Yesterday, the Queen addressed the House of Commons and outlined plans on how the UK will recover from the COVID-19 pandemic and grow stronger over the years to come. Those eagerly awaiting firm commitments of how health and social care would achieve this were likely left disappointed as the speech contained little new information and, once again, failed to acknowledge the elephant in the room: social care reform.
Alongside the national vaccine programme, the NHS will receive support to reduce waiting times. This includes an additional (yet previously announced) £29bn ahead of the Spending Review later this year. Capability areas that are receiving funding include diagnostics equipment (£325m), A&E facilities (£450m) and NHS 111 (£24m). What still needs to be addressed, however, is how additional funding will achieve the goal of reduced waiting times, at a more granular level.
We’ve already seen Integrated Care Systems (ICS) incentivised for increasing activity levels, but the NHS needs to work smarter, not harder. In light of a stretched workforce and to avoid negatively impacting the quality of care provided, the NHS needs to become more efficient in how it utilises available capacity and resources, which is where solutions such as intelligent automation and e-rostering can prove their worth.
The plans set out in the Health and Care Bill to integrate care across the country continue to march on, despite calls to halt the rollout of ICSs over fears of privatisation. The bill also ensures that NHS England (NHSE), in its new combined form, is held accountable whilst maintaining day-to-day operational independence. Additional centralised powers over NHSE have long been an ambition of the Tory Government and with the recent announcement of its CEO, Sir Simon Stevens, stepping down at the end of July, we expect to see greater control and influence from Whitehall moving forward.
There was a lacklustre attempt at appeasing those calling for much-needed social care reform. Proposals will now be brought forward to 2021 although there were no further details of a specific bill that would overhaul how the sector is funded. The Local Government Association has continuously fought for reform, but despite numerous promises and affirmations that it remains a priority, it seems that nobody wants to face up to the potential cost of doing so. It wouldn’t raise many eyebrows to see this eventual reform heavily tie into the system-based health and care model with ICSs taking on more accountability and treating social care as a key enabler of reducing hospital admissions.
In a similar vein, preventative care was also highlighted with continued support to address issues such as obesity and drug misuse. The speech also stated that healthier choices would be made easier and more affordable, including treatment support through GPs alongside a ban on junk-food adverts pre-watershed on TV and completely online. This seems to only reinforce the critique of mixed messages from central government after last year’s ‘Eat Out to Help Out’ scheme halved the cost of eating at fast-food establishments such as Burger King, KFC, and McDonald’s. Given social distancing measures and lockdown restrictions have also left many house-bound over the past year, the Government will need to take more affirmative action to promote healthier lifestyle choices.
Whilst not explicitly referenced, the concept of preventative care likely also covers the Universal Personalised Care model, which includes social prescribers who can direct individuals to wider community support and (theoretically) stave off underlying causes of ill health. Again, digital will be a key enabler of this model to ensure those in the field are connected and can point service users towards local support groups and a vast array of online resources.
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The Mental Health Act will also continue to be reformed, which gives people greater control over their treatment. Survey results from the Mental Health Foundation found recently that while there have been notable improvements in levels of anxiety and hopefulness, feelings of loneliness, hopelessness and suicidal thoughts remain abundent. We’ve seen a few examples of procurement activity addressing mental health recently, such as a contract for a digital mental health solution for children and young people across North West London, awarded by NHS Shared Business Services to Kooth Digital Health. The elective care backlog may dominate headlines, but there is also a much less visible mental health crisis building up in the background and so, to deal with demand, self-service tools will be relied upon to supplement face-to-face care.
The speech also reaffirmed the national intention to make the UK a global leader in life sciences, as mentioned in Build Back Better: our plan for growth. The progress made in the fight against COVID-19 is undoubtedly impressive and so it doubles down on these achievements with promises to further research, tackle health inequalities, and bolster the UK’s health resilience. It also highlights the need to partner with industry, the NHS and academia to further scientific innovation, which will hinge on the ability to collaborate, share and utilise the wealth of clinical data housed within the NHS.
Whilst the points mentioned during the Queen’s Speech seem mostly agreeable, more detail and firm commitments are required around the operational strategy of achieving the high-level goals put forth. On the whole, the speech didn’t unveil many surprise announcements aside from the continued reluctance to deal with social care reform and so one can only hope that a decision will be made in 2021. The challenges faced by the UK health and social care sector, coupled with the intention of becoming a global leader in life sciences, will necessitate closer collaboration with IT suppliers and in particular, those that can help the system gradually recover from the pandemic.
