A new ResPublica publication

The National Health Service is at a critical juncture in its long and illustrious history. Tighter public finances brought about by the most significant programme of fiscal contraction for a generation, together with an ever-ageing population, mean that the current system of healthcare enjoyed by all in England is simply unsustainable.

Under current arrangements, the NHS in England will see a funding shortfall of £34 billion by 2021/22 and it is predicted that long term conditions alone will bankrupt the health system before the end of the decade.

Power to the People: The mutual future of our National Health Service argues that the key to saving one of our most valued institutions would be to move away from the bureaucratic and fragmented health system we currently have, towards an integrated system of healthcare provision that makes it possible to offer whole-person, holistic care to patients. This report highlights the valuable role mutuals could play in integrating disparate public, private and third sector bodies to both improve patient outcomes and plug the impending funding gap.

The rewards of institutional reform are real: successfully integrating current health care provision would drastically reduce A&E admissions and save the NHS at least £4.5bn over the coming decade. These savings ignore the additional gains that could be had from integrating and tackling unreformed residential care and unaddressed public health concerns. This would, in short, help to ensure that the NHS remains free at the point of use without the need for additional taxation or charging.

The new, mutual-centred model of integrated care envisaged in this report would be completely funded within the current efficiency commitments established under the Quality, Innovation, Productivity and Prevention (QIPP) programme, and would realise further savings of £4.5 billion through providing more integrated and community based services. As part of this new system, a revised role for Monitor, the economic regulator for the NHS, would also need to be developed, with a more pro-active role envisaged that has integration at its heart.