The NHS will celebrate its 70th birthday in 2018, after a difficult decade since the global financial crisis culminating in one of the most testing years in our history. The terrorist attacks in London and Manchester, along with the Grenfell Tower tragedy, saw all emergency services, including NHS staff, respond with skill and bravery.
In 1948, at the NHS’s founding, there were no routine antibiotics, anti-cancer drugs or blood pressure treatments, and infectious diseases were common. This has all changed, thanks in part to British science, which has brought the world vaccination, penicillin, IVF, stem cell transplants, artificial hips and MRI scanners, and knowledge of the structure of DNA.
But our greatest innovation by far, with the most far-reaching impact on the health of our nation, has been the NHS. It embodies the British social conscience. Since resources are very stretched, some may question the funding model, and suggest the NHS is not fit for the future. Nothing could be further from the truth. Scientific advances mean it is needed more now than ever before.
Growing up in Africa in the 1960s, I dreamed of moving to Britain and working for its health service. Fulfilling that dream has been a huge privilege. As national medical director I have learned that the NHS will always need to change to match emerging science and shifting disease profiles, and to meet increasing demand within a set budget.
So in the next two years alone we’ll deliver cutting-edge genomic testing for personalised cancer care, a 10% reduction in hepatitis C deaths, and advanced proton beam therapy. And as individual treatments continue to change, so too must the way we provide services: hospitals and GP surgeries still look much as they did when the NHS was founded.
Over the next 12 months we will step up efforts to get different parts of the NHS working better together. Technology will play a part, with more appointments bookable online and greater access to patient records.
Already, in Rushcliffe, Nottinghamshire, extra support for care home residents means they go to A&E nearly a third less often and are almost a quarter less likely to need admission. In Dudley, West Midlands, doctors, nurses and others have worked together to reduce time spent in hospital by the equivalent of 9,600 bed days.
This year NHS bodies in eight places will come together with local councils and other organisations to work as complete care systems, with the needs of patients, not those of institutions, driving decision-making. Local councils can support the NHS through disease prevention via education, housing and transport policies, and social services can help keep people out of hospital. Rather than being the Trojan horse for privatisation that some critics may fear, this is a bold attempt to unite a fractured system and stop people being pushed from pillar to post.
Scientific progress means that soon we will be able to partially predict the future health risk of each child, and hence of the population at large. This science ratifies the wisdom of the founding principles of our NHS, where we share the burden of those risks and pool our money through taxation in order to treat each patient fairly. Our task now as a nation is to enable the NHS to properly adapt to medical advances and public expectations.
This is a challenge. The good news is that, as it heads into its 70th birthday year, we can say that the future of the health service is already in sight in parts of the country, but just not everywhere.
• Bruce Keogh is medical director of the National Health Service in England
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