Tag: Wes Streeting

Zero tolerance for failure under package of tough NHS reforms

Health and Social Care Secretary will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well

  • Wes Streeting to reveal package of reforms and announce new league table of NHS England providers, with top talent attracted to most challenging areas and persistently failing managers to be sacked
  • Turn around teams sent into struggling hospitals, while best performers given greater freedoms over funding to modernise technology and equipment
  • No more rewards for failure, with reforms to ensure every penny of extra investment into NHS is well spent and waiting times for patients slashed

NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a tough package of reforms to be announced by the Health and Social Care Secretary Wes Streeting today (Wednesday 13 November).

Addressing the nation’s health leaders at the NHS Providers’ annual conference in Liverpool, he will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well and get better value for money.

NHS England will carry out a no holds barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised. 

Persistently failing managers will be replaced and turn around teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service.

High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers can’t benefit from it. The reforms today will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment and technology.

The government will deliver a health service fit for the future, fixing the foundations while delivering change with investment and reform to deliver growth, get the NHS back on its feet, and rebuild Britain.

Health and Social Care Secretary Wes Streeting said: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.

“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.

“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.

“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”

Amanda Pritchard, NHS chief executive said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.

“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”

The NHS Oversight Framework which sets out how trusts and integrated care boards are best monitored – will be updated by the next financial year to ensure performance is properly scrutinised.

Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.

Louise Ansari, Chief Executive of Healthwatch England: “People value the hard work of NHS staff, but it’s frustrating when services fail to operate effectively. So, a fresh approach to improving NHS performance is welcome.

“Currently, living in an area with either an outstanding or poorly performing NHS trust feels like a postcode lottery. When a service is underperforming, it often takes far too long for patients to see the necessary improvements.

“This is because the current system focuses on evaluating service performance based on the number of tasks it completes and it does not do enough to measure patients’ overall outcomes and experiences.

“Establishing a better system that encourages NHS managers to focus on delivering the best care as efficiently as possible, and leads to quicker changes at struggling trusts, would be good news for everyone.”

NHS senior managers who fail to make progress will also be ineligible for pay increases. There will be financial implications for Very Senior Managers (VSMs) such as Chief Executives if they are failing to improve their trust’s performance, or letting patients down with poor levels of care.  

A new pay framework for VSMs will be published before April 2025. Senior leaders who are successfully improving performance will be rewarded, to ensure the NHS continues to develop and attract the best talent to the top positions. 

The changes are made in response to Lord Darzi’s investigation into the NHS, which found that: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”

The cost to the health service of hiring temporary workers sits at a staggering £3 billion a year. Under joint plans to be put forward for consultation in the coming weeks, NHS trusts could be banned from using agencies to hire temporary entry level workers in band 2 and 3, such as healthcare assistants and domestic support workers. The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.

Rachel Power, Chief Executive, Patients Association: “We welcome today’s commitment to improving NHS performance and accountability. These reforms signal an important drive for positive change in our health system. The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.

“At the same time, we know from the experience of patients, that real transformation comes through genuine partnership with patients. We look forward to working with NHS England to ensure patient voices help shape how any league tables are developed and how success is measured.

“The proposed support teams for struggling trusts could be particularly effective if they include patient representatives and focus on building a culture of patient partnership. This is an opportunity to combine better management with deeper patient involvement – creating an NHS that is both more efficient and more responsive to people’s needs.

“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services. These are the things that matter most to people using the NHS.”

Lord Darzi’s investigation into the NHS found that hospital productivity has ‘nosedived’ in the past five years. During that time resources have increased by 20%, but the number of patients treated has only increased by 3%.

This comes a month after the Health and Social Care Secretary kicked off the biggest national conversation about the future of the NHS since its birth, calling on the entire country 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, are sharing their experiences, views and ideas for fixing the NHS via the Change NHS online platform, which will be live until the start of next year, and available via the NHS App.

UK Government issues rallying cry to the public to help fix ‘broken’ NHS

  • 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.

Streeting announces crackdown on NHS waste

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.”