Julia Manning is Chief Executive of 2020Health.

Rarely a week goes by without another conference or speech in which it is declared that the NHS is facing a financial crisis and that ‘something has to be done’ about it. Earlier this week, the new NHS England CEO, Simon Stevens, in front of the Health Select Committee said there needed to be a review of what action needs to be taken to put the NHS on a sustainable footing and that he would spend the next 180 days considering this.

Today we bring out the second of our ‘Healthcare and the Economy’ reports: Going with the flow featured in today’s Guardian and subject of ITV’s Tonight programme at 7.30pm this evening. The title reflects our thinking that we need to heed the public and the wisdom of the crowds. Put simply, our ideas include:

  • People like their local hospital – so let’s be more transparent about costs, planning and diversification opportunities. Simon Stevens calls this ‘getting creative’. Let’s look at the mutual models – Foundation Trusts haven’t worked.
  • Let’s also keep it simple and colour code hospitals so people know what is a specialist centre (Blue) and what is a local hospital (Red)
  • The public don’t get the financial reward for health improvements that GPs do, e.g. quitting smoking, reducing blood pressure etc. Yet programmes in Scotland show giving incentives such as grocery vouchers to quit smoking are twice as effective as any other intervention. We should copy what works.
  • Communicating the financial challenges much more clearly with the public. Demographic changes will mean proportionally fewer tax payers supporting more older people living longer – long term raising taxes or NI will be punitive for those in work. A National Financial Plan should be produced so the public understand the cost pressures in health and social care.
  • A National Service Guarantee should be devised to end the postcode lottery, being clear on the basis of cost-effectiveness and cost, what treatments are excluded from the NHS across England.
  • People should be allowed to top-up for the latest technology: it is disingenuous for the NHS to say it will always give you ‘the best’ treatment. Allowing top-ups is not about income generation – it will incentivise innovation, drive reduction in costs to market of new technology and ultimately speed up access for all.

As we say, this isn’t a comprehensive to-do list. There is more to come. But we can’t keep wringing our hands from the sidelines saying ‘something has to be done’ – we need to get on and do it. Hopefully, kind edit allowing, more of these ideas will be aired on ITV’s Tonight at 7:30pm, Thursday 1st May which we filmed before Easter.

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