The long-term sustainability of the NHS Evidence submitted by the Health Foundation to the House of Lords Liaison Committee

The House of Lords Liaison Committee in March 2016 set out plans to establish an ad hoc committee to explore the long-term sustainability of the NHS.

We argued in our submission that there needs to be an inclusive and honest debate with the public about the cost of health care and the choice we face as a society. Namely how, within the broad funding model, we pay for our health and care as our population grows and ages, and the changes that need to be made to increase productivity and reduce avoidable demand.

Our view is that while the model of a tax-funded health care service – one that is comprehensive and free at the point of use – is sustainable, the funding model for social care may need more radical reform.

To support sustainability we argued that a longer-term and more strategic approach is required across several areas. These include: public health and prevention (as well as action across the wider determinants of health), stable and sufficient funding for health and social care, transformation and improvement of health and social care, and the development of the NHS workforce.

Our submission also highlighted how policymakers and system leaders can support the NHS to develop into a learning health system. Such an adaptive and learning culture is essential if the health service is to deliver improvements in quality and productivity at a time of constrained resources.

We also emphasised that while securing the sustainability of the NHS is essential, it is not sufficient if the aim is providing everyone with the chance of a healthy life. This requires a focus on the wider determinants of health including improvements in access to education, good work and decent homes, a healthy food system and strong communities.