Labour party conference: a health system close enough to care
Charlotte Pickles
Director
Director
Why, when successive governments have committed to shifting care closer to home, has the opposite happened?
The core architecture of the NHS, was the answer at our first Labour Party conference panel this morning.
Minister for Care Stephen Kinnock, Pharmacy APPG Chair Steve Race, King’s Fund CEO Sarah Woolnough and Community Pharmacy England Chair joined us to explore what it would take to *actually* shift our healthcare model towards one of prevention and upstream intervention.
Three key takeaways…
- Yes, more money will be needed, but we could make the current budget work much harder through funding model reform. Currently, each part of the system is funded in different ways – block grants, payment for activity, payment for results, per capita… and different parts of the system are commissioning different services with a lack of join up. Where block grants are used, but volume is higher than allocated, providers are having to pick up the bill. When it comes to community pharmacies, despite the core role they play, bankruptcies are high because the funding model isn’t working as it should. Fixating on how money flows through the system, not simply the total amount, will help drive the upstream shift. (And handily we discuss exactly this in two recent reports Close enough to care and Prescription for prevention)
- Pharmacies can do more. The Minister for Care put it perfectly: “Let’s never underestimate the vital role pharmacy plays every single day”. They’re at the heart of their communities, trusted by their local populations, and are particularly important in under-doctored areas. Pharmacy First is a great start, but could go much, much further – more prescribing, more vaccinations, more health checks. But to do this, a fairer funding settlement and workforce reform is needed (including looking again at ARRS).
- Data. I know, when in public services is data not one of the current barriers that needs to be converted to a future enabler? But specifically in community services. We have so much data in acute services, pretty good (if underused) data in primary care, and woeful data on community services. Yet this is the area with such strong preventative potential. And, again, community pharmacies could be a real treasure trove of data to underpin population health interventions. Incentivising and enabling better data collection – in a non-bureaucratic way – could make a real difference.