The next government needs to expand primary and community care capacity in order to improve productivity across the NHS, trust leaders have said.
A report by NHS Providers, called Providers Deliver: Achieving Value for Money, looked at how hospitals, mental health, community and ambulance services are finding ways to provide better care and value for money.
It found that there were good examples of productivity gains through collaboration, digital tools, incentivising staff and standardising delivery models across community teams.
However, it said that the efforts of the health service needed to be ‘matched’ by a commitment from the government to invest in modernising buildings, equipment and technology and that there needed to be a ‘pivot’ towards investing in early intervention.
‘The NHS should take a much broader view of productivity when examining how it can deliver value for the taxpayer,’ it said.
‘It is far more productive to concentrate effort and resources towards initiatives that will reduce the number of patients requiring care. It is imperative that strategies to improve productivity across the NHS need to frame the issue as a whole-system challenge, rather than focusing too closely on individual organisational productivity.’
It added that there should be a population health management approach to healthcare delivery and an increase of the public health grant.
‘There is a proportion of the population’s ill health which is not preventable, but requires resources in upstream services that enable long-term conditions to be managed effectively and avoid deterioration of conditions,’ it said.
‘By expanding the capacity across primary and community care, this will enable patients to receive the most appropriate level of care, reduce the pressure on discharging patients from hospital and result in patients being treated in less costly settings.’
It called for the government to support investment in schemes designed to prevent ill health, even though they will ‘take some time’ to have an impact on demand levels within the NHS.
The report also suggested there should be a focus on technology to help with productivity, alongside repairing and transforming NHS estates, reforming an underfunded social care system and implementing the long-term workforce plan (LTWP).
Sir Julian Hartley, chief executive of NHS Providers, said trusts were working ‘flat out’ to maintain high-quality care, but that help was needed from the government.
‘If we’re serious about improving the sustainability of the health service and want to help it to be as productive as possible then the efforts of trusts must be matched by long-term cross-government support including capital investment in NHS buildings and facilities,’ he said.
Last week, NHS England’s national director of primary care, Dr Amanda Doyle, announced that seven ICBs would establish 15 PCN test sites with the aim of understanding the gap between demand and capacity in primary care.
Part of this would be to test how to make it sustainable to improve population health management and delivering high quality long-term condition management.
