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Grant Thornton responds to Lord Darzi’s report on the state of the NHS

Redirecting care and funding, and moving away from short-termism are key to building sustainable services, says Peter Saunders, Head of NHS Financial Advisory, Grant Thornton UK LLP: 

“Lord Darzi’s investigation into the NHS in England highlights a stark picture and one that is already well known to those who work in or with the NHS or use its services - that the wide-ranging challenges it faces are significant, multi-faceted and complex.  

 

“Many are now familiar with the challenges around access and waiting times but Darzi’s report has given us a clear snapshot of the impact this is having. The deterioration in cancer and cardiovascular treatment and the raiding of capital funding to prop up hospital finances is unsustainable and demonstrates the significant impact on productivity and on the service’s ability to provide effective care and treatment.

 

“Unsurprisingly, there were no real statements around the level of funding the NHS should have, it focuses more on how funding and investment should be targeted and best used. It recognises that continually giving money to finance hospitals is neither sustainable nor effective – instead focus should be shifted towards out of hospital care and funding directed towards capital budgets.  

 

“Darzi’s analysis that £37billion of capital funding - which would have effectively cleared hospital backlog maintenance, funded new hospital builds or refurbished GP surgeries - had been redirected to fill revenue gaps, is concerning. It’s clear that funding flows and finance solutions for capital need to be reformed. But also, that any investments being made are targeted and planned effectively.

 

“Moving the focus of care towards primary, community and mental health is something that everyone in the NHS knows is needed, if services are to be improved and sustainable in the long-term. Darzi points out that funding and financial incentives need to shift to enable this as the current funding and payment mechanisms support and incentivise hospital care. Community and mental health services will also need prioritisation, support and capacity if this is to be delivered.

 

“The importance of social care reform to support the NHS is recognised within the review but a clear plan and rapid actions are needed. Often NHS plans do not integrate or prioritise social care as a core element, but it’s critical that it is front and centre of any plans moving forward.  

 

“As we have previously called for, the NHS needs to be supported in moving away from short-termism and towards longer term planning and funding settlements that provide certainty, if it is going to be able to effectively address the challenges presented. As emphasised by Darzi, and the initial government response, the remedies and fixes are not quick, and we are unlikely to see notable improvements in the short or even medium term. But it’s crucial that this does not deter action and that steps are taken now if we hope to revive our critical national health service.” 

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