Alarm Bells: Alan Milburn joins the Department of Health and Social Care’s board to ‘support the government’s ambitious plans for reform’
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
Mr Milburn ‘brings experience at the highest levels to help transform the health and care system‘
This (Labour) government is determined to work with experts who can provide the best advice to help rebuild an NHS fit for the future
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
The former New Labour Health Secretary has a ‘proven track record of reducing waiting lists and improving satisfaction in the NHS’.
Milburn is also a strong advocate of private healthcare involvement in the NHS. Back in 2015, Milburn intervened in the British election campaign to criticise Labour’s health plans, which would limit private sector involvement in the NHS. Milburn was criticised for doing so while having a personal financial interest in the private health sector.
The current Labour government says the NHS is broken and it is the mission of this government to fix it and make the health service fit for the future. As part of this national mission, experts are being brought in to help develop policy, and NHS staff and patients have been invited to share their experience and ideas to change the NHS at Change.NHS.gov.uk.
Members of the department board provide independent advice and expertise to inform the department’s strategy, performance and governance and the Lead Non-Executive Member provides additional support to the Secretary of State for Health and Social Care in his role as Chair of the board.
The Labour government says that, as a former Secretary of State, Alan brings experience at the highest levels of helping transform the health and care system – but health trade unions will be very wary of Milburn’s appointment.
Health and Social Care Secretary Wes Streeting said: “As Secretary of State, Alan made the reforms which helped deliver the shortest waiting times and highest patient satisfaction in the history of the NHS.
“This government has inherited a broken health service with some of the longest waiting times and lowest patient satisfaction in history. I am delighted to welcome Alan to the department board, where he will offer advice on turning the NHS around once again.
“His unique expertise and experience will be invaluable and he has an outstanding track record of delivering better care for patients.”
Lead Non-Executive Director Alan Milburn said: “I am delighted to be appointed to this role.
“Having spent three decades working in health policy, I have never seen the NHS in a worse state. Big reforms will be needed to make it fit for the future.
“I am confident this government has the right plans in place to transform the health service and the health of the nation. I’m looking forward to working with them to achieve that mission.”
Due to ‘the requirements of the role and the unique expertise and experience Alan Milburn brings’, he was appointed directly by the Secretary of State on following consultation with the Commissioner for Public Appointments, and in compliance with the Governance Code on Public Appointments.
The Department of Health and Social Care would like to thank Samantha Jones for all her work and support as non-executive director since February 2023.
Chancellor confirms the NHS will receive funding needed to deliver extra 40,000 elective appointments per week
Chancellor and Health Secretary confirm funding plans to increase elective appointments ahead of the Budget tomorrow.
New funding and reform puts the NHS on course to reduce waiting lists.
Additional capital investment will further support reduced waiting times, with £1.5bn for new surgical hubs and scanners, alongside £70 million for new radiotherapy machines.
Funding to support the delivery of an extra two million NHS operations, scans and appointments a year to significantly cut waiting lists across England has been announced by the Chancellor and Health Secretary today. This comes following over a decade of neglect and underinvestment of the NHS.
Ahead of her Budget on Wednesday, the Chancellor has confirmed that the NHS will receive the funding needed to deliver an extra 40,000 elective appointments per week, delivering on one of the Government’s First Steps in office to reduce waiting times in the NHS. This includes an additional £1.8bn the government has invested in elective activity this year since the July Statement.
This will be supported by a significant uplift of capital investment, with new capacity including surgical hubs and scanners, meaning thousands of additional procedures and millions of diagnostic tests across the country, alongside funding for new radiotherapy machines to improve cancer treatment.
In his recent independent investigation into the NHS in England, Lord Darzi highlighted that the NHS is in “critical condition”. Patients across England are waiting too long, with the waiting list at over 7.6 million in August. In the same month, over 280,000 had been waiting for an operation, scan or appointment for over a year.
Today’s announcement is an integral step in reducing the waiting list and puts the NHS on course to meet the commitment that 92% of people wait less than 18 weeks to start treatment in the NHS.
The Chancellor’s budget tomorrow will set out how this government will fix the foundations to deliver change, by fixing the NHS and rebuilding Britain, while ensuring working people don’t face higher taxes in their payslips.
It will focus on “investment, investment, investment” in order to get the economy moving again and demonstrate how this government will take the long-term decisions needed to grow the economy and restore the country’s public services.
Chancellor of the Exchequer Rachel Reeves said: “Our NHS is the lifeblood of Britain. It exemplifies public services at their best, there for us when we need it and free at the point of use, for everyone in this country.
“That’s why I am putting an end to the neglect and underinvestment it has seen for over a decade now.
