Reform is the best medicine to bring NHS back to health

Most observers would agree that the NHS is in a more parlous state than ever before. However, I do not believe this needs to be terminal.

The NHS faced major challenges before 2020, but these have been exacerbated hugely by the pandemic. The demand for NHS services has risen, backlogs have grown – the challenges are vast.

Ambulances are queueing outside A&E; patients in A&E are waiting far too long to be admitted; patients in hospital are unable to be discharged because of problems in social care; some patients are unable to get timely appointments with a GP; patients who are referred urgently with possible symptoms of cancer often wait too long to start treatment, in part due to delays in getting scans and other tests.

Patients requiring elective surgery, such as hip replacements, or mental health services have also been waiting much too long.

Recovery from the impact of Covid-19 is made more difficult by ongoing infections, not least amongst NHS staff. The recent heatwave has also put extra pressure on NHS staff carrying out routine care.

Many of the current challenges stem from the dislocation between health and social care services. This needs radical reform.

The NHS, which was founded in the wake of the Second World War, now needs to be complemented by a National Care Service. Health and social care can then be overseen via the new Integrated Care Boards.

But that alone will not be sufficient. The NHS needs internal investment and reform too. The good news is that change is under way in some key areas.

NHS diagnostic services, for example, have been woefully underresourced for decades, with patients waiting far too long to get a diagnosis.

These delays are a major contributing factor to the relatively worse outcomes for cancer in the UK than in other developed countries. Now, with significant investment by government and the NHS in equipment, workforce and IT, diagnostic services are being turned around. This will take time, but over the past year almost 100 community diagnostic centres (CDCS) have been established and more than a million additional tests have been delivered.

More one stop shops’ will hopefully come on stream over the next couple of years. These bring services closer to patients and over time will take some of the strain off acute hospitals.

Many are being located in areas of high deprivation, where travel to a hospital for scans previously took two hours or more. By separating acute and elective diagnostics, throughput will be improved, delivering efficiencies for the NHS.

As in many areas of the NHS, workforce constraints continue to be the biggest challenge.

More consultants, radiographers and other staff are undoubtedly needed and a start has been made on expanding training places.

It is right that hardworking NHS staff, who have given the country so much, are rewarded for their efforts and it is welcome that the Government has accepted the pay review body’s recommendation.

However, funding for diagnostic capacity must not be compromised. It cannot be one or the other – funding must be provided for both.