HCL Issue 10 - Page 29

29 key’ and that ‘as we move towards ICSs, we’re bringing everyone together to make collective decisions about how you spend the Barnsley pound or the Brighton pound’. Minimising the competitive element that has at times characterised relationships between different parts of the health sector can, she says, only be a good thing. ‘In the past there’s been a bit of either the commissioner wins at the expense of the provider, or the provider wins at the expense of the commissioner and we need to move away from those scenarios. ‘We’re all in it together to do the best for the population that we collectively serve,’ Ms Wood says. She does not, however, believe this collaboration drive should take the shape of amendments to the law. ‘We need to make these changes in the existing statutory and legislative framework because major legislative change will stop everybody in their tracks, focusing them on the next reorganisation without delivering transformation in services and outcomes,’ she says. Join up care, embrace prevention and ensure the right patient goes to the right place at the right time, with the right outcome ‘Boost for community-based services’ Ms Wood was pleased to see the long-term plan place greater emphasis on primary and community care than has traditionally been the case in the NHS, alongside a shift towards prevention and keeping patients out of hospital as much as possible. Noting the long-term plan’s ‘welcome boost for community-based services’, she adds that ‘keeping care out of hospital and in an extended primary care setting through primary care networks – so we have less demand on hospitals and patients are treated closer to home’ – is essential to the continued viability of the NHS. ‘When we set up the NHS on a hospital- based model in 1948, accidents and infectious diseases dominated. Today, as a result of medical advances, public health interventions and lifestyle changes, long- term chronic health conditions provide the greatest burden of disease,’ Wood says. ‘So we need to design delivery of care that responds to very different needs.’ This, she argues, not only includes ‘prevention as a key priority’ but also social care. ‘We need to invest outside of the acute sector,’ she says. ‘Yes, we absolutely want a high performing acute sector but we also need highly performing and effective primary care, prevention, community and out-of-hospital services’. It comes back to that health system word of the moment – integration. ‘Join up care so it’s not fragmented, embrace prevention and social care, and ensure the right patient goes to the right place at the right time, with the right outcome. It sounds very simple but it’s awfully complex to deliver. However, that’s the challenge if we are to have an NHS that is fit for the future and can meet the population needs as we move forward’. Healthcare Leader 2019 Issue 10