A new lease of life

Think tank: Social Market Foundation

Author(s): Nick Bosanquet; Andrew Haldenby

January 25, 2024

This report from UK think tank the Social Market Foundation looks at three steps to success for the NHS.

The crisis in the NHS, with unacceptable waiting lists and ever increasing emergency admissions, shows the current model is failing to meet modern healthcare needs.

This Social Market Foundation briefing proposes a new model to increase efficiency, shifting care away from the district general hospital towards fewer, specialist teams, more neighbourhood care and greater transparency.

The status quo in the NHS is untenable: waiting lists are unacceptable, experienced staff will be in shorter supply, bed numbers are likely to remain static. Patterns of demand for healthcare have shifted, with the number of patients with long term conditions like respiratory, cardiac, diabetes and anxiety/depression set to rise from 5.3 million in 2020 to 9.1 million in 2040.

But previous experience with early diagnosis and testing of HIV/AIDS and falling mortality rates from coronary heart disease shows that productivity can be increased in healthcare. To achieve this, the briefing recommends that the NHS should replace the district general hospital model with ‘Dynamo centres’, delivering acute services in fewer locations, which could improve productivity by 20% by making more efficient use of specialists’ time. It should invest in integrated neighbourhood teams, which maintain continuity of care, are more cost effective than hospital-based care, and could reduce admissions by 30%.

The briefing also calls for data on the costs and productivity of different services to be collected and published routinely to allow for diffusion of effective methods, and for Integrated Care Services to be given control over their capital spending, with dedicated funds for maintenance and development that can be carried over from one year to the next.