“We will be known as the government that took the NHS from its worst crisis in its history, got it back on its feet again and made it fit for the bright future ahead of it.”
Health and Social Care Secretary Wes Streeting said: “Our NHS is broken, but it’s not beaten, and this Budget is the moment we start to fix it.
“The Chancellor is backing the NHS with new investment to cut waiting lists, which stand at an unacceptable 7.6 million today. Alongside extra funding, we’re sending crack teams of top surgeons to hospitals across the country, to reform how they run their surgeries, treat more patients, and make the money go further.”
Building an NHS fit for the future is one of this Government’s five priority missions; but it is clear that alongside sustainable investment, the NHS will need significant reform across the board to be truly transformed.
The Chancellor has therefore confirmed an ambitious reform programme across health and social care in England, including reforming the delivery of elective activity and patient pathways. Billions of pounds are set to be invested in technology and digital innovations across the NHS to boost productivity and unlock significant savings for the NHS in the long-term.
The funding comes after the Government last week launched ‘Change NHS: help build a health service fit for the future’, a national conversation to help develop the 10 Year Health Plan, which will set out our long-term vision for health and the path to delivering the three shifts to reform and transform health: hospital to community, analogue to digital, and sickness to prevention.
Starting this week, the NHS will help people back to health and back to work by sending teams of top clinicians to hospitals across the country to help roll out reforms to cut waiting lists in hospitals – which will start with those in areas of the highest economic inactivity.
Health Secretary calls on entire nation (i.e. ENGLAND) to shape the government’s plans to overhaul the NHS
Public, clinicians and experts urged to submit ideas for its future as new online platform Change.NHS.uk goes live today – putting staff and patients in driving seat of reform
Responses will shape government’s 10 Year Health Plan to fix broken health service and deliver government mission to build an NHS fit for the future
The biggest national conversation about the future of the NHS since its birth is set to be launched today (Monday 21 October), as the entire country is called upon to share their experiences of our health service and help shape the government’s 10 Year Health Plan.
Members of the public, as well as NHS staff and experts will be invited to share their experiences views and ideas for fixing the NHS via the online platform, change.nhs.uk, which will be live until the start of next year, and available via the NHS App.
The public engagement exercise will help shape the Westminster government’s 10 Year Health Plan which will be published in spring 2025 and will be underlined by three big shifts in healthcare – hospital to community, analogue to digital, and sickness to prevention.
As part of the first shift “from hospital to community”, the UK government wants to deliver plans for new neighbourhood health centres, which will be closer to homes and communities. Patients will be able to see family doctors, district nurses, care workers, physiotherapists, health visitors, or mental health specialists, all under the same roof.
In transforming the NHS from analogue to digital, the government will create a more modern NHS by bringing together a single patient record, summarising patient health information, test results, and letters in one place, through the NHS App.
It will put patients in control of their own medical history, meaning they don’t have to repeat it at every appointment, and that staff have the full picture of patients’ health.
New laws are set to be introduced to make NHS patient health records available across all NHS trusts, GP surgeries and ambulance services in England – speeding up patient care, reducing repeat medical tests, and minimising medication errors.
Systems will be able to share data more easily, saving NHS staff an estimated 140,000 hours of NHS staffs’ time every year, because staff will have quicker access to patient data, saving time that can then be spent face-to-face with patients who need it most and potentially saving lives.
By moving from sickness to prevention, government wants to shorten the amount of time people spend in-ill health and prevent illnesses before they happen. As an example, the 10 Year Health Plan will explore the opportunities smart watches and other wearable tech may offer patients with diabetes or high blood pressure, so they can monitor their own health from the comfort of their own home.
The launch of the new online platform will take place at a health centre in East London, where the Secretary of State will meet with the Chief Executive of the London Ambulance Service before the first engagement event involving NHS staff from across the healthcare system as a start to the national conversation.
Prime Minister Keir Starmer said: My mum worked for the NHS, my sister worked for the NHS and my wife still works for the NHS – so I know first-hand how difficult it has been for staff, and for patients battling against a broken system for over a decade. But it’s time to roll up our sleeves and fix it.
“We have a clear plan to fix the health service, but it’s only right that we hear from the people who rely on the NHS every day to have their say and shape our plan as we deliver it. Together we can build a healthcare system that puts patients first and delivers the care that everyone deserves.
“We have a huge opportunity to put the NHS back on its feet. So, let’s be the generation that took the NHS from the worst crisis in its history and made it fit for the future.”
Health and Social Care Secretary Wes Streeting said: “When I was diagnosed with kidney cancer, the NHS saved my life, as it has for so many people across our country. We all owe the NHS a debt of gratitude for a moment in our lives when it was there for us, when we needed it. Now we have a chance to repay that debt.
