As the NHS turns 75, it is under unprecedented pressure: record waiting lists, demand for care and delays in discharging patients who are well enough to go home are putting all parts of the health service under immense strain. Sickness absence is at record levels, while nearly 170,000 NHS workers in England quit their jobs last year. Recent strikes by nurses, ambulance staff and junior doctors, coupled with the historic decision by consultants and radiographers to strike, too, show the depth of anger. Five experts spell out what’s needed to make the health service thrive again.
Matthew Taylor, chief executive of the NHS Confederation
As we approach its 75th anniversary we also reach a crucial juncture in the history of the NHS. We now have a real opportunity to grasp head-on the changes needed, and to innovate and improve for patients and ensure it prospers for another 75 years and beyond.
What we need is a holistic health policy to improve access to services and standards of care. It is vital that everyone working in the NHS understands that prevention is always better than cure, ensuring that people are able to access the best possible tools to help them live healthier lifestyles as well as access the care they need before their health declines. This in turn will reduce pressure on the system.
We must seek to address the social conditions that make people sick and rob them of control, as well as building deeper trust and an enduring sense of shared responsibility between the health service and the people and communities it serves.
Despite all the challenges we face, the best days of the NHS lie ahead. Sufficiently funded, properly supported, devolved, preventative, empowering – our health service can and will be ready to grasp present and future opportunities. It is a future worth fighting for.
Pritesh Mistry, fellow in digital technologies at the King’s Fund health thinktank
Greater use of robotics would transform both the standards of care patients receive and hospital bed management. We are now on the cusp of a robotic revolution in healthcare. Robots are already used in pharmacies to dispense medications, but this barely scratches the surface of the great potential they have to change how health and social care is provided. Robotics could play a greater role in operations, and patients might find themselves under a knife held by a robot. This may be unsettling for some, but it can result in surgery that is less invasive for the patient and could mean quicker recovery times, freeing up beds and staff time. It can also save staff from experiencing radiation exposure during operations.
When it comes to diagnostics, robotics improve the quality of medical images, while AI can read scans more accurately, reducing the chance of human error in spotting health issues. Making the robotic revolution a reality will require a concerted effort on everything from funding, tech development, education and training for staff to changes to rooms and buildings. Simultaneously, there also needs to be focus on getting the basics right, as there is a real risk of creating a confused system, where AI robots can assess your X-ray, but doctors don’t have access to wi-fi in the hospital.
Clare Gerada, president of the Royal College of GPs and co-chair of the NHS Assembly. She is writing in a personal capacity
Today’s GPs do more, to a greater degree of complexity, than our counterparts around the world, yet our share of NHS funding falls far short. As a result, patients experience longer waiting times, gaps in service provision, and are forced to seek alternative avenues for care.
Doubling of the number of GPs that the NHS workforce plan promises will help. To achieve this, only medical schools that have an explicit commitment to producing GPs should be allowed to expand their places.
Going forward, GPs need time to care for patients, but the workloads we face are unsustainable. We must insist on a cap on the number of patients we are expected to see per day; and more time for those patients who need it, not the current 10 minutes. And all doctors, irrespective of their final speciality, should spend six months training in general practice – after all, all GPs have spent at least three years training in hospitals.
As a society, we are growing older, fatter and sicker. More – and less burnt-out – GPs are vital if we are to keep patients healthier in their homes and ease the burden on hospitals and the rest of the NHS.
Prof Graham MacGregor, chair of Action on Sugar and Action on Salt
Without doubt, the use of taxes is an effective lever to encourage food and drink manufacturers to reformulate their products to reduce sugar and calories – and it’s working.
The soft drinks industry levy, or sugar tax, was introduced in 2015 to encourage manufacturers to reduce the amount of sugar in their soft drinks. The levy successfully removed a massive 46,000 tonnes of sugar from these drinks between 2015 and 2020 and raised £334m in 2021-22 alone, to be invested in children’s health and wellbeing programmes.
However, the sugar tax only applies to soft drinks – there are many more food and drink products that are loaded with salt, sugar and calories. Long term, a high consumption of these ingredients can lead to weight gain, increasing the risk of type 2 diabetes, stroke, heart attacks and some cancers
Now the government must introduce similar levies to incentivise the food industry to reduce the sugar, salt, fat and calories in their junk food products. What’s needed are mandatory targets in order to create a level playing field for food companies.
As a nation, just cutting one gram of salt from our average daily salt intake would prevent approximately 6,000 avoidable deaths from strokes and heart disease per year and associated life-changing disabilities.
Jennifer Dixon, chief executive of the Health Foundation
The health service needs not only investment but also more systematic use of the latest technology if it is to improve access to treatment and ensure staff have more time to care.
Greater use of “virtual wards”, for example, could allow more patients to receive hospital-level care at home. This can be more convenient for patients and, crucially, frees up much-needed hospital beds, including by supporting people to be discharged from hospital earlier. The NHS also needs to go much further in enabling people with long-term conditions to monitor their health at home using mobile apps and wearable devices, helping avoid unnecessary hospital appointments.
But there’s a lot more that can be done with technology, often behind the scenes, so that staff can spend less time on admin and more time with patients. Using software to automatically transcribe clinical notes can help GPs to focus more on what their patients are saying. AI can rapidly analyse patient feedback, freeing up staff to act on what patients are saying matters most to them.
With severe staff shortages and waiting lists at a record high, the NHS has no choice but to embrace the tech revolution.
