All Change this Spring: Three Strategic Aims for NHS under Labour

Spring 2025 will be remembered as a rather dramatic, extremely busy and very eventful season for the National Health Service in the United Kingdom.

In our previous articles we considered the Labour government’s initial action plan and how Prime Minister Sir Keir Starmer and Health Minister Wes Streeting are dedicated to fully transform the NHS from ‘Analogue to Digital’ including embracing the latest available technologies.

The leader of the UK government since July 2024, Prime Minister Keir Starmer and his team of government Ministers at Westminster are also keen to oversee the implementation of another important part of their NHS reform: ‘Hospital to Communities’.

The second major shift in NHS strategy for this much cherished organisation that employs around 1.6 million people is ‘Hospital to Communities’. ‘Hospital to Communities’ has also been considered, in our previous article about the latest improvements to NHS services, that the largest publicly funded Health Service in the world is focusing on achieving nationwide. (1)

The third key strategic aim for the National Health Service in England is ‘sickness to prevention’. We will explain and examine this policy announced by Prime Minister Sir Keir Starmer and Health Minister Wes Streeting, here in this article. We will also look in more detail at what ‘sickness to prevention’ policy means in practice, for families and individuals living in England, within our HotEnough.com articles in the near future.

The UK’s Prime Minister and Health Minister have received the results of recently commissioned medical industry expert reports and they have also consulted with several senior NHS leaders, health experts and mangers, since coming to power last summer.

The United Kingdom’s Labour government leaders aim to build a healthier nation by investing resources and launching policy that supports citizens of all ages in the UK, to be able to live healthier lifestyles. Delivering ‘sickness to prevention’ also means introducing new laws that discourage and limit unhealthy habits from forming in the first place. In addition, anyone who is eligible for NHS services, will have access to local schemes and facilities that help prevent health problems occurring in the future, wherever possible.

The ‘sickness to prevention’ reform in more detail

This reform is all about prevention of ill health. Ensuring the best ‘sickness to prevention’ NHS healthcare starts with the best possible maternity services, early years services and children and adolescent services.  Great ‘sickness to prevention’ NHS healthcare also covers adult health services and the senior and elderly health care of our aging population.

Delivering optimal ‘sickness to prevention’ NHS healthcare strategy for people living in the UK of all ages involves many broad health areas and government departments including:

1. Preventing smoking and vaping and related avoidable diseases and illnesses
2. Promoting healthy eating, decreasing obesity and maintaining healthy lifestyle
3. Reducing poverty and ameliorating the effects that financial disadvantage can have on health outcomes
4. Physical health – with more physical activity support and guidance to maximise health potential
5. Social services support to enable citizens to live positive, healthy independent lives
6. Mental health services and improving mental health support available

We will look at all these above areas in further detail, in our next HotEnough.com article about the ‘sickness to prevention’ reforms being introduced by Prime Minister Sir Keir Starmer and Health Minister Wes Streeting and their teams and senior managers at the NHS this year.

NHS England scrapped and major changes in the NHS continue

There is a lot of change regarding healthcare generally and in the NHS in the United Kingdom specifically, at the moment. Some NHS Trusts have been reinterviewing professional medical and clerical teams for their jobs over the last few months, in anticipation of widespread shifts in the way that the NHS will operate going forward, under Labour leadership.

Last month Amanda Pritchard Chief Executive Officer of NHS England resigned from her position after making some controversial comments. Amanda Pritchard has shown an unwavering commitment to leading and raising standards in the NHS but has also been frank about the scale of the challenges the NHS faces.

Senior Labour leaders including Amanda Pritchard have admitted the failure of recent but previous conservative government NHS schemes, like the recovery plan for dentistry, which has resulted in ‘dental desserts’ across the British Iles, with millions unable to access an NHS dentist in their area.

This month Paul Corrigan, who was formally a conservative Member of Parliament under the last government and who has been a senior aide to Labour Health Minister Wes Streeting, warmed that the “NHS may be collapsing” according to the Telegraph newspaper. (2)

Paul Corrigan’s warning may likely be overly catastrophising the situation, considering the slight improvements in the statistics monitoring NHS waiting times and hospital services this month, as the annual pressures of the winter flu season on the NHS ease, as we head into March 2025. (3)

However, despite the incredible contribution made by many thousands of highly qualified professionals and their assistants who strive every day to do their best to serve patients in the NHS, there is much work to do to consistently provide the top-quality public healthcare services for all, in the spirit that Labour leader Clement Attlee envisaged at the NHS’s inception in 1946.

This is especially clear when looking at the latest published data, as shockingly the British Medical Journal reported that last month how “48 000 patients waited over twelve hours on trolleys in emergency departments for a hospital bed in February”. (3)

This demonstrates how much work there is to be done in order to improve recruitment, resource allocation and financial investment all across NHS public health services. The need for enhancing NHS systems ranges from upgrading hospital buildings to providing adequate social care services for service users in their local communities.