“Today the NHS is going through the worst crisis in its history. But while the NHS is broken, it’s not beaten. Together, we can fix it.
“Whether you use the NHS or work in it, you see first-hand what’s great, but also what isn’t working. We need your ideas to help turn the NHS around.
“In order to save the things we love about the NHS, we need to change it. Our 10 Year Health Plan will transform the NHS to make it fit for the future, and it will have patients’ and staff’s fingerprints all over it.
“I urge everyone to go to Change.NHS.uk today and help us build a health service fit for the future.“
Investment alone won’t be enough to tackle the problems facing the NHS, why is why it must go hand in hand with fundamental reform.
The three big shifts will be our key principles for reform and will revolutionise the way people manage their health and access care. Our reforms will also shift the NHS away from late diagnosis and treatment to a model where more services are delivered in local communities and illnesses are prevented in the first place.
It is vital the government hears from patients, experts and the NHS workforce to make sure we get this right and preserve the things people value about the health service.
NHS England Chief Executive Amanda Pritchard said: “NHS staff are facing an unprecedented number of challenges – with record demand for care, alongside growing pressures from an ageing population, rising levels of multiple long-term illnesses and patients with more complex needs. And they are often hampered by working in crumbling buildings with outdated tech, meaning too many patients are waiting too long for care they need.
“So, it is vital the health service innovates and adapts – as it has always done throughout its 76-year history – to design and deliver an NHS fit for the future.
“The 10 Year Health Plan is a chance to make the best practice, normal practice across the country. So, we will be carrying out the largest ever staff engagement exercise in NHS history and leaving no stone unturned as we seek to harness frontline views, alongside those of patients and the public, to ensure this happens.
“It is your experiences – good, bad, and sometimes frustrating – that we need to help shape this once in a generation opportunity, so please get involved!”
Bold ambitions for the NHS can only be achieved by listening to the expertise and knowledge of its 1.54 million strong workforce. Their understanding of what’s holding them back from performing at their best will help us bring down waiting times and provide the world class care the public deserve.
The government has already taken immediate action to address challenges in the health service and deliver an NHS fit for the future. Whether that’s agreeing a deal with resident doctors within weeks, securing a funding increase for GP practices to manage rising pressures or hiring an extra 1,000 GPs into the NHS by the end of this year, there are both short- and long-term reforms working hand in hand.
Lord Ara Darzi said: “As my recent Investigation found, the NHS is in need of urgent and fundamental reform. The 10 Year Health Plan comes at a crucial moment—and by describing the ultimate destination for the health service, it will help improve decision-making in the here and now.”
The start of this national conversation on the future of the NHS follows on from Lord Darzi’s independent report into the health service that diagnosed its condition. Lord Darzi concluded the NHS is in a ‘critical condition’ with surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.
The launch of the engagement exercise for the 10 Year Health Plan will build on these findings and is the next step to delivering the Government’s mission to fix the NHS and deliver a health service fit for the future.
Rachel Power, Chief Executive of The Patients Association, said: “We warmly welcome this ambitious initiative to engage with patients, staff, and the public on the future of our NHS.
“For far too long, many patients have felt their voices weren’t fully heard in shaping health services. This national conversation, initiated by the government, marks a significant step towards genuine patient partnership and puts patients at the heart of the NHS’s evolution.
“Through our work as an independent charity, we speak directly with thousands of patients living with various health conditions each year. This gives us valuable insights into diverse experiences across the health and care system, from widely shared patient needs to unique challenges faced by underrepresented groups.
“We’re eager to contribute these wide-ranging perspectives to help shape a health service that truly meets the needs of everyone it serves.”
Louise Ansari, Chief Executive of Healthwatch England said: “We know people appreciate the hard work of NHS staff, but they are all too aware that the NHS faces many challenges that need fixing. The 10-year plan provides the opportunity to do this.
“We urge everyone to have their say on how the NHS should deliver better care to people where and when it is needed, more support to help people stay well, and a culture of listening to and acting on the views of patients.
“All too often, people face unequal access to care, with disabled people and those on lower incomes being particularly at risk. The NHS belongs to us all, so you must speak up and help create a health service that is fit for the future – equal and inclusive for everyone.”
Cllr Louise Gittins, Chair of the Local Government Association said: “The NHS rightly holds a place in our nation’s heart, being there for us at moments of great joy, deep sadness, and everything in between. It is also one of local government’s most important partners. What each side does can impact the other.
“Every one of us is unique, complex and carries different ambitions. The NHS plays a key role in helping us to live the life we want to lead, but it cannot do it alone. Through social care and wider wellbeing activity, councils play an essential role in supporting people to do what matters most to them and live a meaningful life.
