A wise man once said that “the NHS is the best gift a nation ever gave itself”. And throughout this incredibly tough year, at this national time of need, the NHS has been there – as it always is – standing tall to protect us.
But, we all know that this battle against coronavirus is not over yet. And you know better than anybody that the number of hospitalisations are on the rise and we must get this virus under control. And we have seen the very real risk of the NHS being overwhelmed, and so we have acted quickly to make sure that we put in place our new national measures. Because we cannot do this without you, without the NHS. People understand, people feel very deeply, the need to do what they must do to make sure the NHS can be there for us all.
And while we are rightly focused at this moment on the demands of the pandemic and we have thrown everything we have got at making sure that the NHS has what it needs this winter:
- with the extra funding and the Nightingale hospital standing ready once again if needed
- with the increase in the number of doctors and nurses and other staff
- the returners which come back to our wards
- and the upgrades to almost every emergency department in the country
We all know what a huge task is going on right now. But I also today want to cast our eyes forward, to look ahead beyond this critical day-to-day work that we are doing in response to coronavirus and ahead of this winter. I want to ask some crucial questions about the long term, about how we can use the lessons that we have learnt during this crisis to build a better health service for us all.
I have seen so many examples this year of systems working together for the benefit of patients, because that is what system working is all about. I have seen it where hospitals are under pressure with numbers of coronavirus patients. And making sure that the whole NHS comes together to ensure care can be provided.
I have seen healthcare teams working side by side with charities and community groups to offer clinics for hard-to-reach patients. I have seen the phenomenal effort to look after rough sleepers – working together across the system, with local authorities and the NHS side by side. From housing to the NHS, to public health. All to protect the most vulnerable.
I think, in fact I know, that the system works best when it is empowered to work together, when the relationships are strong. And crucially when we remove barriers to our cooperation wherever we find them. To support a better, less fragmented set of decision-making. And to allow the well-rounded care which is vital in a world of complex interrelated conditions.
So, while we work on the day-to-day, so we must learn from how the day-to-day works well and drive this agenda forward, building on the NHS Long Term Plan and working towards a system as the default approach by next year. A systems approach can best serve the interests both of patients and of course of those who are giving the care within the NHS. Because it can give leaders the backing they need to empower them to solve problems in their area. So, whether it is, for instance, breaking down the barriers between community and hospital care, whether it is the joining up health and social care, making sure that prevention and public health agenda are tied together with treatment.
Integration of course is not a ‘silver bullet’ for all problems in healthcare, not by any means. But if we bring to bear the whole wealth and diversity of experience that exists in a local community and learn from where things go well, then we will have a much better chance of helping people live healthier and happier lives for longer. That, after all, is what it is all about.
But building a better NHS is not just about the structures and the systems. I know from talking to so many of you that it is about the culture too. Now of course the culture is underpinned by the legislation in which we operate and by the financial structures that are put in place. But there is an unspoken ethos that drives any organisation. And we must ensure that the culture of how we work together embraces innovation and new ideas and embraces collaboration rather than a silo approach.
During the demands of the pandemic, we have seen how people do their best work because they were trusted to do their job. And here too I want to take forward the lessons that together we have learnt by:
- shedding unnecessary bureaucracy that gets in the way of doing your job
- intensifying our use of the most transformative technologies so that people and clinicians can do their best work and spend more time with patients
- and making it easier to bring the right qualified people to the front line, like of course those returnees
- and like the way we are allowing more people with more clinical qualifications to be trained in order to participate in the vaccination programme
So this is what is behind our People Plan. For the first time ever we have a Chief People Officer in the NHS and Prerana Issar is absolutely brilliant. She has put together a People Plan which is not a single document, it is a whole series of interventions all about showing how we will improve the support we offer to colleagues across the NHS. From practical support like better rest facilities which are so important to people, to the emotional support that is so vital. Every single person working in the NHS has contributed to the unprecedented national effort to beat back this virus and save lives.
And I will do my utmost to protect and support you through this pandemic and beyond. And through our People Plan we will constantly strive to make the NHS a brilliant place to work, that is central to delivering on the promise that the NHS holds out for the people of this country and the patients who we look after and the citizens who we serve.
Now of course coronavirus has also shone a light on some of the inequalities of our health system and the disparities you can find in your health and healthcare depending on your background, where you live, what job you do. We all need to keep working to level up health and care provision. In the same way that as a government we want to level up in education, and housing and so many other areas of our society. And one of the ways that we can do this is by strengthening our public health systems. Not just the standing capacity to respond to future threats to public health through the new National Institute for Health Protection. But also the vital health improvement work. Improving people’s health, which of course improves quality of life and making sure that we support people to get the very best that they can out of life, by making sure we support people to improve their own health.
Now central to this is tackling obesity. And in fact, the coronavirus epidemic and the link from obesity to morbidity has shown yet again how important this agenda is. Our new obesity strategy, which builds upon work of the past, is full of measures to help people make healthier choices.
But there is so much more to do across the whole spectrum of health improvement. We want to embed health improvement more deeply all across the board. And I see this as a critical moment to ensure that we don’t parcel out health improvement and see it as something separate. But see how health improvement is and must be embedded in the work of the NHS, local authorities and so many government departments.
We know that we can help more people to stay out of hospital in the first place. Just as we know that they will get the very best possible medical care when they do come into the NHS. And we all have to lean into the health improvement agenda, especially in primary care. When done right, health improvement has always been at the core of its responsibilities.
Now I know that this has not been an easy year for the NHS. But I also know that when people look back on this tough time in our history, they will be awed by the outstanding contribution that has been made by so many people. And so many people that are taking part in this conference today. You have been there for us, just as you always are. So, I would like to thank you once more, for your incredible efforts and for the efforts that are still to come. You show the country at its best and all of us are in your debt. Thank you.