It is essential, for example, to enable patients who are relatively well again after hospital treatment, to be able to return home again after a hospital stay so they can be able to live independently at home once more, with the right medical support. (3)

NHS England will be dissolved and merged into a single Labour government led public sector NHS.

This week Labour leader Prime Minister Keir Starmer and Health Secretary MP Wes Streeting announced a major shift in National Health Service structure and leadership as they cancelled NHS England completely. NHS England was an ‘arm’s length’ (from the government) governing organisation or ‘Quango’. The acronym Quango stands for “quasi-autonomous non-governmental organization” and NHS England was set up by the previous conservative government and for the last twelve years has been in charge of managing and delivering NHS goals and services. (4)

Taking back control of the NHS more closely under government leadership with one senior team at the helm of the NHS once more will be a big adjustment. “I’m devolving resources and responsibilities to the NHS frontline.” stated Health Minister and MP Wes Streeting in a government press release yesterday. (5)

The move which may cause thousands of jobs losses, is justified by MP Wes Streeting in order to improve efficiency internally within the NHS. “When money is so tight, we cannot justify such a complex bureaucracy with two organisations doing the same jobs.” explained Streeting who believes this radical change in the way the NHS operates, will improve service standards and waiting times in the longer term. (5)

However, there is no doubt that there is now a large-scale restructuring of the NHS afoot and reorganising such a hierarchical and massive organisation such as the NHS is complicated and complex. Reforming the NHS demands considerable time, money and resources even for a government department that is used to dealing with huge scale projects.  Leading major change is notoriously difficult even in the most agile and flexible businesses.

Understandably sometimes governments need to make tough and unpopular decisions, to ensure that the UK fulfils its key healthcare priorities and commitments, within an uncertain global environment where the world is changing rapidly.

Like several other advanced Western nations, in England, Scotland, Wales and Northern Ireland we have an aging population and we have limited resources.

Public funding for health services in England comes from Department of Health and Social Care’s budget. The Department’s spending in 2022/23 was £181.7 billion and is forecast to rise by more than 4% over 2025/26. An extra £22.6 billion was additionally allocated to support NHS services and the upkeep of NHS buildings and estates in the current Chancellor Rachel Reeve’s Autumn 2024 budget last October. (3)  (6)  (7)

Critics have accused Prime Minister Keir Starmer and Health Minister Wes Streeting MP and their teams of instigating an ill-timed and disruption causing reorganisation. This is at a point in time when many people say the NHS and the amazing people that work for the NHS, are still trying to recover and catchup after the difficulties caused by the pandemic healthcare emergency.

Recent international economic events affecting the energy prices and high inflation negatively impacts how far limited NHS resources can be spent. Restructuring the NHS management comes at a time when there has already been a legacy of austerity and underinvestment in infrastructure and areas like social services and mental health services, for more than a generation. Employee morale has a lot of room for improvement in most areas of the NHS including maternity services and community healthcare, currently.

Writing this week in The British Medical Journal, Hugh Alderwick fears that this new NHS organisation shift will inevitably “waste time and effort that could be spent on improving care instead.” (3)

We hope that many of the several thousand people employed by NHS England who may sadly lose their jobs after NHS England has been abolished, find new opportunities within the freshly streamlined new government led centralised NHS. This reorganisation means that NHS departments will be directly led by Prime Minister Keir Starmer and Health Minister Wes Streeting MP and their colleagues who are NHS senior leaders reshaping the new service and will be responsible for guiding its success.

It is wise to consider that sometimes major reorganisation can be a series of changes that can ultimately be justified as just what is needed in organisations, even if it is hard and painful at the time to go through the huge modifications needed to modernise, develop and grow.

We hope that Prime Minister Keir Starmer and health Minister Wes Streeting’s decisions will in the long term enable the UK to be in the most optimal position and ready to be productive and efficient enough to confidently face the new challenges that delivering top quality healthcare in the 21^st century will likely bring, to the world’s oldest and widely respected National Health Service.

NHS under Labour launch ‘hospital to communities’ strategy – what does it mean?

According to The Health Foundation, Labour’s NHS transformation plan for 2025 is a plan of action that involves three key areas. These are ‘Analogue to Digital’, ‘Hospital to Communities’ and ‘Sickness to Prevention’. (1)

The United Kingdom Labour government’s strategy for transforming healthcare standards centres around striding towards more enhanced local community services.

“The National Health Service needs to move to a Neighbourhood Health Service, with more care delivered in local communities to spot problems earlier. To achieve this, we must over time shift resources to primary care and community services.” states Labour’s election manifesto. (2)

Using the latest technology to deliver better local NHS services

In our previous article we outlined how Labour leaders plan to support the use of Artificial Intelligence (AI) technologies to transform the speed and accuracy of diagnostic services. Amanda Pritchard Chief Executive Officer of the NHS said on BBC Radio 4 Today program this morning that most services have caught up with delayed appointments caused by the extra pressures and disruption of running the health service nationally during covid.

