Our NHS is precious. One of our society’s greatest achievements has been the provision of access to universal healthcare, based on need and free at the point of delivery. If this important principle is to be extended to future generations, we must all do our bit today to help our NHS respond to the financial and demographic challenges that threaten its long-term sustainability.
Our group came together in 2013 to explore how NHS health and care delivery in England could be made more sustainable. We consulted with a wide range of stakeholders, distilling our thinking into a report, Patient, manager, expert: individual, published in 2014. We offered our shared vision for sustainable health and care, with 12 recommendations for change.
Just a year later, a great deal has changed in our NHS. We were delighted that the NHS’s Five Year Forward View placed sustainability at the centre of its vision and echoed many of our recommendations. We believe that sustainability must be one of the key criteria against which the evolving models of care andvanguard sites evaluate their success.
When examining progress against our original recommendations, however, we were struck by the lack of leadership for the sustainability agenda. No single organisation has stepped up to assume an overall leadership role. We believe that a new leadership model needs to be adopted, that grows from professionals on the frontline and draws on the creative energies of the entire NHS workforce. Staff must be given the freedom to innovate, even in a cost-constrained system. Small changes to local processes can make a huge difference, especially when shared and implemented at scale.
There is a wealth of international examples of how groups of individuals are pioneering system-wide change and how these changes benefit patients, carers and health economies. We need to be better at sharing these exemplars and making it easy for local commissioners and providers to find evidence-based models to try in their area. A shared health and care sustainability resource, highlighted in our original report, is still needed.
This update revisits the key themes of our original report, acknowledges the progress that has been made and reframes our recommendations to reflect the recent transformations in the NHS landscape. It also introduces a new theme into our work: environmental sustainability. We are re-issuing our call for the sustainability agenda to be prioritised. We hope that our new recommendations will help the health system to identify ways to meet the urgent sustainable healthcare challenge.