Major shift to preventive care needed to avoid NHS financial collapse, senior figures warn

Health and social care services risk running out of money within just a few years unless 'radical and bold' steps are taken to keep people out of expensive acute care, senior figures have warned.

Professor Haslam: NHS must embrace preventive medicine (photo: Pete Hill)
Professor Haslam: NHS must embrace preventive medicine (photo: Pete Hill)

Unless care shifts from hospitals into the community, both health and social care will 'inevitably' run out of funds within years, according to Jon Rouse, director general of social care, local government and care partnerships at the DH.

NICE chairman and former RCGP chairman Professor David Haslam said the NHS would be sustainable financially in the face of rising rates of comorbidities and an ageing population only if there was a renewed focus on disease prevention and improved population health.

Health minister Lord Howe admitted the NHS would be 'really up against it' in 2015/16.

All three addressed the opening morning of the NICE annual conference in Birmingham on Tuesday.

The comments followed a report by The King's Fund released earlier this month that said a significant increase in NHS funding was needed to avoid a financial crisis in the NHS.

Joined-up action 'essential'

Professor Haslam, whose talk began the NICE conference, said the issue of NHS sustainability was of 'increasing importance' to the NHS and social care amid the squeeze on government spending.

A joined-up, integrated approach to clinical and public health measures is 'essential' to tackle the long-term conditions saturating the health service, he said, and urged politicians to take a longer-term view on preventive health measures.

He said: 'Being more sustainable in our approach to healthcare makes economic sense. In recent weeks I think I've lost count of how many articles I've read and seminars I've been to, all asking the same question: is the NHS still affordable, is it sustainable?

'Well it is, absolutely it is, but that will need much more focus on prevention, much more understanding of the evidence as to how health can be improved.'

Mr Rouse from the DH said: 'We're all having to deal with the most difficult of financial equations. We still have a national annual deficit of over £100bn, a huge amount of work to do to reduce that, and that will be the case - and I can say this as a senior civil servant - regardless of what colour or combination of government we have after next May.'

'Radical and bold'

He added: 'We're going to have to be radical and bold. That's really where the integration agenda is coming from: it's saying, look, we have to make a whole-system shift here. We have to get more activity into people's homes, out into the community, and reduce the need for the most expensive type of care, which is acute care.

'If you don't make that journey, if we don't really accelerate that process of change, then both the health and [social] care systems will run out of money, inevitably, over the next few years.'

Health minister Lord Howe said in a discussion following his speech to the conference: 'We're facing a tough year financially in 2014/15. But in 2015/16, I don't want to disguise from anyone in this hall that we are going to be really up against it.'

He added: 'In many ways that is good, it forces us to look at what we're doing, forces us to look at waste in the system, at unnecessary expense in the system, areas where quality and safety can go hand-in-hand with cost effectiveness.'

John Appleby, chief economist at The King's Fund and lead author of the think tank's report, said: ‘There is still scope to improve efficiency in the health service, and efforts to release savings should be re-doubled. However, it is now a question of when, not if, the NHS runs out of money.'

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