The NHS has addressed many of the challenges it faced in 1997, but needs to change rapidly if it is to meet the challenges it faces in the future, according to a major review of the NHS by The King’s Fund.
The review, which assessed the progress made by the NHS between 1997 and 2010, identified the following successes during this period:
• Significant reductions in waiting times and improved access to primary care.
• Less variation in access to drugs and treatment.
• Significant reductions in MRSA and C. difficile infection rates.
• Sustained reductions in deaths due to cancer and cardiovascular disease.
• Sustained reductions in rates of smoking.
The report also observed that reporting of safety incidents has improved, but under-reporting continues to be a major obstacle, particularly in primary care, and will need to be addressed in the future. It further added that there have been considerable efforts to learn from adverse events, but there is some way to go to create a fully open culture of reporting within NHS organisations. There have also been major reductions in waiting times for most hospital treatments and most patients are seen, given tests and treated within 18 weeks of referral by their GP. However, the King’s Fund concluded that more progress is needed in some specialties and services, which are not included in targets, and warned that sustaining short waiting times might prove challenging as funds tighten in the future. Although life expectancy has improved for everyone, the most significant failure identified by the review is that health inequalities – the difference in health outcomes between different groups in society – have widened since 1997. The report highlighted the fact that targets to reduce gaps in infant mortality and life expectancy between the most deprived areas and the national average have not been met. Other key areas where further progress is needed, include:
• Improving productivity, which has declined since 1997.
• Embedding a stronger safety culture across the NHS.
• Improving cancer survival rates which despite recent progress still lag behind some other EU countries.
• Increasing access to out of hours GP care.
• Tackling obesity and alcohol-related illness which have increased since 1997.
Professor Chris Ham, the new chief executive of The King’s Fund said: “The NHS must now transform itself from a service that not only diagnoses and treats sickness but also predicts and prevents it. If the same energy and innovation that went into reducing waiting times and hospital infections could be put into prevention and chronic care, the NHS could become truly world class. This will not be easy and it is vital that politicians engage in an honest dialogue with the public about the changes needed.”
