The NHS at 75: for the people, by the people?

Today the NHS celebrates its 65th anniversary. In that time, it has become an integral part of the national psyche, featuring prominently in the London 2012 opening ceremony and topping opinion polls on what makes people most proud to be British. “Our NHS”, there for us in our time of need and free at the point of delivery.

‘A shift from fragmented to integrated care means healthcare needs to be commissioned alongside a wider range of services’

But as we turn our sights to the future, its founding principles are under threat. By 2023, when the NHS turns 75, growing demands from changing demographics, coupled with continued financial austerity, threaten to create a budget gap of up to £54 billion. Without deliberate and radical action to tackle this challenge, we are facing a future where services are overwhelmed, possibly severely rationed, or simply abandoned by those who can afford to go elsewhere.

Over the course of the past six months we’ve engaged over 200 health sector employees and 4,000 members of the public in a conversation about what the next decade holds for the NHS.

Patient transition

This week we’ve launched our NHS@75 report, which sets out what a “healthy state” for the NHS would be 10 years from now. It is characterised by a system and workforce that is more adaptive and agile, and a public that takes more responsibility for its own health and care.

The transitions necessary to make this future reality present fundamental challenges to those working in the NHS and to the public it serves. Patients must move from being largely passive consumers of care to playing an active and leading role in their own heath and care, with self-management becoming the default.

‘Too often what we all know in principle doesn’t get delivered on the frontline’

For the NHS, a shift from fragmented to integrated care means healthcare needs to be commissioned alongside a wider range of services and transcending current divisions. The current focus on activity needs to shift to a focus on outcomes. We need to move to a more transparent model of healthcare, with data and technology used to their full potential to drive improvements. Overall, a culture of innovation is needed, alongside a more healthy appetite for risk taking.

There won’t be many surprises here for most of us in the health sector. But too often what we all know in principle doesn’t get delivered on the frontline. So over the next few months, PwC will be working with partners across the health sector and with the public to explore the first steps we need to take to start the journey to a healthy NHS at 75.  

Download the full report and join the debate at www.pwc.co.uk/nhs75

Dr Tim Wilson is a partner and Janet Dawson is healthcare lead partner at PwC