As Simon Stevens makes his first major speech as CEO of NHS England, he has a challenge to change a system that lets our most vulnerable people down. With its' approach comprised of too many disconnected services, our health and care services are antiquated and no longer fit for purpose. Too many people fall through the gaps, with current structures and rules preventing flexibility, information sharing and coordination of services. The towering hospitals of today, large in structure and ambition might seem impressive from the outside. But, inside hospital wards up and down the country, people really are often being failed -often our most vulnerable, including the elderly and people with dementia. Not through ill-will or bad intention, but because of outdated structures, training and practices. All too often the universal NHS services (and frequently the A&E admission) are being called on as a response to failure in an underfunded social care system.
Simon Stevens expresses his wishes to 'completely reinvent' the NHS, noting 'deep seated structural problems'. This is a welcome display of leadership and forward-thinking. An approach we desperately need if we're to gear up the NHS to support our ever-growing ageing population. Realising that a national blueprint for healthcare is not viable is a positive first step. However the real question is how to ensure that every person has access to a personalised, flexible service that meets their needs in a timely, cost effective way.
His understanding that traditional structures of large hospitals don't alone best serve our communities is just the beginning. Currently a quarter of our hospital beds are taken by a person living with some form of dementia. Because GP services and hospital care are so separate, there isn't a holistic approach to care. Too often, people with Alzheimer's disease or another form of dementia arrive in hospital, and are assessed and treated with no knowledge of their past history, despite the fact that this information is available through community services they access every week. Patients should be treated differently, rather than uniformly and health and care professionals need to be imaginative in their approach to meeting the complex needs so many older people have.
The recognition that the NHS 'isn't working' in its current form is a relief to me, having spent years giving a voice to those with dementia receiving a 'care package' deemed fit for someone with a condition, rather than an individual. I'm inspired by Simon's 'can do' attitude, but this challenge can't be tackled by government and health professionals alone.
His speech opens the door to reconfiguring the NHS and social care through work with voluntary sector and through engaging with wider business with society as a whole. Those living with long-term conditions and their carers need regular support close to home. Only by the NHS, social services, charities, businesses and the community working better together will we meet this need.
Voluntary organisations like Alzheimer's Society currently provide face to face support and services locally which give real value to people with dementia and their carers. It makes perfect sense to join up communication between professionals caring for our elderly in the community and doctors faced with treating 'patients' whom they've never met when they arrive in hospital.
Things also need to change beyond the boundaries of our hospital wards and doctors surgeries. With more older people in our country than ever before, society's attitude to ageing and 'the old' needs changing. We cannot afford to rely on healthcare professionals to single-handedly care for older people and those who develop dementia. We all need to become dementia-friendly, being aware of how the condition affects people but also taking steps to support those around us in our communities living with dementia. So much good work has begun through our Dementia-Friendly Communities programme. Hundreds of thousands of people are becoming Dementia Friends. Change is on the horizon, as we see businesses, individuals and local organisations assessing the way they work and whether they provide what people with dementia need.
Simon's suggestion that we need to experiment with new ways of making the NHS work for our ageing population is a refreshing and innovative premise. I look forward to working with him and colleagues in local authorities to make this happen. There are many who we will have to win round. But when we consider that 1 in 3 of those over the age of 65 will develop dementia, it's a reminder of the importance of getting it right.