Looking ahead: the NHS at 100

Looking ahead: the NHS at 100 | Healthcare Financial Management Association

Image source: http://www.hfma.org.uk

The challenges facing the NHS are significant. Waiting lists are increasing, A&E attendances are rising and access to GP
appointments can be difficult. Alongside this is a growing population who are living longer and developing more complex conditions, which increases demand on an
already overstretched service.

This report explores the key challenges the HFMA think will have the biggest impact on the financial future of health and social care.  It highlights the likely direction of travel and provides insight to help inform current decision-making.

Full report: Looking ahead: the NHS at 100



Long-term funding of adult social care

The Housing, Communities and Local Government and Health and Social Care Committees have published Long-term funding of adult social care.

The joint report calls for a sustainable funding solution for adult social care and the introduction of a ‘Social Care Premium’, either as an additional element of National Insurance or with the premium paid into dedicated not-for-profit social insurance fund that people would be confident could only be used for social care.

Watch the interactive report:

social care
Image source: social.shorthand.com


The NHS at 70

The Health Foundation, Institute for Fiscal Studies, The King’s Fund and the Nuffield Trust have published the next three briefings in their series marking 70 years of the NHS

Better health and care for all

Better health and care for all: A 10-point plan for the 2020s. The final report of the Lord Darzi Review of Health and Care.| Institute for Public Policy Research

A previous report concluded that a bold long-term funding and reform plan is needed to secure the future of the NHS and social care. This final report of the Lord Darzi Review puts forward a ten-point plan to achieve this, as well as a ten-point offer to the public which sets out what the health and care system will be able to offer if this plan for investment and reform is adopted. 

Full report: Better health and care for all: A 10-point plan for the 2020s.

Summary available here

The £2,000,000,000 question: is there an opportunity to move from meeting to managing demand? Impower report

Impower | April 2018 | The two billion pound question Is there an opportunity to move from meeting to managing demand?

Impower, a consulting firm that aims to improve public services has spent the last year conducting mixed methods research (qualitative and quantitative) with 15 Councils to analyse £126 million of spending plans, a figure that is one-eighth of national allocation.
The report contains their findings,  and provides summary analysis and conclusions from this work. 

Impower’s  report argues that, whilst the funding has helped to meet demand within the system through reduced delayed transfers of care, sustainable change is only possible if the £2 billion is used to manage demand, not just meet it.


two billion
Image source: impower.co.uk

This report posits that there are a range of barriers and concerns shared across health and social care including:
• There is a lack of robust quantitative and qualitative evidence on the outcomes and benefit trajectories of services. This prevents health and social care teams from challenging the value they receive from services, and services continue despite offering poor outcomes or value;
• Local authority Chief Executives and senior officials identified addressing inconsistent behaviours between health and social care systems as a top priority in a recent iMPOWER survey;
• The £2 billion in iBCF is just a tiny proportion of health and social care spend. Different methods of evaluation results in a disjointed response as it encourages a collection of initiatives rather than a co-ordinated approach across the whole system;
• Recruiting and retaining staff in critical roles across health and social care, particularly the home care sector, is impacting on delivering sustainable change;

(Taken from the Executive summary)Further details from Impower 

Full report available from Impower here 

Managing the hospital and social care interface: Interventions targeting older adults

The Nuffield Trust | March 2018  | Managing the hospital and social care interface: Interventions targeting older adults

This research report examines the relationship between the health and social care sectors, particularly the tensions between the two due to rising pressures on hospitals, when the think tank calls for increased collaboration between the two.

Managing the hospital
Image source: nuffieldtrust.org.uk

It explores the actions and strategies that providers and commissioners have put in place to improve the interface between secondary and social care, with a focus on what hospitals can do. With particular focus on:

• collaboration to prevent avoidable hospital admissions
• the interface between hospitals and social care providers when patients are
discharged from hospital
• the relationship between commissioners and social care providers
• wholescale organisational integration.



The report suggests increased

  • collaboration to prevent avoidable hospital admissions
  • the interface between hospitals and social care providers when patients are discharged from hospital
  • the relationship between commissioners and social care providers
  • wholescale organisational integration.

It uses seven case studies to support this and makes five recommendations for national policy-makers. In conjunction to this, the think tank makes  seven recommendations for hospital leaders, derived from discussion with hospitals, integrated care organisations and local authorities  throughout the course of this research.

These are:

  1. Think imaginatively about the workforce. We have already set out the recruitment and retention challenges facing the social care sector, and the way national policy needs to change to help address them. But there are also things that local providers can do.
  2. Do not make decisions about social care, without social care. Hospitals
    that make decisions about providing or commissioning social care
    without consulting their local authority or social care providers may risk
    destabilising the social care market.
  3. Think carefully about different types of integration. Organisational,
    service-level and patient-level integration all have their own strengths and
  4. Consider pooling budgets to facilitate progress. Most of our case studies
    benefited from a shared budget to initiate and sustain integration efforts.
    Some of this came from ‘vanguard’ funding, but most of the case study sites
    also drew on the Better Care Fund.
  5. Make sure that integrated teams have appropriate processes to support
    them. Where integrated teams work effectively, they have appropriate
    processual and managerial support. Shared governance and accountability
    processes mean that everyone is working to the same set of standards.
  6. Make sure that commissioners are on board. Collaboration and buy-in
    from all local commissioners and providers, including primary and
    community care, was a key factor in successful implementation for most of
    the case study sites.
  7. Collaborate with housing partners. There are good examples of
    collaboration with housing partners at the local level.

Long-term sustainability of the NHS and social care

Government response to the report on long-term sustainability of the NHS and adult social care | The Department of Health and Social Care  

This paper responds to the Lords Select Committee report stating that significant efficiencies will be needed to make the NHS and social care system sustainable for the long term.

The original report made 34 recommendations in the areas of:

  • service transformation
  • funding the NHS and adult social care
  • innovation technology and productivity
  • public health, prevention and patient responsibility
  • lasting political consensus


Full document: Government response to the Lords Select Committee report on Long-Term Sustainability of the NHS and Adult Social Care| The Department of Health and Social Care