New approaches to NHS reform could save £21bn a year, says IPPR

New approaches to NHS reform that decentralise resources and decisions could save £21bn a year, according to a new report.

(c) Anthony/Unsplash

(c) Anthony/Unsplash

The research by the IPPR says reliance on central targets, competition and regulation are less likely to deliver on intended goals and calls for a focus on gathering real-time patient feedback, unlocking staff insights and decentralising NHS resources and decisions.

Dr Annie Williamson, IPPR research fellow, practising NHS doctor and lead author of the report, said: ‘Too many overbearing central targets, too much reliance on regulation and inspections, and putting too much faith in competition as the silver bullet to transform care will not deliver what we need. 

‘Instead we need to make more use of different levers in the NHS toolkit – enabling frontline staff to make changes based on their own insights, gathering and acting on patient feedback in real time, and pushing staff, power and resources from the centre to local health systems. Between them, these are more likely to drive the reform the NHS so desperately needs.'

The IPPR argues its approach could contain DHSC spending at its current level of 8% of GDP by the end of this Parliament, below the current trajectory of almost 10% - equivalent to an annual £21bn a year saving.

The think-tank urges the Government to use three different levers to deliver transformation: unlocking insights from frontline staff; empowering patients and to manage their own care more effectively; and devolving more power and resource so that the system responds better to the communities it serves.

In addition, the report says enabling these approaches could be done through redistributing top managers from central bodies such as NHSE to local health systems and equipping them with a small number of broad targets.

Dame Patricia Hewitt, former health secretary, said: ‘To transform the NHS, we need more than a vision for change. What is required is a ruthless focus on the "how" of reform – an evidenced-based, policy toolkit to turn big ambition into effective strategy. The IPPR provides just that.  

‘As IPPR argues, building an NHS fit for the future means moving away from a centralised, command-and-control approach and towards a model which learns, adapts and improves based on the insights of those who use and work in NHS services. This is a must read for anyone involved in health policy and leadership.'

A Department of Health and Social Care spokesperson said: ‘Our Plan for Change is transforming the NHS and making it fit for the future, devolving resources and responsibilities to the NHS frontline. 

‘We've almost halved the number of central targets in the NHS planning guidance giving local leaders the freedom and autonomy to focus on delivering faster treatments for patients like planned surgeries and emergency care.

‘Our plans to bring the NHS back into the department will eliminate duplication, improve productivity, and free up hundreds of millions of pounds for frontline care and better treatment for patients.

‘The department has carried out the biggest conversation in the NHS' history unlocking the voices of staff and patients alike, ensuring their views are central to the upcoming 10 Year Health Plan.'

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