Hospital or bust approach needs changing, NHS Confederation head believes

NHS ‘let down by weak politicians’

NHS ‘let down by weak politicians’

By Alex Stevenson

NHS reforms risk distracting health service workers as they struggle to keep their head above water, the head of the NHS Confederation has warned.

The health service's independent membership organisation is calling for the "hospital-or-bust" approach to end.

Its head, Mike Farrar, used his new year's message to argue that there was no need for the NHS to maintain its current emphasis on hospital-based care.

He claimed one in four patients could be treated as well or better at home, freeing up potential savings but also changing the fundamental character of the NHS.

"There is a value-for-money argument for doing this, but it not just about money and the public need to be told that. This is about building an NHS for the future," Mr Farrar said.

"There would be major potential to deliver better value for money and keep the NHS on a sustainable footing. We all know that quality of care will fall victim to a financial crisis."

The NHS has to make £20 billion in efficiency savings by 2015, but – like the rest of the public sector – is now facing an extended period of austerity.

Mr Farrar said strong political leadership had been lacking, as "politicians have failed to support the NHS even when the case for change has been clear".

Listening to the public, changing how health services are paid for and strong clinical leadership are all required to help bring about change, he argued.

"We have had a lot of talk about changing services but 2012 must be the year we convert talk into action," Mr Farrar added.

"It feels like the focus is on everything but the thing that would make most difference."

His message was greeted cautiously by the Department of Health, which insisted its beleaguered reform package would enable NHS staff to make the right decisions for the future.

"The independent NHS Future Forum has confirmed that every health system in the developed world faces the challenges of rising demand, an ageing population and increasing costs of treatment, and that these challenges won't be met by the NHS doing more of the same," health minister Simon Burns said.

"That is why our plans give doctors, nurses and frontline professionals the freedom to make the best decisions for patients."

Mr Farrar warned that NHS staff could struggle to implement the changes, however.

He said concerns about the quality of care, coping with unprecedented financial pressures and dealing with shifting public and political opinion were among the major challenges for the health service in 2012.

"Those doing the day job however face major pressures in trying to keep the NHS’s head above water," Mr Farrar warned.

"They will be trying to stop waiting times getting out of control. They will be focusing on making all the new structures work as a result of NHS reform. There is a real danger of distraction."