Back to the future?
30th January 2012
The NHS Future Forum recently published a series of reports setting out recommendations for improvements to the health and social care system in England.
The Forum – which comprises 60 clinicians, managers and academics – was originally established by the government last year to advise it on making improvements to the Health and Social Care Bill.
The difference this time is that while the second phase of the Future Forum’s work does include recommendations for government action, a lot of the recommendations are made to a wider range of stakeholders, including NHS employers, statutory bodies and royal colleges (including one recommendation that explicitly references the RCM).
On this occasion the Future Forum was asked to advise on: i) education and training ii) public health iii) information and iv) integration:
• On education and training, the Future Forum recommends that access to education and training is opened up to wider sections of the community and that students are assessed on values and beliefs, not just academic ability. The report criticises providers that are unwilling to offer community placements and calls for the withdrawal of accreditation from poorly performing education providers. The Forum attaches particular importance to the critical role of continuing education and voices concern that some employers treat CPD as an optional extra.
• The workstream report on public health recommends that ‘making every contact count’ is the best way of ensuring that people have a better understanding of how they can improve their health and wellbeing. In addition, NHS staff should get more support from their employers in improving their own health and wellbeing and commissioners of NHS services should be using contracts and incentives to develop policies based on prevention and the promotion of healthy living.
• The report on information starts from the proposition that ‘it’s the patient’s data!’ and that patients need to be genuinely informed patients. But information is about more than data and patients need face-to-face contact and advocacy too. While recognising that it is right to safeguard against leaking or inappropriate dissemination of information, the report criticises the cultural and behavioural barriers in the NHS that prevent more effective use and sharing of information.
• The Future Forum is forthright in its criticism of what it depicts as the lack of incentives for better integration of care. A lot of people need but don’t receive integrated care, whereas disintegrated care is dangerous and wasteful. The solution, according to the Forum, is to build integrated care around the service user, not the provider. Health and wellbeing boards will have a particular responsibility to promote integrated care, especially between health and social care organisations.
So there is much to welcome in these reports and the members of the Future Forum should be congratulated for producing thoughtful reports that combine sound observations, progressive aspirations and sensible recommendations.
Andrew Lansley has been quick to welcome the reports, but doubts must remain as to how the government will interpret the proposals. After all the government accepted all the recommendations made by the Future Forum last year for improving the Health and Social Care Bill, yet the legislation does not appear to be substantially different to the pre-Future Forum version.
Furthermore, many of the recommendations in the report are not new; they have appeared at other times and in other reports. The Future Forum itself draws attention to landmark reports like the 2007 Tooke report on reforming education and training and the 2009 Boorman NHS health and wellbeing review that have yet to be implemented in full.
It is therefore reasonable to ask which of these recommendations will be implemented. The fear is that the reports will instead be consigned to a basement in the Department of Health. The RCM will be monitoring developments and doing what we can to ensure that the Future Forum reports don’t just gather dust on some bureaucrat’s shelf.
