Thanks to South Tyneside SHA and Iain Malcolm for hosting this event, and for Sharon Hodgson and Emma Lewell Buck for taking the time to come.

Five Year Forward View

Emma Lewell Buck

There was a full discussion, and the following points emerged.

  • There have been drastic reductions on spending on social services and public health spending is set drop.
  • Health inequalities, particularly with children, continue to widen. A recent report highlights this.
  • Budgets for prevention should not be cut. This undermines the Five Year Forward View.
  • Local Authorities need more power to implement effective public health measures.
  • There is universal agreement that health and social care should work together, and there should be more joint working between the NHS and local government.
  • The present legislation puts barriers in the way of this. The present competitive model needs to be reformed. Perverse incentives need to be removed.
  • The original concept of the Sustainable Transformation Plans was of joint working between local authorities and the NHS. This does not seem to be happening. Local Authorities are only involved when the plans have been developed.
  • The original Five Year Forward View talked about “breaking down barriers”.
  • Health could be better delivered on a regional basis. Regional networks have helped public health initiatives such as “Fresh”. The present lack of a regional structure prevents effective plans across the region.
  • There needs to be better democratic oversight of the NHS, particularly if there is integration with local authorities.

This can be summed up as follows:

  1. The NHS, Social Care and Public Health need more funding.
  2. There has to be effective integration of social care, public health and the NHS.
  3. This will probably necessitate legal changes to the present competitive model to a more cooperative one.
  4. Health care can be better delivered on a regional basis.
  5. Sustainable Transformation Plans are not necessarily a bad thing, but must work more closely with local authorities and involve the public more.
  6. Integration must be accompanied by better democratic oversight.
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One Comment

  1. Tony Jewell says:

    The key issue is NHS ‘largely free at the point of use’ and social care ‘means tested’. Until this is sorted it is hard to get seamless integration.

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