NHS leaders have called for an “open and honest debate” on the future shape of health services in order to tackle a funding shortfall that is predicted to reach £30bn over the next decade.
NHS England warned that the NHS funding gap could grow to £30bn between 2013-14 and 2020-21, if government funding levels remained “flat” and services continued to be delivered largely in hospitals.
As a result, it called on the public, NHS staff and politicians to debate the future shape of the NHS in order to meet rising demands and patient expectations.
It has published a “call to action” document setting out the challenges facing the NHS. The document said the NHS must change to meet such demands and make the most of new treatments and technology, while stating it would not contemplate reducing or charging for core services.
NHS England chief executive Sir David Nicholson said: “I am clear that our future must be about changing, not charging. To do so we must make bold, clinically-led changes to how NHS services are delivered over the next couple of years.”
He said the “focus” needed to shift from buildings and onto patients, echoing sentiments made repeatedly in recent years by senior clinicians and politicians about the need to provide more services in community settings rather than in more costly hospitals.
This message comes against a background of patient groups and local MPs continuing to campaign against service reconfigurations that involve hospital closures or downgrading.
Sir David said: “New technology means earlier diagnosis and better treatment, but this costs more and we are not reaching everyone we need to. The NHS can increasingly deliver care at home, yet too often patients have to travel are around buildings.
“This [funding] gap cannot be solved from the public purse but by freeing up NHS services and staff from old style practices and buildings,” he said.
NHS England will be providing support to local clinical commissioning groups, charities and patient groups to hold meetings to discuss the topic.
Feedback from the meetings, national events and online contributions via NHS Choices will be published and used to help shape a longer term strategy for the NHS.
Peter Carter, chief executive and general secretary of the Royal College of Nursing, welcomed the opportunity for NHS staff to “feel empowered to have their say on its future”.
“The NHS faces significant challenges and we agree that it cannot hope to meet these without change,” he said.
“We welcome new innovation and ideas about the future design of services as well as the better integration of health and social care services as a priority. We also need to make sure we’re getting the basics right, such as ensuring safe staffing levels throughout the NHS.”
He added: “The RCN will be encouraging nursing staff to make a key contribution to this programme of engagement alongside other health care professionals and the public.”
However, Unison said the funding gap highlighted by NHS England “must not be taken as set in stone”.
The union argued that NHS funding should be raised through taxation and there was “huge potential” for savings if the government reined in the increasing role of profit-led private companies.
Unison head of health Christina McAnea said: “Of course we should have a debate about the future of our NHS and how it should respond to the needs of patients and staff in the future.”
But she added: “The government’s political drive towards a market driven NHS is leading to precious money going out of the service and into the pockets of private healthcare companies.
“Realistic levels of funding and a more integrated approach between health and social care is the way forward,” she said.
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