End ‘mass centralisation’ of NHS and treat people close to home

New chief executive of the NHS, Simon Stevens having his blood pressure taken
New chief executive of the NHS, Simon Stevens having his blood pressure taken
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The NHS must end “mass centralisation” and instead expand its local services to treat people in their own communities, the new boss of NHS England has said.

Chief executive Simon Stevens, who began the role last month, said too many patients are being robbed of “dignity and compassion” because of a lack of local care. Many health services in western Europe were already successfully serving their local communities without centralising everything, he added.

He told The Daily Telegraph: “A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS.

“Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised.”

He warned the complex care systems outside of hospitals must change and investment is needed in community services for the elderly to stop spiralling numbers ending up in hospital.

“You cannot have a modern health service that is not treating older patients with dignity and compassion, supporting them at home and ensuring targeted prevention [of ill health].

He added: “There is a big opportunity to reorganise that so it meets the needs of those at home. At the moment it is too complicated and too fragmented.

“If you were starting from scratch you would not design community services like that.”

Businesses should also financially reward employees for losing weight and adopting a healthy lifestyle, he suggested, mimicking similar schemes in the US.

He told of how he put on weight while living in the US, but lost almost three stone after being spurred into action by a company scheme which offered financial rewards to staff who reduced their Body Mass Index.

Mr Stevens said he intended to encourage employers in Britain to introduce similar perks to “nudge” staff towards a more healthy lifestyle.

He blamed the European Working Time Directive for damaging healthcare in the NHS and making it harder for smaller hospitals to remain open, while waiting targets introduced under Labour became an impediment to care in too many cases.

On Wednesday he will make a speech to the NHS Confederation’s conference in Liverpool, outlining new models of care to build community services around small hospitals and meet the needs of an ageing population.

“The single most important question facing us is how do we best support older people? Two thirds of hospital patients are over retirement age.”

Too often such patients suffered failings in care, because systems were not designed around their needs, he said.

He said it could see hospitals taking over the running of some GP services, and more close working between specialist and community care.

Before taking on his new role, Mr Stevens was president of global health and group executive vice-president at UnitedHealth, the US private healthcare firm, and had also worked across the NHS running hospitals, health authorities and community services. Mr Stevens had been widely regarded as David Cameron’s preferred candidate for the job and was previously a health adviser to Tony Blair when he was prime minister.