12th September 2024
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NHS broken but not beaten, says PM following release of Darzi Report
The Prime Minister has responded to the findings of the Darzi Report by promising major reform through the 'biggest reimaging of the NHS'
“I have no doubt that significant progress will be possible, but it is unlikely that waiting lists can be cleared and other performance standards restored in one parliamentary term.” Lord Ara Darzi, author of the Independent Investigation of the National Health Service in England
The NHS “may be broken, but it’s not beaten”, said the Prime Minister in response to the Darzi report, speaking to The King’s Fund on the morning of its publication.
The report by Lord Ara Darzi, a cancer surgeon and former health minister under Gordon Brown, was commissioned when Labour came to power in July, and was completed in nine weeks. It has concluded, amongst many things, that long delays for appointments are leading to thousands of unnecessary deaths, and this has broken “the social contract between the NHS and the people.”
In an analysis of the problems faced by NHS England, Darzi argues that it will take the new government more than five years to restore waiting times to an acceptable length: “I have no doubt that significant progress will be possible, but it is unlikely that waiting lists can be cleared and other performance standards restored in one parliamentary term.” He also says that the NHS must “reform or die”.
Long delays for hospital, GP and mental health services are leading to thousands of unnecessary deaths and have ruptured “the social contract between the NHS and the people”, the inquiry concluded.
People living longer in poor health
In his detailed analysis of NHS England’s problems, Darzi warns the prime minister that it will take his government longer than the five years Labour promised before the election to get treatment waiting times back on track. He has estimated privately that the task will take “four to eight years”.
The report also argues that the NHS is facing rising demand for care as a result of people living longer in ill health, combined with low productivity in hospitals and poor staff morale. Many people are finding it hard to make a GP appointment. “GPs are seeing more patients than ever before, but with the number of fully qualified GPs relative to the population falling, waiting times are rising and patient satisfaction is at its lowest ever level,” the report says.
Darzi draws particular attention to accident and emergency services, which he says are in “an awful state”. He cites evidence he received from the body representing A&E doctors that “long waits are likely to be causing an additional 14,000 more deaths a year – more than double all British armed forces combat deaths since the health service was founded in 1948”.
He also notes the surge in long-term conditions, including a rise in poor mental health among children and young people. A t the start of 2024, 2.8 million people were economically inactive due to long-term sickness, with most of the rise since the pandemic down to mental health conditions, Darzi says.
The report states that the NHS experienced three shocks during the 2010s: austerity funding under the Conservative-Liberal Democrat coalition government; Andrew Lansley’s reorganisation, described as “disastrous”; and the arrival of the Covid pandemic.
Government identify three ‘big shifts’ to fix NHS, including analogue to digital
Darzi says that falling productivity in hospitals was one of the root problems. He argues that the £165 billion annual NHS England budget is “not being spent where it should be” and criticised ministers for their “knee-jerk response to throw more money at hospitals.” The failure to invest in GPs and community care meant that patients have no choice but to “flock to hospitals”.
The prime minister, Keir Starmer, is to respond by promising to work on three fundamental areas of reform, to form part of a new 10-year plan to be published in the spring:
- Moving from an analogue to a digital NHS – what he calls a “tomorrow service, not just a today service”
- Shifting more care from hospitals to communities
- Becoming “much bolder in moving from sickness to prevention”
Speaking on Thursday, Sir Keir is expected to say that the NHS is at a fork in the road, but that he will not raise taxes to meet the increasing costs. Instead, he will focus on reform: “This Government is working at pace to build a 10-year plan. Something so different from anything that has come before. Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.”
“The Darzi review identifies and recognises the challenges that the NHS faces, and it is an accurate and honest reflection of the current state of the NHS. I believe that is through the effective and efficient implementation of innovation across health and social care that we can establish a pragmatic and fit for purpose approach to the challenge. Future Care Capital has experience of identifying and delivering innovation both locally and at scale to support the NHS. It is important that we now focus on supporting implementation and embrace innovative solutions to tackling the existing challenges and boundaries presented in the Darzi’s review.” Dr. Lauren Evans, Director of Research and Innovation at FCC
FCC Insight
The Darzi report, completed in just nine weeks, paints a very bleak picture of the state of the NHS, noting that long waiting lists for treatment are leading to thousands of people dying unnecessarily. The stress on primary care and a lack of community services has driven people into hospitals, which are then unable to cope with the demand.
Darzi is right to point out that this is not just a funding problem, but it will require a rethink in how money is allocated within the NHS – reform must come before any more funding is allocated. It is also not just an issue with needing more doctors or increasing the wider workforce; the lack of productivity appears to be at the central of the issues raised.
The government has said that the 10-year plan to reform the NHS will focus around three key areas – hospital care to community care, sickness to preventative care, and digitising the health service. The innovative use of data, technology and AI will also undoubtedly help with this cultural shift. Recommendations like those from the Tony Blair Institute like creating digital health records and a central database acting as a single source of truth, would support the development, adoption and spread of such technologies across the NHS, supporting the drive to increase productivity. It would also support the move towards a more integrated model of care, enable more data-driven decision-making, create greater efficiencies, leading to improvements in patient care.
The NHS’s fragility is also not solely down to the Covid pandemic and it was already struggling before it struck. One way the pandemic did demonstrate how innovative the NHS can be was when through the issuing of a Control of Patient Information (COPI) notice, all patient information had to be shared for the purposes of Covid-19; in essence, it effectively temporarily joined up datasets from across health and care providers, creating a huge advantage to be able to have a fuller picture of what played out. This bigger-picture thinking has to become the norm.
At FCC, we want to see a fit-for-purpose health and care system. We do this by supporting the acceleration, development and implementation of innovative digital health technologies across these sectors. Our ultimate goal is to improve the health outcomes of all those using products and services across the UK.
If you’d like to explore how we can support accelerating change to create a positive impact, please get in touch at research@futurecarecapital.org.uk.