“This exercise is therefore crucial for the future of health, social care and wellbeing.”
Caroline Abrahams, Charity Director at Age UK said: “We are delighted to see this first, essential part of developing the 10-year plan getting going.
“With our rapidly ageing population it’s important that the plan takes fully into account the needs of tomorrow’s older people as well as today’s and helps all of us to age confidently and well. We encourage everyone to get involved and have their say – it’s almost certainly a once in a generation opportunity to do so.”
The Deputy Chief Executive of NHS Providers, Saffron Cordery said: “This will be a landmark moment for the NHS.
“Trust leaders are ready and willing to work with the government to tackle the many challenges the NHS currently faces to create a ‘next generation’ NHS fit for the future.”
Jacob Lant, Chief Executive of National Voices said: “We are encouraged by the ambitious approach the Government is taking to involve patients and organisations from across the sector in shaping the 10 Year Plan.
“We are excited to play our part in this, and will be working with our members to ensure that people from marginalised and minoritised communities are able to shape the discussions and big decisions ahead.
“Closing the gap in healthy life expectancy is a shared ambition of this Government and the National Voices coalition, and we will work tirelessly to ensure no groups are left behind.”
Matthew Taylor, Chief Executive of the NHS Confederation said: “Following more than a decade of underinvestment and in the face of some serious challenges we are reaching a turning point for the NHS.
“The 10-year plan will set the service on a path towards being put on sustainable footing so that it can best serve our population. No one working in the NHS will argue that it works perfectly – its staff have been crying out for change and we hope the ten-year plan will deliver for them and their communities, including by listening to the reality of their experiences and by incorporating the many examples of best practice and innovation that are taking place across the country.”
Helen Walker, Chief Executive of Carers UK said: “We are excited to see this first engagement phase of the NHS 10 Year Plan, a process which will include unpaid carers and ask for their views about the kind of health service they want to see in the future.
“We wholeheartedly agree with the recommendations from the Darzi review which suggested there should be a “fresh approach to supporting unpaid carers”. Unpaid carers are critical to the NHS and the NHS is a critical service for them, but it’s not always set up to help carers and can make their lives harder.
“England’s 4.7 million unpaid carers provide the bulk of support for older, ill and disabled relatives, helping millions to live in local communities where they want to be. Their support is valued at £152 billion, the equivalent of a second NHS, but they also face greater health inequalities and poorer health outcomes.
“With one in three NHS staff also juggling work and care, there’s a real opportunity to create a service which truly supports families who provide unpaid care. We see this as a win:win situation – helping families and building an NHS which is fit for the future; delivering better outcomes for everyone.”
Cancer Research UK’s chief executive, Michelle Mitchell, said: “We welcome the UK Government’s move to start a public conversation about the future of the NHS in England.
“Despite the best efforts of its hard-working staff, the NHS is under extreme pressure. This exercise is another important step in the process towards developing a 10-Year-Plan that should ensure all cancer patients across the UK get the care they deserve.”
NO mention of Scotland?Health is a devolved issue, but I’m sure our suggestions will be welcomed, too! – Ed.
A new strategy is being published to radically cut the number of single-use medical devices in the health service
Move to scrap single-use MedTech as Health and Social Care Secretary launches waste blitz
Tens of millions of disposable items are binned after just one use
MedTech companies incentivised to produce sustainable products – pumping millions back to NHS frontline and cash into economy
The government is launching a major crackdown on waste in the NHS to save millions of pounds a year, helping to divert more resources to frontline care.
A new strategy – the Design for Life Roadmap – is being published to radically cut the number of single-use medical devices in the health service and reduce our reliance on foreign imports.
Disposable medical devices substantially contribute to the 156,000 tonnes of clinical waste that the NHS produces every year in England alone. The roadmap paves the way to slashing this waste and maximising reuse, remanufacture and recycling in the NHS.
Doing so will create thousands more UK jobs and help transform the country into a life sciences superpower. As it stands, millions of devices like walking aids and surgical instruments are thrown away after just one use.
Harmonic shears – surgical devices which seal patients’ wounds using ultrasound waves – each cost more than £500 and around 90% of them are binned after a single use. Innovative companies are already purchasing these used devices and safely remanufacturing them at a lower price.
The government will encourage more of this kind of innovation to safely remanufacture a wider range of products and drive costs down, including by changing procurement rules to incentivise reusable products and rolling out examples where hospitals are already leading the way on cutting wasteful spending and practices.
Approximately £10 billion each year is spent on medical technology like this in the NHS, but too much of it is imported via vulnerable routes that risk disrupting patient care.
