Urgent action call to rebuild trust in NHS

The NHS Confederation said the health service has been too slow to develop into a “truly modern and efficient service”.

The body, which represents all organisations that commission and provide NHS services, said recent criticism of management capability and quality of care showed the NHS had more to do to rebuild public confidence and reassure the public it will be involved in decisions over the future of the health service.

A new NHS Confederation report highlights the “unprecedented financial predicament” the NHS faces, warning demand for care continues to grow at a rate current funding cannot match.

It comes as health chiefs across England draw up plans for highly-controversial reconfigurations of services which could see district hospitals lose key specialties among them A&E and maternity care, as well as axe hundreds of beds, as services are increasingly moved into the community or into centres of excellence.

NHS Confederation chief executive Mike Farrar, a former top executive in the NHS in Yorkshire, said it was critical the health service was more transparent about variations in outcomes and costs of care. He said improving outcomes and care and compassion went “hand in hand” with managing finances well, and the NHS must maintain a focus on all three if it was to be sustainable.

The best performing NHS organisations demonstrated that higher quality services could reduce costs and save money. While certain improvements would help the NHS in the short to medium term, Mr Farrar said more radical changes were needed to improve outcomes and manage resources on a sustainable basis

Poor care cost money, and overspending badly in one area of the country required other organisations to underspend, denying them resources, he added.

“The NHS has come under fire in recent weeks and has been accused of not being open and honest with patients and the public,” he said. “We need to address this head-on and make sure that our public services are fully accountable to the people who pay for them.

“The NHS is facing severe pressure on its finances. We are coming to a critical juncture and need to have a frank discussion about the road ahead. This is a crucial time to show our commitment to improving the way we work and how we involve the public in decisions about their care.

“The simple truth is that we have been slow to change the NHS into a truly modern and efficient service. In the past the easier options have been to spend more money on health or to focus on doing more for less.

“We know we can do much more to create an affordable system that works in the best interests of patients. Getting real bang for our buck will require some tough choices and will require strong political will and public support. We need to talk openly and honestly with the public about why our health services need to change, presenting all the facts. We need to talk about what needs to happen, where it needs to happen and why.

“If we fail to discuss these issues now, we will have no mandate for change in the future. We will feel the full force of public wrath for failing to consult on the choices we have. We cannot risk the wheels coming off and patient care suffering. That is something that no-one wants to see happen.”

Among the pressures facing the NHS, the report said the growing impact of smoking, excessive drinking and obesity meant nearly £18 billion a year - almost a fifth of its budget - was spent on services to treat people living with associated diseases. It said the costs of financing private finance initiative schemes were set to double over the next 17 years.