“We’ve seen a reduction in longest waits really significantly over the last couple of years – after Covid people were waiting two years for care, now we’ve reduced the number of people waiting a year by over 50%.” Amanda Pritchard CEO of the NHS said today. Nationally the BBC reported today that more than 25% of people across the country were still waiting more than the NHS target 64 days to commence cancer treatment. (3)

Chancellor Rachel Reeves unveiled a package in her first Autumn budget that announced £1.5 billion of capitol investment for new surgical hubs and scanners. (8)

Offering advanced screening facilities locally, without any delays due to unexpected backlogs, will definitely help service users identify any problems earlier and therefore improve their treatment options. For example, using AI technology has enabled breast cancer screening to be more accurate and this process has been successfully rolled out across the country.

Neighbourhood Health Centres: Labour’s solution to delivering improved GP doctor services

A report by Amanda Dahlstrand, Nestor Le Nestour and Guy Michaels for the London School of Economics studies the cost savings of introducing a variety of online services for patients contacting their local NHS GP doctor’s surgery.

Dahlstrand and her team observe the advantages that “Consulting doctors online offers convenience and accessibility for patients, and the prospect of much needed cost savings.” Reduced contagion risk is another benefit of meeting online when possible.

Access to GP services standards can differ widely according to the area and the GPs available at that location. Making and attending General Practitioner doctors (GPs) appointments has sometimes become difficult in many areas. Last summer a retired lady in Hampshire was amazed to find there were several dozen people in the queue in front of her, when telephoning the GP surgery to book an face-to-face appointment.

“However, older patients and immigrants are more sceptical of online consultations. Given this finding and our results on sorting into online consultations, we explore the possibility that online consultations may be better suited for less vulnerable patients.” Reports Dahlstrand, Nestor and Michaels at LSE recently.

Access and confidence to use digital devices with internet connections and also language barriers can be insurmountable obstacles to communicating with GPs. This can affect older people, those with special needs, those who are living in poverty and people who have recently moved to the UK and/or English is not their first language disproportionately. (9)

Although online video meeting technology has made it possible for GPs to meet with many people in a wide geographical area in much less time than visiting them at home (or traveling to the surgery out of hours) sometimes GP’s have unintentionally struggled to diagnose and pick up non-verbal communication and underlying health problems, that they otherwise would have identified, when spending time with their patients in person.

Prime Minister Keir Starmer and his team envisage integrated health service hubs in each constituency and town with Neighbourhood Health Centres “bringing together existing services such as family doctors, district nurses, care workers, physiotherapists, palliative care, and mental health specialists under one roof.” (4)

Ironically this is a rather unfortunate turn of phrase as we know that the hospital and healthcare buildings that we have in England, Scotland, Wales and Northern Ireland at the moment are often in dire need of repair and reconstruction. CEO of the NHS Amanda Pritchard suggested on radio 4’s Today program this morning that the “NHS needs to consider private investment to improve hospital buildings….and think radically to improve the healthcare estate.”

Adapting or building hundreds of new Neighbourhood Health Centres is not impossible but will be a challenging idea to fund and deliver in every community. If possible, to achieve it may well save money to have many different professionals all in one place and improve residents’ health in the long term. It is questionable whether the increases in NHS funding that Labour has committed to over the next two years will be enough to deliver the hundreds of Neighbourhood Health Centres across the country.

NHS CEO Amanda Pritchard praised the exceptional people that work for the NHS and explained how in her opinion they are all ready for change. Pritchard outlined a difficult situation where despite 25 billion pounds of extra investment into the NHS allocated by the government over the next two years it was difficult to fund all the services and facilities needed nationally.

Talking on the Today program on BBC Radio 4, NHS CEO Amanda Pritchard admitted that currently NHS services provided for individuals at all ages and stages of life were being squeezed by a combination of increased pay rises for NHS workers and professionals, increased inflation and growth in demand every year of about 3.3 percent.

This growth in demand figure is because our aging population demographic in the UK means that people are living longer lives, which is generally a positive trend overall. However, seniors are often living decades with complex health needs that require several different NHS services and professionals to assist and support their lives, especially if they are living independently.

NHS Dental services unavailable: Labour commits to providing a fresh comprehensive dentistry upgrade

Labour’s manifesto promised to transform dental services so every family could access affordable dentistry in their local area. When Prime Minister Keir Starmer came to power last summer it was common to find ‘Dental desserts’ across the country which means that millions of people are living without any services that they can use. This is because private dentist visits are unaffordable for them during a cost-of-living crisis and very few dentists have been taking on any new NHS patients.

It appears that the government incentives for dentists to work in the public service and welcome NHS patients has not been an attractive contract that will result in dentists joining the current NHS payment program. Paying NHS dentists enough money to make it reasonably comparable with private work would mean most of the population could again receive subsidised dental healthcare.

