The NHS at 65: what’s next?

As the NHS passes another milestone, one wonders how 2013 will be remembered. The beginning of a slow and steady decline? Or is 65 the new 45 and the time to re-think the future?

At the Health Foundation we’re optimistic that it’s the latter. While 2013 has not been without its challenges – the salutary lessons of the Francis report, the seismic shake up of commissioning structures in England and the relentless downward pressure on costs – if it’s true that necessity is the mother of invention then perhaps these challenges will spur change. 

There are three areas where the Foundation is looking to help. 

First, we are continuing to create the space for those with the ideas and skills to improve the quality of healthcare to realise their ambition. We have funded ten primary research projects, appointed five more improvement science fellowships andPhD scholarships at eight universtities making a significant contribution to building knowledge of the science and art of improvement. Evidence based improvement will be fundamental to bringing about the change required. 

Second, our work on making care person-centred provides an opportunity to re-think the role of the NHS. Is it time to think more in terms of a health support service rather than a health care service? A service that supports people to live well and make the right choices about the care they need?

Our online resources for shared decision making and self management support are the fruition of seven years of investment in teams working to make care person centred. Changing practice though is dependent on changing mindsets and our Enabling people to live well report provides some fresh perspectives on how health professionals need to re-think the relationship with those using their services.

Finally, patient safety has been an enduring focus of the Health Foundation. Our new patient safety resource centre will help connect people to the latest knowledge and practice in improving patient safety. And in April we published a seminal report on the measurement and monitoring of patient safety. It eloquently argues that while we are in a better place to be able to answer the question 'how harmful has care was last week, last month or last year?', we still struggle to be able to say how safe care is today and will be tomorrow. 

I feel sure that the NHS is too much a part of the British psyche for the current context to challenge its core values, however change is both needed and necessary and the Foundation will continue to play a part. 

Jo is Director of Strategy at the Health Foundation.