Sunday, 27 April 2025

A once in a lifetime (well mine anyway) opportunity to change UK health care

Last Wednesday, I attended the NHS Confederation Annual Mental Health Network Conference. It was held in the rather grand Cloth Hall Court building in Leeds. Hooray, we didn’t need to travel to London. Sally Warren was one of the speakers*. For those folk who perhaps have not been keeping up, Sally is leading on the development of the NHS 10 Year Health Plan. She has the rather grand title of Director General.

The plan is due to be published in June. Sally was never going to tell the conference what the plan would say. However, she did share information about the consultation around it, some of the emergent themes, and what had been said about current and future mental health services. You can find out more about how the consultation was undertaken and how the 10 Year Health Plan is being developed here.

She started her presentation with a question. If you asked a room full of people, the kind you find on the ubiquitous omnibus, would they like to be in hospital today, what would they be likely to say? I can almost guarantee that nobody would put their hand up and say ‘yes please’. Yet surprisingly, Sally noted that the majority of people would inevitably say that the hospital is the best place to receive their health care.

It was an observation about hospitals noted by many people during the consultation process. However, the number one concern that participants raised was around access. People were concerned that they couldn’t gain access to their GP, A&E or to dental care. When people did get access to health services, they reported experiences that were fragmented and uncoordinated. The more people interacted with NHS services, the more uncoordinated people found their treatment and care to be. Linked to this was a concern, expressed by healthcare professionals. Many felt they couldn’t always maintain their professional standards when providing care to those they looked after.

People wanted what we have now to work better. There was, however, an almost universal agreement that more could be done to tackle the underlying determinants of poor health and health inequalities. That said, it appears that many people found it hard to visualise, and understand, what a future health service might look like. This was particularly the case over the increased use of digital technologies.

Comments from NHS colleagues suggested something similar. Collectively, we tend to underestimate what might be possible over the next 10 years, and overestimate what can be achieved in just one year.

From a mental health perspective, there were several observations that sadly resonate with those of us working in mental health services. Top of the list was a desire for parity with physical healthcare services. There was a particular concern that we should make funding for mental health services compared to physical services, a lot more transparent than the current situation. I’m not sure this will really help achieve parity, sadly.  Stigma still seems to get in the way of folk seeking early help. Rightly so, there was concern that we are still not meeting the needs of children and young people effectively. We need to banish out-of-area placements for people who need a mental health bed; reduce the length of time people spend in hospital; and for those ‘stuck’ in hospital, to find better community-based solutions for their continued care. There was much more to be told, but readers of this blog will have to wait for the plan to be published to learn the full picture.

Intriguingly, the plan, when it is published, will seemingly not have individual chapters on various services. Cancer, mental health or cardiovascular disease for example. However, Sally did not elaborate on how the findings will be presented instead. Hence my intrigue. Of course, having a plan is one thing, implementing it will be the acid test. Arguably, over the course of several different political parties promising to make the NHS better, the social contract between the public and the NHS appears to have been broken. I hope this is not the case. NHS colleagues, local authorities, communities, and voluntary organisations need to hear the voices of those who participated in the NHS 10 Year Health Plan, and act. It really is a once in a lifetime opportunity to change.   

 

*Other speakers included Claire Murdock – ‘be angry and don’t sleep’ and Jim Mackey ‘if you are not living in mental health services, you see mental health as a single entity

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