A new report from The King’s Fund has called for fundamental changes in how health services are commissioned, paid for and regulated to deliver the vision set out in the NHS Five Year Forward View. The Forward View has been endorsed by all three main political parties and will set the agenda for NHS reform in the next parliament.
However, without significant changes to policy and new approaches to leadership in the NHS, The King’s Fund argues that it risks suffering the fate of previous policy documents which have failed to deliver on their ambitions.
The report argues that dealing with growing financial and service pressures could crowd out the time and space needed to implement longterm changes to NHS services. It argues that delivering these changes will require leadership of the highest order, with much resting on whether the coalition of NHS bodies assembled behind the Forward View can be kept in place.
The report makes the following recommendations:
- An integrated approach to commissioning is needed, with a much greater emphasis on pooling budgets currently held by NHS England, clinical commissioning groups and local authorities.
- New ways of paying for NHS services should incentivise the delivery of integrated care instead of encouraging admissions to hospital as under the current system of Payment by Results.
- The Care Quality Commission’s work should focus on assessing how well care is integrated across local systems of care rather than just inspecting individual NHS organisations.
- A national strategy for quality improvement and leadership development is needed to ensure the NHS becomes a ‘learning organisation’ focused on improving quality of care.
