The case for change

Time to Think Differentlywww.kingsfund.org.uk/think

Major progress has been made in improving the performance of the NHS in the past decade.

Waiting times for treatment in hospital have fallen dramatically and generally remain stable.

Hospital-acquired infection rates like MRSA have fallen dramatically.

The NHS continues to be highly valued by the public.

Source: Ipsos Mori 2013

The NHS continues to perform well on most indicators when compared to other countries.

However, the current health and social care delivery system has failed to keep pace with the needs of an ageing population, the changing burden of disease, and rising patient and public expectations.

Fundamental change is needed. It is time to think differently.

The case for change is compelling:

1. Variations in quality and outcomes of care

2. Funding pressures3. Delivery system not fit for the future4. Future trends – magnifying the

pressures

1. Variations in quality and outcomes of care

‘The UK has the second highest rate of mortality amenable to health care in 16 high-income nations.’

Source: Nolte and McKee 2011

For many diseases, there is unwarranted variation.

There are wide variations in performance and gaps in the quality of care of general practice.

2. Funding pressures

Current spending projections suggest significant financial pressures on services for the next 20 years.

Historic pressures to increase NHS spending.

Source: Appleby 2012

Increasing pressure to achieve productivity gains.

By 2015£20

billionNicholson challenge for productivity

gains

By 2021£30

billion more

NHS England estimates of a funding gap

Projected spending on long-term care 2016/17–2061/2

Source: OBR 2012

3. Delivery system not fit for the future

A significant proportion of patients occupying beds do not need to be in hospital on clinical grounds.

Source: Goddard et al 2000; Audit Commission 2003

The separation between general practitioners and hospital-based specialists, and between health and social care, often inhibit the provision of timely and high-quality, integrated care to people who need to access a range of services relevant to their needs.

Source: Ham et al 2012

There are significant problems with standards of dignity and care.

Obesity is associated with an increased risk of diseases including diabetes, heart disease, osteoarthritis and cancer. 

Source: National Obesity Observatory 2012

4. Future trends: magnifying the pressures

Demographics are changing.

More people with long-term conditions.

A rise in chronic disease.

Population lifestyles present significant risks to health.

What is the future model of care?

Integrated care, co-ordinated around the needs of patients and service users.Patients and service users actively involved in the design of their care and working with professionals as part of the care team.Re-designing the care pathway, with greater specialisation in hospitals, increased capacity and more consistent standards in primary care.Stronger focus on prevention.

If you would like to know more:

Visit www.kingsfund.org.uk/think for guest blogs, videos and supporting data on trends.

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