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NHS needs some “creative destruction” to bring in new ways to deliver care, says think tank

BMJ 2012; 345 doi: (Published 10 September 2012) Cite this as: BMJ 2012;345:e6084
  1. Nigel Hawkes
  1. 1London

A fundamental change is needed in the way that healthcare and social care are delivered, the King’s Fund concludes in a new report.1

The focus should switch from structures to services, and “outdated ways of working” that provide poor value for money and a lack of responsiveness to patients should be abandoned, it says.

If the financial challenges that lie ahead are to be met, “salami slicing” of budgets and incremental adjustments to existing services will not be enough. The NHS has fallen behind other sectors such as banking and retailing, where the use of new technology has transformed relations between service providers and their customers, say the authors of the report, Chris Ham, Anna Dixon, and Beatrice Brook.

Ham, the King’s Fund’s chief executive, acknowledged that the message was not new. “So, what’s different this time round?” he asked at a meeting at the fund to launch the report. “How are we going to make it different? What are the routes to improvement?” He suggested that two possibilities were the entry of new providers and the decommissioning of existing services. …

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