Interim Permanent Secretary Sir Chris Whitty and other senior bosses from NHS England and the Department of Health and Social Care (DHSC) including Amanda Pritchard CEO of the NHS have told a committee of MPs that the dental recovery plan outlined a year ago has failed. A completely “radical” new approach is needed to bring NHS dental healthcare to the entire population once more, as it was first designed when the NHS was launched in 1948. (6)

“NHS dentistry is under pressure – patients and dental teams deserve better.” exclaimed Amanda Pritchard on her Twitter feed last week. Fixing Great Britain’s broken NHS dentistry system is definitely work in progress and more than six months since taking office Labour leaders are still at the consultation stage, in working out how to deliver the radical reform that is needed.

Hospital care waits exacerbated by lack of care in the community, for patients ready to be discharged

Intense annual winter pressures in hospitals throughout the country due to the spreading of seasonal flus and viruses at this time of year are being amplified. This is because of problems with discharging patients well enough to go home with the right NHS healthcare support in the community. This is happening as a lack of social care services, professionals and care assistants who are able to provide care at home to patients who are recently discharged.

High alert levels in hospitals struggling to cope with more demand than services can cope with, is not a new phenomenon. It is a big problem that Labour leaders are keen to tackle and Rachel Reeves announced £25.7 billion in order increase NHS resources to help alleviate these frustrating service bottlenecks. Today the BBC spent a day inside the Royal Free Hospital in North London and found hospital staff having to treat people in corridors as they had run out of space inside one of the capitols hospitals. (7)

Despite thousands of patients receiving excellent care in hospitals all over the UK, many NHS hospital managers are unable to keep the flow of patients moving, ensuring bed spaces are freed up in a timely fashion as the safety of patients at home needs to be prioritised and considered carefully.  (7)

Partnerships with local professionals and businesses will boost community healthcare provision

In addition to doctors, district nurses, care workers, physiotherapists, palliative care, and mental health specialists working together in Neighbourhood Health Centres in the future, Labour leaders are keen roll out their NHS plan to forge ever closer relationships with commercially operating healthcare providers. These companies already provide professional services as opticians, pharmacists and audiologists.

Labour’s manifesto introduces the “Community Pharmacist Prescribing Service, granting more pharmacists independent prescribing rights where clinically appropriate. We will allow other professionals, such as opticians, to make direct referrals to specialist services or tests, as well as expanding self-referral routes where appropriate.” (2)

This is a good practical idea as it uses existing facilities and professionals to provide care to patients without waiting for costly premises to be built or extra personnel to be recruited. However, this system is not perfect for everyone. Recently another retired lady from Hampshire was dismayed at the shock of an unexpected cost of attending an NHS appointment at an audiologist in her high street, who then prescribed an unexpectedly expensive hearing aid.

Quality and quantity: can a vast budget ensure good NHS services for all?

At the end of October 2024, the Chancellor Rachel Reeves announced in her memorable Autumn Budget a £22.6 billion increase in the day-to-day NHS health budget as well as a £3.1 billion increase in the NHS capital budget for this year and next.

Simultaneously over the last six months since Labour have come to power in the UK, NHS wage costs have risen, energy costs have risen, interest rates have risen and the number of people requiring services and the number and complexity of the services required, is growing every day. Incredible as it seems to the average tax payer, the NHS budget of £192 billion is not currently enough resources to deliver the mental, physical and social care that everyone needs.

UK Healthcare leaders need to take action to swiftly introduce significant changes and updates to community services and upgrades to social care services fast. Otherwise, UK resident’s health problems that can be treated by their local community teams through GP services for example, will continue to present when they are progressively more serious and perhaps then require hospital care, when patients inevitably present at Accident and Emergency departments needing urgent help. (8)

Introducing new localised healthcare hubs, in the form of Neighbourhood Health Centres, new computing and communications technology such as the NHS app and fresh ways of working is ambitious and expensive. Ultimately the vision that Labour leaders and the current NHS top team have, may well transform the service for the 21^st century.

It is going to be a bumpy ride, particularly for patients on waiting lists for operations and treatment now. This is a time of great change for the much loved and cherished National Health Service and the amazing people that work hard to provide the NHS services we are privileged to receive in the UK. If departments like social care, mental health services, dental care and maternity care can be massively boosted it will help the whole healthcare system work more efficiently.

In our previous article we looked at an overview about what Labour is planning to do to transform the National Health Service in the United Kingdom. We will look at one of these important aspects in more detail here and consider what Labour leaders are currently doing at this time, to deliver transformation of NHS service standards and performance.

