Most people don’t like going to hospital.
Whether it’s the smell, people smoking around the entrance or simply the trepidation of what you are going in there for. NHS buildings are generally old and outdated and while the care delivered in them can be excellent, the hospital experience is one few look forward to. A&Es are often full of people going through mental health crises, waiting hours lying on trolleys in brightly lit corridors. The Government’s Ten Year Health Plan aims to change hospitals by taking much of NHS care away from them – so they are freed up to carry out operations and treat the most seriously ill – and become more streamlined, pleasant places to get care.
The plan has been billed as “one of the most fundamental changes in the way we receive our healthcare in history”. Tests, rehabilitation, mental health and lifestyle support will now be offered in local centres.
Sir Keir Starmer, whose wife works as a nurse, says his plan will “fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps”. Here’s what the new ‘Neighbourhood Health Service’ will mean for you.
Neighbourhood Health Centres
Patients will be offered scans, checkups, straightforward treatment, and broader life help at around 300 new local health centres.
Every area will be slightly different but centres will include doctors, nurses, dentists, pharmacists, counsellors, physios, health visitors, weight-loss specialists and even job advisers. The centres will be open in the evenings and on weekends. Currently Mondays are the busiest day of the week for A&Es and GP surgeries because of the reduced service at weekends.
Brits are now living longer but with multiple chronic health conditions, often spending more of our lives in ill health. Different parts of the NHS currently treat each condition – despite them often affecting each other – leading to patients being “passed from pillar to post”.
The centres will treat the whole patient for all their ailments and aim to keep them well, out of hospital and living independently for as long as possible. By 2027 at least 95% of people with complex needs will be given personalised care plans. Neighbourhood health teams will be encouraged to go door-to-door to spot illnesses early.
The centres will carry out cancer tests and other diagnostics, post-operative care and rehab services. By 2035 most outpatient hospital appointments will take place away from hospitals.
Return of the Family Doctor
These neighbourhood health centres will sometimes include GPs but in many cases will work in parallel to the local GP surgery. They will take a lot of the burden off overstretched GP practices which will also see a recruitment drive to attract thousands of new family doctors in England.
Crucially, the government is promising a return to an expectation that you will see the same named GP on each visit.
Health Secretary Wes Streeting explained: “We want to bring back that family doctor relationship, that continuity of care that particularly matters to people with a range of different health conditions, with ongoing health conditions, who are fed up of explaining themselves over and over.”
It comes after surging demand for GPs and unmanageable workloads led to an exodus from the profession during the last decade, with just over 28,000 now compared with 29,500 in 2015.
Artificial intelligence (AI) systems will be used to take down GP notes during your appointment, and draft follow-up letters. The Government calculates that every 90 seconds saved per GP appointment could save the same time as adding 2,000 more doctors into general practice.
AI call management systems will also see GPs phone lines answered quicker so patients can be better triaged. This is aimed at ending the “8am scramble” to get an appointment.
Most people will come to rely on the NHS App
A key part of the Government’s reforms is the promise to move the service “from analogue to digital”. In practice, this will mean the vast majority of us will routinely interact with the NHS via its app.
When reporting a health concern via the app, AI will be used to triage symptoms and signpost people to the right care. Hospital performance and waiting time league tables will be published and patients will be able to ‘shop around’ on the app to see where they want to go for care.
The NHS will become “digital-by-default” with remote monitoring offered where possible.
Experts have raised concerns that this could leave behind the most vulnerable and frail if they are unable to navigate systems. Ministers insist that most using the app will free up phone lines for those who are uncomfortable using the tech.
But will we see drastic NHS improvements without fixing social care?
Currently 12,000 hospital beds are filled every day with elderly and frail people who are medically fit for discharge. So-called “bed blockers” are taking up much of our hospital beds because of a collapse in social care.
Hospitals have a responsibility not to discharge people if there is nowhere safe for them to go. This usually means they may need a care home place or home visits arranged to help the elderly live independently.
The Government has made bold promises on reforming social care but the timeline for substantial changes may run into the next Parliament. It has launched an independent commission into adult social care, chaired by Baroness Louise Casey, tasked with setting out the plan for implementing a National Care Service. It will produce a first report by 2026 but only make “longer-term” recommendations for the transformation of adult social care by 2028.
Professor Martin Green OBE, chief executive of Care England, which represents care homes, said: “This is a plan that talks our language – prevention, personalisation, community-based care. But we’ve heard similar aspirations before, and the challenge has always been implementation.
“Neighbourhood Health Services could transform how people experience care. But without social care at the centre, they risk becoming a brilliant idea lost in translation. If we’re serious about delivering care closer to home, we must start by backing the sector already delivering it.”
