How can the independent sector support Sajid Javid’s burgeoning in-tray?

IHPN’s Policy Director, David Furness, takes a look at what the key priorities will be for the new Health and Social Care Secretary, and how the independent sector can help him to deliver them

Becoming Secretary of State for Health and Social Care and ultimately overseeing a £120bn+ health service which treats over a million patients every 24 hours is always a daunting task. But with a global pandemic that “has not thrown its last surprise at us”, an elective care backlog of eye-watering proportions, potential legislation setting out the biggest reforms to the NHS in a decade, not to mention contending with the perennially thorny issues around social care and staffing shortages, it’s definitely not a job for the faint hearted.

So with the new Secretary of State Sajid Javid facing an array of short and long term challenges, how can the independent sector help support the delivery of his key priorities?

First up is waiting times – as we wrote about last month, NHS waiting times and waiting lists are long and getting ever longer. The latest figures show a record 5.1 million people currently waiting for treatment, and even this number is a huge underestimate given the “hidden waiting list” of over 7.2 million who ordinarily would have been referred for treatment since the beginning of the pandemic.

NHS waiting lists of 6, 7, 8 million or even potentially 10 million may therefore be a reality in the coming months and years as society begins to open back up, and therefore it was welcome to see  Javid his debut appearance in the Commons this week, stating that tackling this backlog will be “an absolute priority” for the Government.

While there’s unfortunately no silver bullet on bringing waiting lists down, independent providers can offer much needed capacity and expertise that will be vital over the coming months and years. Building on the incredible partnerships that have taken place during covid (over 3.2 million NHS treatments alone were delivered under the national NHS/independent sector hospitals contract throughout the pandemic), it’s vital that the Health Secretary endorses an “all shoulders to the wheel” approach to tackling the backlog, making use of all local capacity whether that’s from the NHS, independent or voluntary and social enterprise sector. And with waiting lists the public’s number one priority for the NHS, it’s something the public will expect nothing less on.

The Health and Social Care Secretary’s next priority will undoubtedly be around what to do with the impending Health and Care Bill and how to make a success of the move towards “integrated care.” As with the elective backlog, if new Integrated Care Systems (ICSs) are to get the health system back on track post-covid and deliver more joined up care to an ageing and complex population, then it’s going to need to be “all hands on deck” with local areas making use of all available resources in their healthcare communities. Indeed, there’s much to learn from the response to the pandemic which clearly showed that the NHS is a system of interconnected pieces – including local government, pharmacies, the voluntary sector, social enterprises and independent sector providers – and not simply a set of public sector NHS organisations.

This may sound like an obvious point but there are real concerns across the health system, including from the Nuffield Trust and the Commons Health and Social Care Committee, that the legislative proposals as they currently stand risk the creation of “cosy local monopolies”, which prioritise the needs of providers rather than patients, and excludes innovators. With the new Secretary of State  seen as very much a “numbers” man who demands clear evidence for policy changes, he’d be wise to learn from research looking at integrated care across the world, the best examples of which have been found to be produced by dynamic, open, systems with a meaningful role for independent, voluntary and social enterprise providers.

Finally, and an issue that has not had the same visibility over the last year but is undoubtedly one the new Secretary of State will need to grapple with, is patient safety and the need to ensure a “whole systems” approach. Inquiry after inquiry – whether it’s the case of Ian Paterson or the Medicines and Medical Devices Review into surgical mesh – all make clear the need for more concerted action around patient safety and for organisations across the healthcare system to better communicate and coordinate action to ensure patients are accessing the safest possible care.

The independent sector is already doing it’s bit on this agenda, notably through strengthening the oversight of clinicians working across both independent and NHS providers through the implementation of our Medical Practitioners Assurance Framework. But there is still much more to do on this agenda, and we’ll be working closely with officials in the Department to ensure that everything is being done to ensure patients are receiving the safe and seamless care they deserve.

These are just some of the many, many issues that the new Secretary of State will need to grapple with. And while there are going to be no quick fixes on the treatment backlog, integration or safety, working together with, and making use of the capacity and innovation within the independent health sector, is not a bad place to start.