On the ‘Sunday Morning Show with Trevor Phillips’ politics show yesterday Pat McFadden was unsurprised about the 60 or so consultations across different government departments that are being carried out by the new Labour government since taking office in July this year. (1)

According to The Health Foundation, Labour’s NHS transformation plan for 2025 (yet to be launched) is a plan of action that involves three key areas. These are ‘Analogue to Digital’, ‘Hospital to Communities’ and ‘Sickness to Prevention’. We will look at the first of these key areas ‘Analogue to Digital’ in this article and then the other areas in our next few posts soon. (2)

We know that Sir Keir Starmer formed a new government this summer and so from Labour’s point of view, it is ‘early days.’ We understand there are currently more consultations being conducted and we expect a more detailed NHS and healthcare in the United Kingdom plan to be presented by Sir Keir Starmer and his Labour leadership team this Spring 2025, although we do not have a specific date yet.

However, in order to deliver the kind of change that Health Minister Wes Streeting has identified through his consultations with experts and NHS employees, it is crucial to ‘hit the ground running’ in terms of introducing new policy. This is in order to assist the amazing professional people who are currently doing exceptional work throughout the NHS to be able to treat more people of all ages, in better and more efficient ways, without any delays, in the best environment and circumstances possible.

The NHS today is a wonderfully huge and complicated organisation. It is also important to consider that there are United Kingdom residents that are currently on waiting lists for treatment and there are people who may be in urgent need of additional care services, that are not currently being sufficiently provided. These UK citizens do not wish to wait any longer than they need to for their health needs to be met.

We outlined in our previous article what the new Labour government have set out in their manifesto and more recently on their official website. This initial article outlined what Keir Starmer and his Labour leadership team’s general priorities, aims and objectives are for improving the NHS.

Here we will consider what Labour is doing now in order to set the wheels in motion for transforming and updating this great, highly regarded and treasured but often severely challenged public service organisation that is the National Health Service in the United Kingdom today.

Analogue to Digital

NHS: A digital journey

The transition from analogue records to digital records in the NHS has involved introducing computer service networks that were originally designed and launched quite a number of years ago now.

Consequently, it is a difficult (but not impossible) task to upgrade and integrate IT systems physically located in different departments, hospitals and healthcare trusts to run on a secure and confidential system that meets the needs of the latest technology and demands of a variety of different services simultaneously. Sharing of data between doctors, nurses and other healthcare assistants can be crucial to providing holistic healthcare to patients, especially if a person has multiple health problems at the same time.

In the last few years digitisation in the NHS has leaped forward, motivated by the extra demands placed on the NHS during the Covid time.  “By the end of 2022 app sign ups had reached over 30 million. There has been a growth in online booking services, telephone and remote appointments and e-prescribing.” Explained Elizabeth Bell and Tomos Lewis of Blake Morgan. (3)

Digital NHS: the priorities this year

A priority for Labour this year is finding the resources to start “building a robust digital infrastructure” says the private consulting company Simmons and Simmons who describe how healthcare managers under Labour leadership direction will use the latest Artificial Intelligence software. (4)

The new digital plan includes a focus on analysing patient data and improving disease prevention and diagnosis better and faster than traditional scanning ‘by sight’ methods alone. This is already having excellent preventative effects in areas such as breast cancer detection and early treatment. (5)

“An AI tool tested by the NHS successfully identified tiny signs of breast cancer in 11 women which had been missed by human doctors. The tool, called Mia, was piloted alongside NHS clinicians and analysed the mammograms of over 10,000 women.” Stated the BBC in March. (6)

Artificial Intelligence software is also now being used in the NHS at General Practitioner settings and James Tapper at The Guardian has highlighted this development in his article that describes how doctors are using the ‘C the Signs’ A.I. tool. “‘C the Signs’ analyses a patient’s medical record to pull together their past medical history, test results, prescriptions and treatments, as well as other personal characteristics that might indicate cancer risk, such as their postcode, age and family history.” (7)

“AI-driven genomics also enables the NHS to screen new-borns for rare diseases, identifying those at risk before symptoms arise.” (4) says Simmons and Simmons echoing BBC news reporting that recently covered a successful trial program which is now being offered to hundreds more new parents across the UK.

New digital system will improve NHS efficiency

“Labour will pool resources across neighbouring hospitals to introduce shared waiting lists to allow patients to be treated quicker.” is an admirable strategy. This efficiency improvement only works if the organisations involved can communicate seamlessly, in real time, on sophisticated software that can be shared across what can be very different models of healthcare provision. For example: computer record systems in a privately funded healthcare facility and also computer record systems in a traditional NHS Trust hospital facility sharing one patient’s data and information. (2)

Transforming the NHS into a digital service that embraces the latest artificial intelligence driven clinical software solutions is ambitious. It will mean that the technology suppliers that provide hardware and software and infrastructure support for this large organisation will have to meet the demands of a procurements process “known for its rigour and competitive nature”. As Simmons and Simmons advises, new technology suppliers will need to be competitive whilst being able to “meet regulatory standards but also demonstrate value for money and integration capabilities with existing systems.”

