Where is care going?

There is a lot of debate about the future of the NHS, and it is not hard to see why.

People are less and less satisfied with the services on offer; many patients report that they are experiencing long delays in getting care; staff tell us they are exhausted and demoralised; accessing services remains a constant source of frustration for many.

There has also been a lot of debate about the causes. More than a decade of ineffective austerity leading to chronic under-investment; shocking lack of progress in social care policy; long delays in getting a properly funded workforce plan, limited progress in public health measures; the effects of the cost-of-living crisis; and of course, the recent pandemic. Others have added in the negative impact of Brexit.

It is not surprising then that the future of health and care services is on most people’s agenda. They are asking, Do we need a new vision? Perhaps a new funding model?

I am not entirely convinced that we really need a new vision. There has been widespread agreement over many years about how health and care services should work. Services should provide integrated, personalised and responsive care closer to where people live. The direction of travel should be away from acute settings such as hospitals into community settings building on individual and community assets.

This all seems fairly clear to me.

I will be arguing as Chair of our Health and Wellbeing Scrutiny Committee that it is not this vision that is giving rise to the challenges we are facing. Rather, it is a health and care system which places a continued emphasis on hospitals and emergency care that is at the heart so many of our recent experiences.

There are, of course, many shining examples of excellence we can point to. Cases where care is meeting all of the needs of patients and carers. However, this does not mean that that the fundamental barriers to progress in developing the desired localised care delivery have been properly understood or overcome on a widespread basis.

I would argue that it is not the vision that is the fundamental problem, we have just struggled to make a reality of it.

We simply must make progress on it.

Patients trying to navigate a complex system, carers struggling to cope, the amazing staff who work in our care services, and of course the general public, deserve nothing less from us.