This year marks the 70thanniversary of the UK’s National Health Service, but rather than an optimistic celebration, it’s given us a reason to scrutinise its struggles and work out whether this septuagenarian organisation is on its last legs.

Established in 1948, the NHS was set up as one of the major social reforms following WW2. Its mission was to provide “comprehensive health and rehabilitation services for prevention and cure of disease”, that would be freely accessible to all, regardless of their wealth.

Although adjustments have been made over the years, these principles have been largely upheld. It’s undoubtedly become part of the fabric of our country and has changed Britain for the better. Despite imperfections, it has become one of the most successful state healthcare systems in the world, sparking replica institutions all over the globe. So, where is it all going wrong?

 

Why is the NHS in so much trouble?

The NHS was set up to look after people when they’re sick. Although it’s a good thing that medical advancements are keeping people alive for longer, the result is an ageing population that is suffering from the most-difficult to treat diseases. Ongoing specialist care for illnesses such as heart disease and diabetes does not come cheap. The generation that was born into the NHS – known as the Baby Boomers – are beginning to reach their later stages of life, making them the largest generation to rely on the NHS, stretching its resources to the max.

The rest of the population aren’t exactly pulling their weight either. Too many people are settling into unhealthy lifestyles, putting pressure on the system with treatments for the effects of smoking, lack of exercise and poor diet. On top of this, we no longer expect the NHS to simply treat us when we have a physical sickness or injury. Maternity services, mental health support, social care and vaccinations are all considered a standard requirement.

The foundations necessary to withstand this kind of strain were never put into place, leaving us with a rapidly-failing system that can barely keep up with the minimum requirements.

 

What’s already happening to resolve the problem?

In June, the Prime Minister released a 5-year plan for addressing the future of NHS funding. The plan includes increasing the NHS funding by 3.4% each year (that’s £20.5bn in real terms) so that it can begin to regain control over its basic levels of service.

This money is also geared toward securing the NHS enough for it to start implementing a 10-year plan, which will be decided upon later this year. Key issues will include: meeting agreed standards for performance and care, improving mental health provisions and providing preventative measures to help the population live healthier lives.

Active measures are also in place to try and reduce spending. One of these is to try and keep fewer patients in hospitals by moving their care programmes into local GP surgeries and clinics, but this is putting hospital incomes into jeopardy. At the same time, there’s a movement to centralise services into medical “hubs”, so patients can receive multidisciplinary care under one roof.

Who has the right answers?

Although it’s only right that the organisation’s top management and the government should be leading the way, the very nature of the NHS means that just about everyone in the UK has a stake in the way it works and how it might be improved.

The staff on the ground should absolutely be consulted, as they are the ones experiencing the system’s difficulties first-hand. Their insight about how their local services could be re-organised to save money and perform more efficiently is invaluable.

At the same time, tax payers and those using the NHS have a right to decide how their money is being spent and what, in their view, are the biggest problems with the current setup. A live debate was recently held to discuss possible methods of funding the NHS in future, where audience members could vote to express their preference at the end. More sessions like this, backed by evidence and held at a local level could help to address specific needs within communities.

Maybe a more business-oriented approach needs to be applied. The principle of lean management is already being used within the NHS, which is about reducing waste wherever possible. This includes physical and monetary waste (for example, clinics pooling resources to regulate orders and benefit from bulk purchasing savings) but also intangible ones, like reducing waiting times for A&E departments through triage. A more universal application of lean management could potentially enable larger savings and more effective streamlining across services.

 

Ultimately, the future of the NHS isn’t clear and nor is the best approach for sustaining it. The good news is that despite its current shortcomings, it seems like pretty much everyone wants to see it survive for at least another 70 years.

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