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Supporting the NHS model

The terrible state of the NHS and social care across the country and across sectors is clear to all.

Delays and lack of access are damaging the quality of care and there is no doubt that patients of all ages are being harmed. Patient and public experience and perception of healthcare is poor and confidence in the service is declining.

Staff are facing continued and unacceptable pressures due to increasing workload and staff shortages leading to a cycle of burnout, demoralisation and departure from the service which further impacts on the quality of care for patients.

As the Academy’s report of September 2022, Fixing the NHS, stated, we must not normalise unacceptable standards of care. But since then, the position has been getting worse not better.

The document set out a clear prescription for fixing the NHS which entailed both reform and providing additional resources. It included:

  • Expanding workforce numbers
  • Embracing new ways of working
  • Improving access in all settings
  • Reforming social care
  • Revitalising primary care
  • Grasping the digital agenda
  • Modernising the estate
  • Valuing staff and encouraging clinical leadership
  • Putting more emphasis on health disparities and prevention
  • Making better use of resources and ensuring there is adequate investment

We firmly believe that vigorous pursuit of all these objectives as part of a coherent strategy will restore the NHS to health.

However medical royal colleges and the Academy are absolutely clear that in doing this we must stick with the fundamental model on which the NHS is built – a comprehensive service available to all, funded through general taxation, based on clinical need, not a person’s ability to pay.

As we come to towards the 75th anniversary of the NHS there are siren voices who say that we need to change our model of healthcare to make the improvements we want and, indeed, that it is the current model which is contributing to the problems.

We believe this a misleading and dangerous argument.

The Health Foundation/Ipsos report on public perceptions of health and social care published in September 2022 shows that the public wants a better health service, not a departure from the NHS model. 77% believe, ‘The NHS is crucial to British society, and we must do everything to maintain it.’ And they back additional spending to support it: 71% think greater government investment in the NHS is necessary over and above new funds raised through the health and care levy.

Other models of healthcare can obviously provide high quality services and as we are currently seeing, our current model is no guarantee of quality in itself. The strength of the current model is that equality of access and treatment are at its core. Jettisoning this model would threaten those precious social assets with no guarantee of improving quality and strong likelihood of increasing costs.

Medical royal colleges believe that calls to abandon the current model of health care are dangerous, they potentially disguise the true cause of the decline in quality and standards and would be a diversion from implementing the actions which would actually make the improvements to the system that are required.