A Circular Economy Taskforce has already been created to foster more highly skilled green jobs and smarter use of our resources. An economy wide shift to a circular economy could add £75 billion to the economy and create 500,000 jobs by 2030.
Health and Social Care Secretary Wes Streeting said: “The NHS is broken. It is the mission of this government to get it back on its feet, and we can’t afford a single penny going to waste.
“Because the NHS deals in the billions, too often it doesn’t think about the millions. That has to change. This government inherited a £22 billion blackhole in the public finances, so we will have a laser-like focus on getting better value for taxpayers’ money.
“Every year, millions of expensive medical devices are chucked in the bin after being used just once. We are going to work closely with our medical technology industry, to eliminate waste and support homegrown medtech and equipment.”
The below case studies illustrate the potential savings:
Mid Yorkshire Trust uses 330,000 single use tourniquets in a year, but a single reusable tourniquet can be used 10,000 times. In a one-year trial, reusable alternatives saved £20,000 in procurement costs and 0.75 metric tonnes of plastic waste.
In Northampton Hospitals NHS Trust, a single Ophthalmology department saved 1,000 pairs of disposable scissors and £12,000 in a year by switching to reusable pairs. Single-use scissors are often used in surgical settings. NHS procurement data shows that several million pairs of single-use scissors were purchased by the NHS in a single year (2022-23). That is the equivalent of hundreds of pairs of scissors thrown away every hour.
Leeds Teaching Hospitals Trust saved £76,610 in costs purchasing 604 remanufactured Electrophysiology (EP) Catheters, and generated a further £22,923 for selling used devices for collection. If the same approach were to be scaled up across the UK, the NHS could save millions of pounds per year on EP catheters alone, just a few product lines among hundreds of thousands.
Harmonic shears are complex devices for performing surgical procedures and cost more than £500 each, yet around 90% are binned after a single use. Leeds University Teaching Hospitals Trust has demonstrated that companies can safely remanufacture them, giving up to 50% cost savings.
The Design for Life programme will reduce this kind of waste and achieve an NHS-wide move to sustainable alternatives– also supporting the government’s net zero goals.
A new roadmap sets out 30 actions to achieve this shift – including how the government will work with companies to encourage the production of more sustainable products, along with training for NHS staff on how to use them.
Taking this approach will mean more money can be spent in the UK, driving growth, creating more engineering, life sciences and research jobs – all while securing savings for the NHS budget.
Many of these products include precious metals such as platinum and titanium which are in high demand but go to landfill when they could be recovered and sold. A reduction in the amount of disposed single-use devices will also reduce the country’s carbon footprint and plastic pollution.
The government will encourage industry figures to innovate by making sure benefits of reusable MedTech are part of how the NHS chooses the products it buys.
Baroness Merron visited University College London Hospital yesterday (Tuesday, 15 October). The hospital is a member of the Circular Economy Healthcare Alliance, which advocates for sustainable practices within the NHS.
Health Minister Baroness Gillian Merron said: “Design for Life doesn’t just deliver on the Health Mission, to build an NHS fit for the future, it also delivers on our Growth Mission to make the UK a life science superpower and our commitment to get the NHS to net zero by 2045.“
She toured a mock operating theatre and was shown various sustainable products its NHS staff use – from simple products like gowns and scissors to sophisticated, expensive products like harmonic shears.
Professor Sir Stephen Powis, National Medical Director of NHS England, said: “While the NHS is treating record numbers of patients, we know there is much more to do to ensure taxpayers get value for money.
“The NHS made a record £7.25bn worth of efficiency savings last year and is targeting a further £9bn of savings for 2024/25. But we are rightly still looking for ways to get our money’s worth for every penny we spend.”
PM to pledge ‘the biggest reimagining of our NHS since its birth’
PM to set out plan for long term, fundamental reform to fix broken NHS
Lord Darzi’s independent investigation concludes NHS is in ‘critical condition’
Findings provide a diagnosis of the challenges facing the health service, which will inform government’s 10 year plan to reform the NHS
The PM will pledge the ‘biggest reimagining of our NHS since its birth’ in a speech this morning [12 September 2024], following the publication today of a full and independent investigation into the state of the NHS.
Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.
The PM will say that the scale of the damage done to the NHS revealed by the report is “unforgivable”, recognising the tragic consequences for too many patients and their families: “People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.
“Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.
“People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.
He will also address the causes behind the state of the NHS, including the long term impacts of the 2012 Health and Social Care Act which is described in the report as “a calamity without international precedent” which “proved disastrous”, as well as the far reaching consequences of underinvestment throughout the 2010s.
