Time to manage expectations


NHS Confederation cautions it is time to reassess what the NHS can realistically be expected to deliver as the service prepares to go into winter pressures with a massive backlog of treatment that was postponed or cancelled due to COVID-19 and a second surge of the virus looming.

As part of its NHS Reset campaign, the report, ‘NHS Reset: a new direction for health and care’ has identified five factors which it believes are fundamental to achieving a sustainable health and care system.


Honesty and realism

The effect of the pandemic is likely to be felt on the NHS for some years and as Trusts work to restore routine services leaders are not confident in their abilities to meet targets. Therefore, the expectations of the public must be managed as they want to see routine services resume and government investment should support new ways of working so that services can be safely restored.


Extra funding for health and social care

If the NHS is going to catch up with the backlog of treatment, additional revenue and capital funding will be needed which should be addressed in the forthcoming planned Comprehensive Spending Review. Almost 75% of leaders responding to the survey said they did not have enough capital funding to upgrade buildings, IT and other infrastructure.

A significant surge in demand for mental healthcare is also anticipated – as much as 20% is thought to be realistic – which will also require a long-term funding settlement.

In return NHS Confederation says it is reasonable to expect the NHS to drive the change set out in the Long Term Plan and confirms there is commitment among health leaders to innovate and deliver services in new ways.


A lighter, leaner culture

NHS leaders want to see a continuation of the more agile ways of working that have been introduced during the pandemic and have the flexibility and freedom to innovate without the burden of unnecessary bureaucracy. In particular, leaders want local NHS bodies to be able to listen and co-produce services with patient groups and the communities they serve.


Integrating health and care

There is support for a legislative framework that brings simplicity and clarity together with a common purpose for local leaders and support for system thinking. The pandemic has demonstrated the value of uniting providers with a common purpose, breaking down barriers and enabling services to be transformed.


Tackling health inequalities

The pandemic has highlighted that people living in poorer communities, and those from black and minority ethnic backgrounds suffer poorer health outcomes than others. A step change in caring for diverse and marginalised communities is needed. This will require sustained and funded action at national and local level.


The NHS Reset campaign has involved six months of engagement with health and care leaders and a survey of 250 NHS leaders.

Download the full report here.

A further report in the NHS Reset campaign has also been published by NHS Confederation this month: ‘Covid-19 and the Health and Care Workforce, Supporting our Greatest Asset’. Download this report here.

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