To move the NHS from a sickness to a wellness system, we all need to be partners in our own health, a new pamphlet from the Fabian Society has today declared.
To achieve this, the next government should make ‘longer healthier life expectancy’ an organising principle for itself and NHS England.
By the People, With the People is written by health experts Paul Corrigan CBE and Dr Charlotte Augst. It recommends a series of changes that will shift the NHS from a service that does things for people to one that works in partnership with them.
The report shows that thinking about the necessary shift from a sickness service (the medical model) to a more holistic wellness service has been happening for years. However, the authors conclude that although many of the basic aspects of this framework already exist, they are not properly interacting with each other. This leads to disjointed progress and a lack of ‘big picture’ thinking.
It has also led to a situation in which resource allocation is explicitly not following policy thinking. Investment into the old, broken model continues even as it is proving ever more inadequate. Funding is increasingly concentrated in hospitals while it is decreasing for primary care. Community services and public health budgets have been in serious decline whereas all policy thinking suggests that this should be inverted.
The authors argue for a shift throughout the whole healthcare system to a ‘health creation’ paradigm. This new approach would shift funding, resources, responsibility and thinking from the medical model to a system that puts the relationship between users and deliverers at the heart of policymaking.
The pamphlet sets out a series of recommendations. These include:
- A cross-departmental cabinet committee charged with delivering on the goal of longer, healthier life expectancy.
- The appointment of a ‘patient tsar’ and an NHS England patient director to oversee and champion patient-centric approaches to health and healthcare.
- Building a community of health through far greater and wider integration and data sharing with other key players such as local councils and the voluntary sector.
- A reversal in the decline of public health budgets.
- A new focus on the outcomes that matter to people, including new metrics to measure progress and a renewed focus on patient experience and patient involvement.
- Better use of tools such as the NHS App to widely share data to allow a far greater community of involvement in local healthcare.
- Relentless work to overcome the digital divide in order to ensure that all users are equally able to participate in their own health and healthcare.
Report co-author Dr Charlotte Augst said:
“Leaders drawing up strategies for the future of the NHS are in the habit of stating that ‘people need to do more to manage or improve their health’ – but there is a distinct absence of insight for what is needed for communities and people to sustain their health.
“Unsurprisingly then, a clear focus on supporting people to engage with their own health is missed out in most plans. In this report, we aim to set out how measurements, funding flows, and relationships have to change to create ‘health by the people, for the people’.”
Report co-author Paul Corrigan CBE said:
“For some time, policy makers have been arguing that patients and their own health care activity needs to be at the heart of every NHS consultation. Here, our practical examples demonstrate the different ways in which that has been achieved.
“Given the growth in demand caused by increased ill health in our society, if the NHS is not to be overwhelmed , it will, as a whole, need to work in partnership with the activities of patients and their communities “
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- Contact: Emma Burnell, Media Consultant, Fabian Society firstname.lastname@example.org or 07851 941111.
- The report is published at https://fabians.org.uk/publication/by-the-people-with-the-people.
- By the People, With the People is published by the Fabian Society. It was edited by Kate Murray and Iggy Wood.
- Dr Charlotte Augst came to London in 1997 to pursue postgraduate studies after her law degree in Germany. She completed a social science masters and a PhD in law and medical ethics at the University of London. Since then, she has engaged in health, care and research policymaking – in parliament (for the chair of the Science and Technology Select Committee), for national regulators (HFEA and GPhC), and in the voluntary and community sector. For the last 10 years, she has led work in collaborations and coalitions (Richmond Group of Charities, National Voices), building networks and connecting decision makers with experts. She is now the executive director for policy, campaigns and improvement at Diabetes UK. She has authored this report in a personal capacity.
- Dr Paul Corrigan served as a special adviser on health policy to Alan Milburn, John Reid and Tony Blair. He was then director of strategy for NHS London before becoming a non-executive director of the Care Quality Commission 2013-2019. He previously worked as a social scientist, teaching and researching social policy at Warwick University and the Polytechnic of North London.
- The Fabian Society is Britain’s oldest political think tank. Founded in 1884, the society is at the forefront of developing political ideas and public policy on the left. The society is alone among think tanks in being a democratically-constituted membership organisation, with around 7,000 members. It is constitutionally affiliated to the Labour party.
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