The PM is expected to say: “Our NHS went into the pandemic in a much more fragile state.
“We had higher bed-occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.
“And let’s be clear about what caused that…a “scorched earth” approach to health reform, the effects of which are still felt to this day.
“Lord Darzi describes [the 2010s] as “the most austere decade since the NHS was founded”. Crumbling buildings, decrepit portacabins, mental health patients accommodated in Victorian-era cells infested with vermin.
“The 2010s were a lost decade for our NHS…which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”
As well as recognising the cost to people’s health, the PM will also address the inextricable link between the state of the NHS and the nation’s economy: It’s not just the state of our National Health Service in crisis – it’s also the state of our national health.
“There are 2.8 million people economically inactive due to long term sickness, and more than half of those on the current waiting lists for inpatient treatment are working age adults.
“Getting people back to health and work will not only reduce the costs on the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.
In the face of these dire findings and the growing pressures on the NHS from an ageing society and preventable illnesses, the PM will set out his belief in the ‘profound responsibility’ of government to do the hard work necessary to tackle them: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.
“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.
“Raise taxes on working people to meet the ever-higher costs of aging population – or reform to secure its future.
“We know working people can’t afford to pay more, so it’s reform or die.”
Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the Prime Minister will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process.He is expected to say: “”This government is working at pace to build a Ten-Year Plan. Something so different from anything that has come before.
“Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.
“And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.
“Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.
“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.
“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.”
Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.
Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation – not just in the health service but in the state of the nation’s health.
“We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards.
“My colleagues in the NHS are working harder than ever but our productivity has fallen.
“We get caught up frantically trying to find beds that have been axed or using IT that is outdated or trying to work out how to get things done because operational processes are overwhelmed. It sucks the joy from our work – we became clinicians to help patients get better, not to go into battle with a broken system.
“We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance – the NHS is now an open book.
“In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low. Two out of three of those shocks were choices made in Westminster.
“It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again.”
Despite the damning analysis, Lord Darzi insists the NHS’s vital signs ‘remain strong’ and he praised staff for their ‘shared passion and determination to make the NHS better for our patients’.
In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.
Responding to the report, Secretary of State Wes Streeting said: “I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in.
“Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.
“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.”
Today’s report has been welcomed by NHS England and health organisations who have pledged to work closely with the government on its mission to rebuild the NHS.
Amanda Pritchard, NHS England Chief Executive, said: “As this report sets out, staff are the beating heart of the NHS with a shared passion and determination for making the NHS better for patients – but it is also clear they are facing unprecedented challenges.
“Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.
“While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.
“As Lord Darzi rightly points out, many of the solutions can be found in parts of the NHS today. That is why we are fully committed to working with government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations”
Key findings from Lord Darzi’s 142-page report include:
Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions.
Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.
Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.
Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community.
Responding to the publication of Professor Lord Darzi’s Independent Investigation of the National Health Service in England, Nuffield Trust Chief Executive Thea Stein said:“Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service.
“Wide-ranging problems have been growing in plain sight for years and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.
“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.
“The big question now is what happens next.
“The Government has an early opportunity to make good on long-argued points on dysfunctional NHS funding in its first Budget next month. The health service is staring down the barrel of a significant shortfall in funding this current year [2] and the Chancellor will need to set out clear plans to tackle this, ahead of a longer-term funding settlement.
“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.
“Ultimately, the Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”
A call to value our workforce & embrace Third Sector solutions with immediate increased funding
With over 40 years of experience in various roles within the health and care systems, from a clinician in the acute sector to working in primary care, and now as the Chair of LifeCare Edinburgh, I have witnessed significant changes and challenges (writes LORNA JACKSON-HALL).
The recent impact of financial cuts to third sector care contracts in Edinburgh, along with the recent changes in the Westminster Government, compel me to share some thoughts on short-term solutions as we work towards long-term strategies.
Valuing Our People
It’s crucial to value everyone involved in our health and care systems, both the workforce and those we serve.
The NHS faces immense pressure, primarily driven by the need to manage patient flow into hospitals and expedite their discharge into supportive environments. The workforce crisis, identified over a decade ago, continues to escalate.
An ageing population among clinical staff, coupled with cuts in university courses, training places, and bursaries, has led to a crisis in the number of Allied Health Professionals, Nurses, and Doctors.
Addressing this workforce gap will take approximately ten years as we train and equip new staff with the necessary skills.
Maximising the Potential of the Care Staff Workforce
In the interim, we must focus on our care staff workforce in both social care and the third sector.
It’s essential to examine the health economics of utilising this workforce to its full potential. These dedicated individuals perform incredible work, significantly contributing to keeping people supported in their home environments, thereby delaying or even preventing hospital admissions.
