Coalition of 21 health organisations demands political action on health and care

BMJ 2014; 349 doi: (Published 11 September 2014) Cite this as: BMJ 2014;349:g5611
  1. Zosia Kmietowicz
  1. 1The BMJ

A group of 21 health organisations has set out what it sees as essential elements that politicians must include in their manifestos on the future of the NHS and social care, ahead of the general election next May. These included a commitment to adequate funding, a government-wide approach to keeping people well, and an end to top-down reorganisation of the NHS and social care.

One of the groups backing the call—the NHS Confederation, the membership body for commissioners and providers of NHS services—condemned what it called a “summer of silence” from political parties on the challenges facing health and social care. The Royal College of General Practitioners, the Royal College of Physicians, and the College of Emergency Medicine are all supporting the action.

The 2015 Challenge Manifesto1 described where health and care services should be heading and what political parties need to cover when setting out their proposed solutions. It followed on from the 2015 Challenge Declaration published in May, which listed the seven major challenges facing health and care.2 These included the rising demand for care, creating a more open and transparent culture in the NHS, shifting more care to people’s homes while maintaining hospital care, and debating how health and social care should be funded.

The new manifesto included 15 “asks” that politicians should take note of (see box). As well as calling for an end to structural changes in the NHS, the coalition urged new models of care that are politically supported locally as well as nationally, workforce reforms that value staff and secure the workforce of the future, consensus around seven day services, wider programmes to support more self care, and genuine parity of esteem for mental health.

It said that politicians must also decide how the payment system for NHS and care services should be reformed, commit to a £2bn (€2.5bn; $3.2bn) fund to support change for at least two years, and reinstate political accountability for decisions on funding to recognise that more money is needed to deliver more services.

Rob Webster, chief executive of the NHS Confederation, said, “Back in May, the 2015 Challenge Declaration set out the seven major challenges facing health and care. Overcoming these is going to take political courage and a real debate on how to provide the funding and support radical changes in care. Instead we have had a summer of silence, punctuated by announcements on parking, contracting and hospital food. These are important issues but none of them tackle the fundamental challenges.

“Today, we have set out a clear vision of a future health service which is better for patients and is sustainable. We look to politicians of all parties for honesty, courage and substance between now and the general election.”

Gill Morgan, independent chair of the coalition, said, “This document encapsulates the views of organisations representing patients, doctors, nurses, therapists, leading charities, local government, and NHS managers. The evidence for change that is required is unarguable. We now need the political parties to listen to what the experts are saying about the future, if they are to set manifestos that safeguard the future of the NHS.”

The 15 “asks” detailed in the manifesto are:

  • A government-wide approach to keeping people well

  • No top-down reorganisations

  • New models of care that are supported politically at a national and local level

  • Politicians playing a leadership role in ensuring that debates about change focus constructively on the implications for people’s health and wellbeing

  • Flexibility for providers on new organisational models with a clarified policy on provider futures and the foundation trust pipeline

  • A national sector led programme to support self care at scale

  • Workforce reforms that value staff and secure the workforce of the future

  • The government must build consensus around the expectations on the health and care workforce to provide seven day services and provide support to meet these expectations

  • Genuine parity of esteem for mental health

  • Local leaders driving change within a national framework

  • Enabling locally led deployment of new technologies, coordinated information systems, and cutting edge research at pace and scale

  • Longer term settlements for health and care that support service change, with adequate funding to meet demand across health and care

  • Payment system reform to incentivise new models of care

  • A non-recurrent £2bn fund to support change for at least two years over and above this

  • Political accountability for decisions on funding—recognising that health and care cannot absorb current pressures and deliver everything that we currently do without more funding.


Cite this as: BMJ 2014;349:g5611


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