The future of the NHS

Here is the NHS plan.

It may appear at first that the NHS has no plan and is haphazardly bouncing from one idea to the next.

Whilst that is true in part (we must all be responsive to outside forces beyond our control), the NHS is moving towards integration. You have probably all heard the term as it’s a buzzword of the moment, but what does it actually mean? It’s not an NHS idea. It’s not unique to the UK. It’s a global movement.

The WHO and OECD are championing integration as a mechanism for

• improving communication in healthcare
• improving the patient experience
• reducing healthcare touchpoints
• reducing healthcare-related adverse events
• improving healthcare cost-effectiveness

Integrated care requires the alignment of provider objectives and incentives. The aim is to break down barriers between healthcare departments and enable cooperation toward the same goals.

Ironically, integrated healthcare aims to do this without creating a monopoly provider whilst preserving a healthy market of provider competition.

“What does this have to do with the NHS?”, you might ask – as the NHS is already an integrated provider.

Here’s the key point.

The NHS is not a provider. In fact, the NHS isn’t a legally identifiable company or business at all. The NHS is a network of thousands of independent organisations with unique contracts, aims, and objectives.

For the NHS to achieve integrated care it needs to create contracts that enable these providers to work with each other for the good of patients. These contracts need to ensure that no provider receives detriment for co-working and can continue to flourish independently without tying one’s fate to the decisions of others who are not within your scope of influence. Alternatively, these businesses need to be encouraged to merge.

So, the future of the NHS isn’t really about providers stepping up to the plate to transform care for the better.

The future of the NHS is about whether commissioners can create legal and economic conditions necessary for safe cooperation and the merging of providers.

Either way – we need to be prepared to be team players – because that’s the only game in town.