No part of the health service is ‘100% protected’ from cost savings, according to Sir Jim Mackey, chief executive of NHS England.
Speaking at a Health and Social Care Committee (HSCC) session on the 10 year plan yesterday (14 July), Sir Jim said that ‘everything’ was going to have to be challenged.
The comment came in response to a question from Labour MP Danny Beales on how they were going to drive a digital NHS amid cuts that might mean less staff working in digital functions.
Sir Jim said: ‘There isn’t a part of the health service we can say is 100% protected from a cost saving point of view.’
However, he added that they want to be ‘sensitive’ and ‘understand need and not shrink something when it actually is going to disable capability and capacity moving forward’ and said there was ‘huge variation’ across the system on this issue and what people are investing in it.
Will the changes make a difference?
Sir Jim was also asked whether the new structure of the NHS would be ‘suitably different’ to drive different outcomes.
He said: ‘Some of those previous incarnations, the involvement representation on a board or some kind of governance system, what we’re trying to say here is work with partners actively.’
He was pressed on what this means and how ‘working with partners actively’ would be different to someone on a board.
Sir Jim said: ‘I’m talking about operational, clinical social care colleagues, practical people on the ground working within a set of rules.
‘It’s about working at every level. My point is, it’s not done when you’ve appointed somebody onto a board. This has got to work right the way through the system and be less bothered about who works for who and more about what they’re delivering for people.’
Health secretary Wes Streeting, who was also questioned in the committee, added that in terms of neighbourhood health and care plans, he wants to ‘see people working together to develop those plans and sign them off together in a spirit of partnership’.
When questioned on how different CDCs, multidisciplinary GP surgeries and neighbourhood hubs would be, Mr Streeting added that it would be an ‘opportunity’ to get faster access to consultations and diagnostics.
Conservative MP for Isle of Wight East Joe Robertson asked: ‘What’s the difference between community diagnostic centres, multidisciplinary GP surgeries, Darzi centres and now your word for it, neighbourhood hubs? I mean, these are things that have run from 2000, 2008, 2012, and now your plan, they sound like the same thing just with different names.’
Mr Streeting responded: ‘What neighbourhood health centres will do is bring under one roof a whole range of different services to give patients a one-stop shop with a principle that anything that that can be done outside of a hospital setting in communities, in neighbourhoods, should be.
‘What we want to see happening in neighbourhoods is the opportunity to go in and get much faster access to consultations and diagnostics, to be able to have things like your blood tests, scans, all under one roof.
‘All of that can be done in primary care. And the reason we know that to be true is because in pockets of exceptional practice in this country, it’s already happening. And one of the core themes of the plan is to take the best of the NHS, to the rest of the NHS.’
‘Enthusiasm’ for general practice
Mr Streeting added that he thought the 10 year plan reforms would generate ‘enthusiasm’ about working in general practice from future generations of doctors.
He told MPs: ‘If you’re reading all the time in the newspapers that GPs are overworked and burned out, and constantly seeing GPs given a kicking because people can’t get an appointment, you’re not going to think “you know what? That’s where I want to go to work”.
‘Actually, the pitch I want to make to the doctors and nurses of the future is that community neighbourhood health is where some of the most exciting medicine will be practiced.
‘It’s where you can make the most difference to patients in tackling health inequalities. And I think that will really speak to the values of the generation that’s coming through and what they want to achieve. So I hope that we’ll see a good deal of enthusiasm for working in general practice.’
It comes as more ICBs have announced plans to cluster in order to meet the cuts to the health service.
Last week, ICBs were invited to apply for the first wave of the neighbourhood health programme, which will prioritise 42 places over England.
