With the NHS nearing its 75th birthday, many are taking this opportunity to reflect on where the NHS has excelled and what is needed to keep it afloat for another 75 years.
The recent NHS ConfedExpo was an opportunity to have difficult discussions and ask tough questions about what is needed to ensure the health system not only survives the next 75 years but thrives during them. The prevailing feeling was that ‘with the health and care sector at a crossroads, the time has come for an ambitious new social contract that empowers the public to take greater control of their own health and experience of care.’
In his keynote speech, Matthew Taylor noted that a thriving health service also requires external change, such as tackling the crisis unfolding in social care, action on smoking, nutrition and exercise, and action on the social determinants of health.
Given persistently high levels of burnout and the continued knock-on effects of industrial action, addressing workforce challenges is still high on the agenda. Luckily, a long-awaited plan has emerged.
Train. Retain. Reform.
The NHS Long Term Workforce Plan, which sets out how the NHS intends to address existing vacancies and meet the challenges of a growing and ageing population, has been backed by the government today. The core elements of the plan are to train more staff, improve retention, and reform current ways of working and training.
As well as training record numbers of doctors, nurses, dentists and other healthcare staff, the NHS intends to increase apprenticeships and alternative routes into professional roles, ‘including new roles designed to better meet the changing needs of patients and support the ongoing transformation of care.’
This plan does not intend to lay a precise path for the next 75 years - its authors admit that precise planning for the next 15 is next to impossible - but it sets a direction of travel.
‘Evidence from our history tells us that the pace of technological and scientific progress means we cannot predict with certainty how the workforce needs of the NHS will look’ in the coming years, but we can ‘commit – as we are – to this being the start of an ongoing process.’
With the plan being hailed as a ‘once-in-a-generation opportunity’ to return the NHS to stable footing, the pressure is on for the plan to deliver results.
World Sickle Cell Day
On World Sickle Cell Day, NHS England announced ‘the creation of new expert clinics to provide specialist care when people need it most, allowing them to bypass A&E.’ This is a phenomenal shift that will massively change the lives of this chronically underserved patient population.
A recent survey ‘found that hundreds of patients strongly disliked A&E and being admitted’, but ‘many of these patients are rushed to A&E monthly due to living with conditions like Sickle Cell’. Many people with SCD have had poor experiences of A&E care at some point in their lives, with many reporting their pain is not taken seriously by staff who are not educated on their condition. The option to avoid these difficult and potentially traumatic experiences of A&E will be life-changing.
Mental health support for rough sleepers
‘Research shows people are around 50% more likely to have spent over a year sleeping rough if they are also experiencing mental ill health’, yet accessing support is often difficult if you do not have a fixed address with which to register.
More than a dozen new clinics are set to offer support to rough sleepers in towns with high rates of homelessness. This is excellent news and will hopefully help improve some of the gaps in access that are being exacerbated by an increasing shift towards a digital-first approach.
Professor Tim Kendall, NHS England clinical national director for mental health,
Commented that ‘while the NHS cannot solve homelessness on its own, we are trying to reach out to homeless people and working hard to ensure that those who need mental health support get it.’
New eating disorder support AI falls at first hurdle
While technology is making substantial improvements to many elements of healthcare, it seems there are some areas that innovations such as AI are not quite ready for.
The National Eating Disorders Association (NEDA) recently closed its human-staffed helplines to allow their AI replacement, Tessa, to single handedly support people seeking help. Set to replace six paid employees and around 200 volunteers, Tessa was intended to save valuable resources and provide faster response times. However, in its short time online, Tessa ‘recommended weight loss, counting calories, and measuring body fat’ - all of which could be triggering for those with eating disorders.
Tessa had quickly deviated from the ‘very specific algorithm’ written by the experts that created it. In a statement issued less than a week after the initial announcement that human staff were being replaced, NEDA acknowledged that Tessa ‘may have given information that was harmful’ and confirmed that the chatbot would be offline until further notice.
For now, it seems AI may be best suited for use behind the scenes of mental health care, freeing up time for staff to focus their time and energy on these crucial patient interactions.