and NHS England have already disclosed that the plan will involve a massive expansion in the help available to people with mental health problems, as well as major improvements in other key areas such as maternity services and care provided in or near people’s homes.
On Sunday night, Stevens outlined how the transformation of care would also see every child who is diagnosed with cancer given a genomic test, patients offered digital consultations with a GP and a huge drive to ramp up the early detection and treatment of diseases in order to reduce avoidable loss of life.
If implemented these plans will lead to up to 500,000 more lives being saved over the next decade, through 85,000 fewer premature deaths a year, Stevens said. For example, from April the NHS will ensure that 85% of all those who suffer from heart failure take part in a “healthy living” programme involving exercise and better diet. Prevention of illness will also become a key priority as a way of reducing the pressures on the service.
Genetic testing will be deployed to identify people with high cholesterol. People who have had a stroke because of a blood clot in their brain will undergo a procedure called mechanical thrombectomy, which has been shown to greatly increase their chances of avoiding becoming disabled. And there will be big moves to make it easier for people to be tested for cancer as part of an attempt to improve Britain’s poor record on early diagnosis of the disease.
However, the emergence of key details of the plan prompted senior figures in health to caution that NHS England may not be able to deliver everything proposed.
Dr Jennifer Dixon, the chief executive of the Health Foundation thinktank, said: “This is a pragmatic plan with an ambitious vision to improve NHS care, but making it a reality will be extremely tough given growing pressures on services, widespread staff shortages and continued cuts to other parts of the health and care system.”
She highlighted the growing NHS-wide shortage of nurses, doctors and almost every other type of health professional as a particular danger. “The NHS is already short of 100,000 doctors, nurses and other staff. While there are initiatives in the plan to build the workforce, they need to be matched with action from central government to secure training budgets and a supportive migration policy to allow international recruitment that is vital to staffing the NHS.”
Nigel Edwards, the chief executive of the Nuffield Trust health thinktank, said that improvements in care may come to a halt because the extra funding “is enough to move forwards, but with little room for manoeuvre. If we face a no-deal Brexit, the extra costs and tasks required would eat up the first instalments, stopping progress dead in its tracks. And if social care and public health continue to be starved of funding, a stretched NHS will have even less to spare.”
Dr Chaand Nagpaul, the chair of the British Medical Association, said the plan needed to include clear proposals to enable hospitals to resume meeting key waiting times in A&E and cancer care and planned operations, which are being “spectacularly missed”.
Among ministers and NHS leaders, “there is a need for honesty about how far the £20.5bn over five years will stretch. This is well below the 4% uplift that independent experts have calculated is required, and below historic spending levels since inception of the NHS. It would be disingenuous to suggest this money will in itself wipe out the daily pressures patients are experiencing in the NHS,” Nagpaul added.
Source: The Guardian