Yesterday marked the NHS’s 70th birthday.
If the anniversary was a time for celebration, funding and demand pressures nevertheless remain across all parts of the health service and will continue to grow.
Speaking in the House of Lords on Wednesday, entrepreneur Lord Andrew Mawson suggested four steps – based on ‘hard-won practical experience’ – to securing the survival of the NHS for another 70 years.
1) Redefining health
The first step in ensuring that the NHS will still be around in 70 years’ time, Lord Mawson suggests, is to go back to the question raised by the Peckham Experiment: ‘what is health?’.
The Peckham Experiment was an investigation into what health really is that ran from 1926 to 1950 at the Pioneer Health Centre in south London. As part of the project, doctors observed how families interacted with each other in a social setting.
According to the Pioneer Health Foundation – an organisation that promotes the legacy and ideas of the centre – the experiment found that ‘health is more than just an absence of disease’ and the role played by the environment in promoting health is ‘crucial’.
It has been estimated that around 20% of patients present to their GP primarily with a social problem, which costs the NHS around £395m per year, according to Citizen Advice.
2) No more health centres
Lord Mawson also concludes that we should stop building health centres.
An entrepreneur, he owns the Bromley by Bow Centre in London, a healthy living centre that combines ‘an extensive neighbourhood hub with a medical practice and a community research project’.
Lord Mawson says his health centres are similar to John Lewis stores, where a range of choices are presented to the customer.
‘The people who run successful department stores know that a diverse product range makes complete sense for the customer and financial sense for the business’, he adds.
‘It is the same principle in integrated holistic centres, where health is about life and living, not just disease and illness.
‘We need to create a locally blended offer, where doctors sit alongside others, including patients and local residents, to provide what people need.’
However, dentist Baroness Trixie Gardner of Parkes – also speaking in the House of Lords on Wednesday – argues that health centres are ‘a very effective way of giving treatment to children’.
3) Social prescribing services
All practices in England should have social prescribing services but at the moment they are only available in 20% of GP surgeries, Lord Mawson says.
‘Social prescribing should be the norm in every practice, because it focuses on what matters to patients rather than what is the matter with them’, he continues.
‘It also ensures maximum engagement with patients in managing their own health.’
In 2016, a social prescribing scheme carried out by researchers at the University of the West of England reduced GP appointments and accident and emergency admissions by 21% and 23% respectively in the South West.
The researchers reported that for every £1 invested into the scheme, there was a social return on investment of £1.69.
In May, the Royal College of General Practitioners called on the Government to fund all GP practices to provide access to a social prescriber to ‘tackle crippling workload and free up GPs time for patients most in need of medical care’.
4) Focus on early intervention
Lord Mawson believes there should be a greater focus on early intervention and less emphasis on beds and hospitals.
He says: ‘People believe that the NHS will solve their health problems; often it will not.
‘We are breeding a massive dependency culture through an institution that I would suggest is far from well.
‘It’s not lack of resources that is the problem, but what we have chosen to focus on.’
A 2016 study by the Oxford Health NHS Foundation Trust found that early community intervention in psychosis alone could save £33.5m for the NHS every year and £63m for society as a whole.