Denial of service attacks and malicious interference by hackers are real threats to computer networks with confidential patient data records. I.T. systems need to be designed with the ability for many different healthcare settings to look up and edit patient records whilst ensuring that no security firewall backdoors can compromise the digital computer network. Simultaneously it is important that the whole system cannot be attacked by a spreading computer virus or other malware that could cause havoc throughout the different computer records systems in such a large and diverse organisation such as the NHS.

New digital consultation and managing change in the NHS

As part of a countrywide consultation programme to lead change in updating and improving the NHS for the future under Labour, members of the public, clinicians and experts have been urged to submit ideas for the NHS future plan that is being formed this season. A new government online platform was launched on the 21^st October 2024 called ‘change.nhs.uk’ The new platform has been designed to put staff and patients in driving seat of reform which is an admirable initiative. (7)

It is also realistic to remember that many long-term NHS employees are tired and wary of each successive government and political party that comes into power thinking that they can completely redesign the structure of a very established and hierarchical National Health Service. Every new Health minister and his or her team is keen on radically changing who makes decisions within the organisation and how the health service should operate.

‘Analysis paralysis’ is a factor that may, without some caution, stand in the way of delivering a better NHS now under Labour. It takes time and money to pay consultants to do reports and doesn’t instantly create policies that actually help people to obtain better and improved health. Experienced NHS employees know that this can cause major disruption that does not always lead to a better and more efficient outcomes for healthcare workers and their patients. As with most big businesses and civil service departments all around the world, overcoming resistance to change throughout the NHS and its culture will be a challenge in itself.

Going digital where possible means using technology to work faster and more efficiently which means that communication is improved and resources can be focused on spending time with patients when needed. Working smarter not harder using the latest technology is brilliant. This is especially true in this medical environment where patient numbers are massive as the UK population has gone up and trained doctors, nurses and healthcare providers are in demand as they are relatively (to the number of patients) in much smaller numbers.

More clarity on budgets and a detailed plan for training new and existing NHS employees on the new digital systems is an area that we need more information from Labour ministers and NHS leaders. We need a clear plan that ensures that patients can receive the healthcare that they need with teams of professionals and their assistants that can work together, without being overwhelmed, by patient waiting lists and workload.

We need more detail as soon as possible (most likely early in the Spring of 2025) with a plan from Labour with exactly how these new systems will be procured and who will benefit from improved digital technology across the NHS and which areas and departments will receive these resources first.

This NHS transformation plan will possibly cost more money than even the Conservative Party government was spending on the NHS during extraordinary covid times. Investing in people and the latest healthcare systems makes sense if Labour’s economic objective is growth, as it will create a healthier national workforce. If digital systems are fully invested in and rolled out across the country then this will put the NHS in a confident position to continue to be the much-loved and admired institution it is today and to thrive as we look ahead to better health outcomes for everyone in the United Kingdom as we head into the 21^st century.

What is the NHS?

The purpose of the United Kingdom’s National Health Service is to deliver high-quality services for all. (1) On 5^th July 1948 the National Health Service was established in the United Kingdom. Britain was the first western country to offer free at the point of use medical care to the whole population. More than 75 years after the time of post-World War II Labour Prime Minister Clement Attlee introduced the NHS it continues to be a distinguishing feature of the British welfare state. (2)

Ask almost any member of public in the UK and they will tell you how much they value ‘their NHS’ and how they (or a loved one) have experienced amazing care and support from one or a team of the exceptional people that consistently give outstanding care, around the clock, in every town and city across the British Isles and Northern Ireland.

“The best health services should be available, free for all. Money should no longer be the passport to the best treatment. People should get the best that modern science can offer.” (5)

Pressures for the NHS in recent years

“There is no denying that the past few years have been the most challenging in our 75-year history for everyone working in the NHS.” stated Amanda Pritchard NHS Chief Executive in June 2023. (4)

The UK’s health services, like the rest of the world, has had a very difficult few years dealing with many challenges and pressures. This recent period includes the economic ‘austerity’ years and then numerous pressures during Brexit, the covid pandemic, recruitment and retention issues and strikes about pay from qualified medical staff.

In addition, global economic factors have meant that financial inflation has been, in real terms, eating into the value of the limited resources allocated by central government to fund a universal NHS. Furthermore, the NHS needs to deliver high quality services to a growing UK population, that also has an aging population, who are all more likely to be experiencing complex needs.

Many hospital and medical facilities and healthcare buildings need major overdue investment now. Updating the technology and computer networks needed to efficiently keep secure healthcare records of tens of millions of citizens whilst simultaneously providing instant and appropriate multi-departmental information access across the NHS systems, is also a big and important challenge.

