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 21st 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.
(1) ‘Labour’s first 100 days in health and care policy’ Leo Ewbank, Jennie Leggat, The Health Foundation, 11 October 2024 ‘Labour’s first 100 days in health and care policy’ Leo Ewbank, Jennie Leggat, The Health Foundation, 11 October 2024
(2) ‘Build an NHS fit for the future’ Labour official website manifesto, 13 February 2025 ‘Build an NHS fit for the future’ Labour official website
(3) ‘NHS boss defends job after critical remarks by MPs’ The Standard online, 13th February 2025 ‘NHS boss defends job after critical remarks by MPs’ The Standard
(4) ‘Government issues rallying cry to the nation to help fix NHS’ Department of Health and Social Care Press release 21 October 2024 ‘Government issues rallying cry to the nation to help fix NHS’ Department of Health and Social Care
(5) Amanda Pritchard CEO of the NHS on the Today program, Radio 4 News and Current Affairs, 13th February 2025 Amanda Pritchard CEO of the NHS on the Today program, Radio 4 News and Current Affairs
(6) ‘NHS ‘recovery plan’ fails to deliver new dentists or more appointments’ BBC News, 13th February 2025 ‘NHS ‘recovery plan’ fails to deliver new dentists or more appointments’ BBC
(7) ‘I spent four days in A&E, but I’m full of praise for the hospital’ – inside the NHS, BBC News, 13 February 2025 ‘I spent four days in A&E, but I’m full of praise for the hospital’ – inside the NHS, BBC News
(8) ‘Rachel Reeves’ budget: £22.6bn health spend increase announced by chancellor’ NationalHealthExecutive.com news website, 30th October 2024 ‘Rachel Reeves’ budget: £22.6bn health spend increase announced by chancellor’ NationalHealthExecutive.com News
(9) ‘How do online doctor consultations compare to in-person ones?’ London School of Economics online, Amanda Dahlstrand, Nestor Le Nestour, Guy Michaels, August 16th 2024 ‘How do online doctor consultations compare to in-person ones?’ London School of Economics