Programmes such as befriending services like Vintage Vibes and buddying services for isolated individuals, play a vital role in enhancing the health and well-being of our older population.
Urgent and immediate increased funding for third sector organisations such as LIfeCare Edinburgh could help to alleviate some of the current pressures on hospitals.
These organisations run meals on wheels, care at home services, and day services, all of which support frail elderly individuals and/or those living with dementia their carers to remain at home longer.
Impact on Hospital and GP Services
Implementing these measures would help reduce the influx of patients into hospitals and improve the discharge process, allowing acute hospitals to focus on reducing elective lists.
This, in turn, would ease the burden on GP Practice services, enabling them to prioritise preventative care. Such a shift is essential to support the growing number of people living with multimorbidity in Scotland today.
By valuing our workforce and maximising the potential of third sector organisations through true partnership working and appropriate funding, we can make meaningful progress in addressing the immediate challenges while laying the foundation for a healthier future.
UK government will recruit more than 1,000 newly qualified GPs thanks to action to remove red tape
Government acts to fix front door to NHS and deliver more appointments
Slashing burdensome red tape to boost capacity in surgeries and hire over 1000 more newly-qualified doctors
Government listening to sector to help end scandal of patients struggling to see a doctor
More than 1,000 newly qualified GPs will be recruited thanks to government action to remove red tape currently preventing surgeries from hiring doctors.
Bringing back the family doctor is central to the Government’s plan to rebuild the health service, and the changes being made to cut through the current rules will help more patients get access to GPs, and ensure more GPs are able to find roles, so that people in communities across England will receive the timely care they deserve this year.
Currently, under a scheme known as the Additional Roles Reimbursement Scheme, primary care networks (PCNs) can claim reimbursement for the salaries (and some on costs) of 17 new roles within the multidisciplinary team – meaning more specialists are available to treat patients.
They are selected to meet the needs of the local population, but are currently prevented from using this to recruit additional GPs. The changes announced today means that newly qualified GPs can quickly be recruited into the NHS through this scheme in 2024-2025.
It’s thought hundreds of newly qualified GPs could be without a job this summer in England. But thanks to this intervention, they will be able to be hired by the end of the year.
The Government is listening to GPs, and this has been hard fought by the British Medical Association, Royal College of General Practitioners, and many other groups who petitioned for it, receiving over 11,000 signatures.
It comes as the Government accepts recommendations of the Pay Review Bodies in full, increasing GPs’ pay by 6% – their first meaningful pay rise in years.
Health and Social Care Secretary Wes Streeting said: “It is absurd that patients can’t book appointments while GPs can’t find work.This government is taking immediate action to put GPs to work, so patients can get the care they need.
“This is a first step, as we begin the long-term work of shifting the focus of healthcare out of hospitals and into the community, to fix the front door to the NHS.
“I want to work with GPs to rebuild our NHS, so it is there for all of us when we need it.”
Dr Amanda Doyle, National Director for Primary Care and Community Services, said: “With hard-working GP teams delivering millions more appointments a month compared to before the pandemic, it is vital they are given the resources to manage this increase in demand.
“Adding General Practitioners to the scheme is something that the profession has been calling for in recent months to make it easier for practices to hire more staff – so I welcome this measure which is an important first step to increasing GP employment in the long-term.
“We will continue to work with GPs, the BMA and the Government to avert any potential action but in the meantime the NHS has a duty to plan for any possible disruption to ensure services continue to be provided for patients – so the public should continue to come forward for care in the normal way if collective action does go ahead.”
This is an emergency measure for 2024-2025 to ensure patients are able to access GPs and GPs are able to find roles, while the Government works with the profession to identify longer term solutions to GP unemployment and general practice sustainability as part of the next fiscal event.
The Government will ensure the NHS has the funding it needs to deliver this, paid for by £82 million from the existing department budget.
In expanding general practice capacity, the Additional Roles Reimbursement Scheme improves access for patients, supports the delivery of new services and widens the range of offers available in primary care.
Significant activity is underway to clear the longest NHS waits following the allocation of £30 million of targeted funding.
The funding has been allocated to specialty areas where it can have the greatest impact against the longest waits – this includes cancer, ophthalmology, orthopaedics, dermatology and diagnostics.
It is estimated the £30 million, initially announced in April, will help boards across the country deliver around; 12,000 additional procedures, 40,000 extra diagnostic procedures and 12,000 new outpatient appointments.
Activity levels will increase over the coming weeks and the Scottish Government will work closely with Boards to support delivery.