Surgeon Reports that NHS is in Critical Condition

This year Lord (Ara) Darzi, surgeon and former health minister, was commissioned to rapidly review the National Health Service’s performance. “His investigation concluded the NHS is in critical condition” (7)

This summer Labour member of Parliament for Ilford North and Secretary of State for Health and Social Care Wes Streeting declared the United Kingdom’s National Health Service to be “broken”. Therefore, ‘the only way is up’ for the senior Labour politicians who are now in power to work with healthcare leaders across the UK, to transform their beloved NHS. Labour’s vision is to transform the NHS into an efficient and effective organisation for everyone in England, Wales, Scotland and Northern Ireland to be proud of every day. (3) (A222_ref6)

The new Secretary of State for Health and Social Care has been forthright with his damming assessment of the state of the nation’s largest publicly funded service, a year after the latest NHS Long Term Workforce Plan was published. (4)

NHS Long Term Workforce Plan – created by 2019 Conservative government

The NHS Long Term Workforce Plan which was first designed in 2019 under a Conservative government aims to focus on ways to train and retain more doctors, dentists, nurses, midwives and healthcare professionals. The strategy also sets out a direction for reform of the NHS which will improve productivity by delivering the training required to meet service needs, whilst providing extra flexibility. The reform plan includes using technology and smarter working practices to free up clinician’s time to care for patients.  (4)

The NHS Long Term Workforce Plan explains the importance of the workplace environment and culture and how providing a good work/life balance for NHS employees is key. There are other sections of the plan called NHS People Plan and NHS People Promise which fit into the overall aims of the Long Term Workforce Plan. (4)

This NHS Long Term Workforce Plan talks about Urgent Treatment Centres (UTCs) being important to improving emergency service provision.

The NHS Long Term Workforce Plan recognises that many of the illnesses that the NHS treats are preventable and that prevention is better and cheaper than cure. Therefore, the NHS Long Term Workforce Plan funds specific new evidence based ‘NHS prevention programmes’ including: to cut smoking and reduce obesity partly by enrolling people onto diabetes type 2 prevention programmes, limit alcohol related Accident and Emergency (A&E) admissions and to lower air pollution. (4)

The NHS Long Term Workforce Plan outlines the priorities of raising standards for care quality and achieving improved outcomes in the areas of childbirth, cancer treatment, cardiovascular disease treatment, treating mental health (and preventing suicides), treating diabetes, treating multimorbidity and supporting healthy aging and preventing and supporting people living with dementia.

The NHS Long Term Workforce Plan describes how creating Integrated Care Systems (ICCs) that bring together local organisations to deliver the ‘triple integration’ of: primary and specialist care and physical and mental health services and also health with social care.

The NHS Long Term Workforce Plan reflections with a new Labour government

Some of the aims of the NHS Long Term Workforce Plan such as introducing new legislation to prevent young people smoking and training more midwives have been achieved since the NHS Long Term Workforce Plan was first written. (12)

However, there is a lot of work to do for the new Labour government to for example: reduce poverty in families and raise healthcare service standards and access to good quality housing environments. Deliver important preventative healthcare such as NHS dental services, consistently across the country for every household.

Improving working culture and conditions to ensure trained employees are retained in the UK for a long time (and most often for their whole careers) is also critical to building a more efficient and better NHS over the long term.

So now what are Labour going to do to improve NHS services?

11 priorities in the action plan to transform service standards across the UK

1. Cut waiting times

Labour’s official website pledges to build an NHS fit for the future by committing to cut NHS waiting times with 40,000 more appointments every week. Patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment for non-urgent health conditions.  (5)

Sir Keir Starmer and his team started their term in power by negotiating a pay settlement deal with the British Medical Association which means that resident (or junior) doctors and hospital staff will be working consistently every day without any strike action. This will be an improvement in NHS performance as strike action has disrupted recent services at many NHS hospitals around the country in recent months and years. (7)

2. Sir Keir Starmer’s NHS action plan for 2025 and beyond

According to industry experts Labour leaders are introducing a plan which centres around three key areas: ‘analogue to digital’, ‘hospital to communities’ and ‘sickness to prevention’. (7)

3. Analogue to Digital & Modernisation

The new Labour government pledge to double the number of cancer scanners.

A new ‘Fit For the Future’ fund to double the number of CT and MRI scanners (some of which utilise new Artificial Intelligence software) will allow the NHS healthcare specialists to catch cancer and other conditions earlier, saving lives.

Keir Starmer’s plan aims to maximise the potential of clinical trials available to the general public using the latest ‘app’ software technology. This means connecting with more people with certain health conditions via their smart phones.

Labour’s Health Minister Wes Streeting and his team aim to improve the utilisation of the existing NHS smart phone ‘app’ to notify patients about local services information, vaccinations and health checks. (5)

Modernisation

The New Hospitals Programme in progress under the previous Conservative leadership will be fully delivered by the Labour government if all goes according to plan. (5)

4. Hospital to Communities & Transition to Neighbourhood Health Services

Labour’s manifesto idea to deliver “more care delivered in local communities to spot problems earlier.” involves shifting resources to primary care and community services. This means that local communities will also need the financial support to deliver the services that Labour leaders are recommending in their action plans. (5)

A return to community care whenever the availability of specialists and technology allows will certainly be welcomed by people who find it difficult to travel any more than a very local distance to attend an appointment. Travelling out of their neighbourhood is often difficult for residents. This particularly affects the elderly and people who are disabled or unwell, who are the very people we need to support locally if it is possible.

