MIAA’s Annual Health Check
Date: Friday, April 06, 2018
Venue: Haydock Park Racecourse (Lancaster Suite)
Speakers: Anita Charlesworth, Chief Economist, The Health Foundation Steve Wilson Executive Lead - Finance and Investment, Greater Manchester Health and Social Care Partnership Chris Hopson, Chief Executive, NHS Providers.
Anita Charlesworth, Chief Economist, The Health Foundation
Steve Wilson Executive Lead - Finance and Investment, Greater Manchester Health and Social Care Partnership
Chris Hopson, Chief Executive, NHS Providers.
Tim Crowley, Managing Director MIAA opened MIAA’s 5th Annual Health Check on the state of the NHS and Social Care by introducing Steve Wilson, Executive Lead, Finance and Investment, Greater Manchester Health and Social Care Partnership.
Steve presented an account of the realities of devolution from the perspective of what was happening at Greater Manchester (GM) as they worked to get better alignment between the growth of the economy and investment in public services. Their strategic financial plan provided an opportunity to ‘take charge’ and it is supported by a comprehensive framework of transformation. In reality however each of the 10 localities across GM is at a different stage in their transformation journey. The future commissioning/provider relationship is still being explored and different options for local care organisations within a fully accountable system are being considered. The future is about leaving an enduring legacy of devolution with an understanding of what needs to be done to sustain the transformation and to ‘supercharge’ projects within different localities so they get on with things.
Anita Charlesworth, Director of Research and Economics, The Health Foundation decided to explore a different question. The Prime Minister has committed to a 10 year settlement for the NHS to mark the 70th anniversary for the NHS in July this year. Anita used her presentation to explore:
• How much money?
• The scope of the commitment – is it all of health and social care?
• What to spend it on?
• How to fund it?
The UK is about average for European countries for health spending but we have a big gap in social care funding. The UK economy is growing the slowest because we have low productivity. There is evidence however that life expectancy would be increased by as much as 3 years through greater investment in health spending. Mortality is influenced by the health system. The priorities for investment Anita believes should be addressing:
• Healthy life expectancy gap
• Child outcomes
• Mental health
• Cancer survival
• Outcomes for women
Anita believes that it is important that we craft a convincing and compelling vision of what the health system can deliver over the next 10 years to persuade people that raising taxes by 4% - the amount Anita thinks is necessary -possibly through National Insurance contributions will be acceptable to the general public. It is a big ask she believes, to ask the public to pay more tax and an even bigger responsibility to use that money really well to decide what it should be spent on.
Chris Hopson, Chief Executive, NHS Providers reinforced the fact that we are in the middle of the longest and deepest squeeze in NHS history and that the pressure on the NHS continues and the size of the financial challenge enormous. It is becoming increasingly clear that this is not a sustainable way to run the NHS and the consequences are beginning to stack up. There are high levels of concern in the system about the deliverability of the 18/19 provider task expected and difficulties in the finance and performance ask. There are real risks around setting providers an impossible task and seeing a cycle of perpetual failure based upon a difficult culture of pretence where provider executive teams sign up for targets they can’t deliver. However we are on a promise of extra funding for the NHS of a multi-year settlement with a plan before the next spending review and the plan would be generated by a government led process with NHS involvement.
There are according to Chris 5 obvious tensions
1. Afordability and need
2. Health and social care
3. More performance or recovery
4. Reform or stabilise – the 5YFW is no longer fit for purpose
5. Whose approach will be followed
Chris reinforced the need for a compelling vision of what the NHS is going to deliver in the future and provided 6 suggestions for a local level macro strategy.
Recognise the NHS is in a period of financial and performance challenge and calibrate accordingly.
There are lots of opportunities to do things better – have a clear strategy to do this with staff participation at the heart
Life is better and easier without the regulators on your pitch although they are getting better at offering support.
Don’t sign up to anything that isn’t deliverable – if you are pressured into it have a full audit trail.
Engage as effectively as you can in your local STP.
Leadership capacity and capability seems to be one of the scarcest resources so prioritise accordingly and grow some more.
Tim chaired a question time with the speakers with the audience and finished before lunch describing the event as honest and challenging as providers, commissioners and the system grapple for solutions whilst the promise of increased funding looks like it is around the corner.
Updated by: Administrator on 26, Feb 26, 2018