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Friday, 16 September 2016

New care models promised in Five Year Forward View may be 15 years away

New models of care outlined in the NHS Five Year Forward View to provide care at scale could take a decade longer to set up than planned and may fail to deliver efficiency savings, NHS Providers has warned.

Developing new care models is ‘much more complicated and difficult than we thought’ and could take up to 15 years to deliver, NHS Providers chief executive Chris Hopson has said.

His comments came just a day after he warned on the BBC's Andrew Marr Show that delivering a seven-day NHS was 'impossible' within current resources and with existing NHS staff levels.

Speaking at a Westminster Health Forum event this week, he said it was a ‘profound mistake’ to believe new care models could be ushered in within five years, after vanguard test sites experienced setbacks.

NHS efficiency savings

He added that there was so far ‘little evidence’ that moving to new care models will release significant efficiency savings once they have been brought in.

Some areas are reportedly finding that it took 12-18 months just to get an initial alignment between what were previously separate institutions – such as the CCG, providers, the local authority and all the GP surgeries, he told the conference.

Others were struggling to devote the vast amounts of time necessary to invigorate change while trying to balance keeping current services running.

He said: ‘As we go round and talk to vanguards, it’s really pretty clear to us that this is much more complicated and difficult than we thought.

‘The idea that this would take three to five years seems to us to have been pretty profoundly mistaken. This is a five to 15 year journey.

New care models

 

‘There’s a clear view around vanguard sites they want to change much, much more than they originally anticipated. They actually find that almost everything they do they want to change – the single patient record isn’t right, the funding model’s not right, the contracting model’s not right, the performance management framework’s not right…

‘We all get the sense that if you want to do this properly, you’ve actually got to change a huge amount, much more than you might initially expect.’

He went on to add: ‘It’s very clear there is little evidence that moving to new care models will release rapid or significant efficiency savings. So for all the people out there who are thinking that new care models are the answer to the funding gap between increasing demand and funding available: it is not going to be the answer.

‘It’s also clear that the existing framework – the way money and regulation works – actually stops you from automatically moving towards new care models. You have to change the model because it’s acting as a pretty big drag on everyone else.’


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