Labour’s official website states that Sir Keir Starmer’s senior healthcare team plan to recruit an additional 8,500 NHS mental health staff to support adults and children. This mental health recruitment drive will need very careful budgeting as it will likely cost more than £250 million in salaries alone, per year.

5. Social Care Reform

Labour strives to ensure that “everyone lives an independent, prosperous life” and social care is key to achieving this outcome. (5)

Two areas that Labour will focus on are inconsistent social care standards and chronic healthcare staff shortages. Labour wants to introduce reforms under a programme entitled ‘National Care Service’ which will be delivered locally (see Transition to Neighbourhood Health Services).

Critics have suggested that the current Labour policy, or lack of a “serious policy agenda” for social care (7) means that reform of care services is currently an afterthought. It is quite possible that more research is currently being carried out by Labour experts into the best ways of improving the vital but complex and ‘failing in many areas’ social care system.

We may find that new Labour policy is launched with confidence soon. However, morale in social care is often low and time is of the essence to fix the NHS care system that is in crisis in several areas such as hospice care and emergency mental health support services.

6. Hospital to Communities

Labour aims to work closely with healthcare providers and trade unions to improve patient services, and terms and conditions and training standards for social care workers. They aim to develop the role of social care workers in the community to provide more support and care services to patients locally, often in their homes. This is part of a strategy to free up hospital beds which will in turn provide better medical services for the most seriously ill who need it most urgently.

This means that more experienced and qualified community care workers can be approved to undertake basic but important nursing duties (that would otherwise involve a trip to the doctors or hospital clinic) and this practice can help people live healthier and for longer in their own homes.

7. Mental Health Provision

Equally Sir Keir Starmer and his senior team are aware of the need to update mental health provision for young people. They have outlined a plan to do this by setting up ‘Young Future’s’ hubs in every community and recruiting 8,500 new staff nationally, whilst addressing outdated mental health legislation. (5)

8. Sickness to Prevention

Labour is launching a new Dentistry Rescue Plan.

Labour’s Dentistry Rescue Plan will include resources to support very young children with education and healthcare for improved oral healthcare.

The Labour manifesto also prioritises the return of the family doctor.  (5)

Labour has committed to delivering the Tobacco and Vapes Bill that was proposed by the Conservative government last year. The Tobacco and Vapes Bill is currently on its final stages in the House of Commons and if approved by the House of Lords it should be approved as law in 2025.

The Tobacco and Vapes Bill will have a major impact on cutting down access to harmful smoking and vaping in teenagers and young adults and be key to achieving the first ‘smoke free’ generation in the UK soon.

9. Expanding services – Dentistry Rescue Plan

Labour plan to provide 700,000 more urgent dental appointments “and recruit new dentists to areas that need them most.” In recent years it has been very difficult to persuade the limited number of qualified dentists to work in rural and other less popular locations and work within strict NHS payment contracts. (5)

10. Expanding services – maternity care

Labour is promising to train thousands more midwives as part of the NHS Workforce Plan which was started by the previous Conservative government.

11. Expanding services – Dementia prevention and treatment

Labour wants to champion a plan that will put Britain at “the forefront of transforming treatment for dementia” (14)

Possibility of the change in UK law regarding Assisted Dying under Labour leadership.

Labour life peer Lord Falconer of Thoroton has sponsored a bill to propose amending the law regarding ‘Assisted Dying’ in the House of Lords which has reached its second reading stage. The ‘Assisted Dying for Terminally Ill Adults Bill has received its second reading this week in the House of Commons put forward by Labour’s Kim Leadbeater. (9)

The Terminally Ill Adults Bill which includes strict safeguards, could enable terminally ill adults expected to die within six months to seek help to end their life if two doctors and a High Court judge verify, they are eligible and have made their decision voluntarily.

Kim Leadbeater explained that this bill could prevent “harrowing deaths” and as predicted it has proved controversial as ministers have expressed concerns that although admirable in its aims, some vulnerable people may feel pressured to end their own lives inappropriately. As with many important moral questions this is a complicated area with many serious aspects and consequences to consider which could have a massive impact on our society in the long term. (10)

Improving NHS services: the big picture

Decisions that are made by the Chancellor and in central government about who, how much and when to fund all the departments involved in running a nation with more than 67 million people have a direct impact on what funds are available to enable Labour’s admirable National Healthcare Service transformation and improvements strategy to be a success.

We will look at all these important strategic areas in more detail in our next article at HotEnough.com very soon. It is admirable to focus on creating the best National Healthcare Service possible fit for the 21^st century.