Speaking on a visit to Ninewells Hospital’s ophthalmology ward in Dundee, Health Secretary Neil Gray said: “This initial investment of £30 million will target reductions to national backlogs that built up through the pandemic. This is all part of our programme to tackle waiting times, including waiting lists for orthopaedic treatment and diagnostics for cancer.
“Together, our actions will help Scotland’s NHS maximise capacity, build greater resilience and deliver year-on-year reductions in the number of patients who have waited too long for treatment. The number people waiting over two years for a new outpatient appointment is down by more than half in the last two years, and we want to build on that progress.
“As part of the £30 million, we have invested close to £2 million in ophthalmology helping to increase activity in the short term as we aim to deliver one cataract procedure every 30 minutes on standard lists. This will allow a more resilient and sustainable service for the future.”
Professor Lord Darzi appointed to establish the state of the nation’s health service
Report will provide ‘raw and honest assessment’ of issues facing health service
Work will be led by Rt Hon Professor Lord Darzi, OM, KBE, a lifelong surgeon and innovator, independent peer and former health minister
Findings will feed into government’s 10-year plan to radically reform the nation’s health service
Health and Social Care Secretary, Wes Streeting, has ordered a full and independent investigation into the state of the NHS, to uncover the extent of the issues facing the nation’s health service.
Mr Streeting says he wants a ‘raw and honest’ assessment that will deliver ‘the hard truths’. He has appointed Professor Lord Darzi, a lifelong surgeon and innovator, independent peer and former health minister, to lead the rapid assessment, which will be delivered in September.
Its findings will provide the basis for the government’s 10-year plan to radically reform the NHS and build a health service that is fit for the future.
Health and Social Care Secretary, Wes Streeting, said: “Anyone who works in or uses the NHS can see it is broken. This government will be honest about the challenges facing the health service, and serious about tackling them.
“This investigation will uncover hard truths and I’ve asked for nothing to be held back. I trust Lord Darzi will leave no stone unturned and have told him to speak truth to power.
“I want a raw and frank assessment of the state of the NHS. This is the necessary first step on the road to recovery for our National Health Service, so it can be there for us when we need it, once again.”
Professor Lord Darzi said: “As every clinician and every patient knows, the first step to addressing any health problem is a proper diagnosis.
“My work will analyse the evidence to understand where we are today – and how we got to here – so that the health service can move forward.
“This is an important step to re-establishing quality of care as the organising principle of the NHS.”
Amanda Pritchard, NHS Chief Executive, said: “Frontline NHS staff are doing an incredible job, despite the huge pressures they face, to deliver care to over a million people every day, but we know that they face huge struggles and patients are not always getting the timely, high quality care they need.
“We will work closely with the government, independent experts and NHS staff to take a detailed look at the scale of the challenges and set out plans to address them – this comprehensive analysis will be an important step in helping us to build an NHS fit for the future.”
The Health and Social Care Secretary’s promise to fix the broken NHS was backed by action last week when he met with key figures across the health service.
This included meetings with junior doctors to discuss ending the strikes, and talks with the British Dental Association about rebuilding NHS dentistry.
He also visited a GP surgery in north London to see first-hand how the practice is delivering a patient-led service providing continuity of care – a key pillar of the government’s ambition to improve primary care.
Mr Streeting also set out his wider commitment to support the government’s growth mission by improving the health of the nation.
The aims are based on 3 key steps:
cutting waiting times to get people back to work
making the UK a life sciences and medical technology superpower
creating training and job opportunities through the NHS to deliver growth up and down the country.
This is the response from The Royal College of Emergency Medicine (RCEM) Scotland as the latest Emergency Department performance data reveals that one in every nine people waited eight hours or more to be seen in A&E last month.
The data also shows long waits have increased significantly since the 2010s.
Since May 2017, for example, the numbers waiting four hours or more has increased by nearly five times, eight hours or more by 21 times, and 12 hours or more by 89 times. Despite attendance only increasing by 0.5% in the same period.
Dr John-Paul Loughrey, RCEM Vice President for Scotland said: “It is right that the First Minister has apologised to people who have been forced to withstand treatment in corridors.
“It is unbearable for the people experiencing this loss of dignity at an already difficult time, and for the medical practitioners caring for them in impossible conditions.
“The data clearly shows that extended A&E waiting times due to overcrowding is not a new issue. It is sadly what A&E staff have come to expect.
“We once again call on the Scottish Government to take action to prevent overcrowding in Emergency Departments and the subsequent need to treat people in corridors by increasing the number of hospital beds and improving social care options so people can leave hospital when they are ready.
“I, personally, am growing weary of the inaction to rectify these longstanding issues and the resulting harms.”
“The government is duty-bound to provide the people of Scotland with safe and dignified emergency care, and now is the time to do so.”
