Independent Investigation Ordered Into State Of NHS

12th July 2024

Professor Lord Darzi appointed to establish the state of the nation's health service.

Report will provide ‘raw and honest assessment' of issues facing health service
Work will be led by Rt Hon Professor Lord Darzi, OM, KBE, a lifelong surgeon and innovator, independent peer and former health minister
Findings will feed into government's 10-year plan to radically reform the nation's health service
Health and Social Care Secretary, Wes Streeting, has ordered a full and independent investigation into the state of the NHS, to uncover the extent of the issues facing the nation's health service.

Mr Streeting says he wants a ‘raw and honest' assessment that will deliver ‘the hard truths'.

Today (11 July 2024), he has appointed Professor Lord Darzi, a lifelong surgeon and innovator, independent peer and former health minister, to lead the rapid assessment, which will be delivered in September.

Its findings will provide the basis for the government’s 10-year plan to radically reform the NHS and build a health service that is fit for the future.

Health and Social Care Secretary, Wes Streeting, said:

Anyone who works in or uses the NHS can see it is broken. This government will be honest about the challenges facing the health service, and serious about tackling them.

This investigation will uncover hard truths and I’ve asked for nothing to be held back. I trust Lord Darzi will leave no stone unturned and have told him to speak truth to power.

I want a raw and frank assessment of the state of the NHS. This is the necessary first step on the road to recovery for our National Health Service, so it can be there for us when we need it, once again.

Professor Lord Darzi said:

As every clinician and every patient knows, the first step to addressing any health problem is a proper diagnosis.

My work will analyse the evidence to understand where we are today - and how we got to here - so that the health service can move forward.

This is an important step to re-establishing quality of care as the organising principle of the NHS.

Amanda Pritchard, NHS Chief Executive, said:

Frontline NHS staff are doing an incredible job, despite the huge pressures they face, to deliver care to over a million people every day, but we know that they face huge struggles and patients are not always getting the timely, high quality care they need.

We will work closely with the government, independent experts and NHS staff to take a detailed look at the scale of the challenges and set out plans to address them - this comprehensive analysis will be an important step in helping us to build an NHS fit for the future.

The Health and Social Care Secretary’s promise to fix the broken NHS was backed by action this week as he met with key figures across the health service.

This included meetings with junior doctors to discuss ending the strikes, and talks with the British Dental Association about rebuilding NHS dentistry. He also visited a GP surgery in north London to see first-hand how the practice is delivering a patient-led service providing continuity of care - a key pillar of the government’s ambition to improve primary care.

Mr Streeting also set out his wider commitment to support the government’s growth mission by improving the health of the nation.

The aims are based on 3 key steps:

cutting waiting times to get people back to work

making the UK a life sciences and medical technology superpower

creating training and job opportunities through the NHS to deliver growth up and down the country

Comment
Some people think this is just kicking the can down the road as surely many of the issues are already well known.

Here is commentary from Roy Lilley NHS Managers.net

I wasn’t just me.

From the evidence of my in-box, probably you as well.

The new secretary of state for health has got off to a bad start.

It is not a good idea to insult people, as he has done with NHS managers. Threaten careers, as he has done with partnership GPs. Neither is it good to undermine the efforts of the workforce by declaring their careers, vocations and workplaces, broken...

... the clear implication, they are in some way complicit in breaking it.

All against the background of there being no plan to sort anything out other than the hope that a few knackered staff can be persuaded to ‘do a bit of overtime’ and be paid with money from tax changes that have no certainty of yielding a shilling.

I’m hearing... his approach has not played well with older and wiser heads in Labour’s high command.

Hence a very smart idea, to calm everything down. Put some space between his indiscretions and the actuality. Bring in a very wise-head to review the NHS… figure out what needs to be done, when and how. Buy some time.

That wise-head is Ari Darzi, international star surgeon and futurist, Lord Darzi of Denham.

He’s done this before. Gordon Brown called him in to lead a review. Most of the recommendations were what I’d call aspirational and spiritual.

The stand out practical policy, Darzi centres. Polyclinics. Aggregating up GP practices into one building, creating the space for them to do more stuff, ended in failure.

Darzi was furious, as well he might. Political interference lead to poor implementation. Denounced by the BMA. Unpopular with GPs.

I was invited to the opening of one. A huge building, resembling a Premier Inn. Home to seven GP practices… all of whom insisted on keeping their individual back-office, practice managers, separate record storage, phone numbers and waiting rooms.

A ludicrous waste of money.

Nonetheless, Darzi is a good choice. He is dead straight and knows his stuff.

I like him a lot. So much so that I thought I’d help by drafting his report.

He will say;

The NHS has suffered from funding austerity, has insufficient supply-side capacity, a dearth of capital investment and until social care is fixed the NHS will struggle.

I know he’ll say that because, it’s the stripped-pine truth. He can say nothing other.

He will also talk about moving care into community settings and the role that technology could play in improving NHS performance.

There will also be words on the importance of stopping people getting sick in the first place and treating staff better.

I know he will say that because nothing much has changed since the last time he said it.

Let’s have a closer look.

Shifting care out of Trusts into the community means shifting the money into primary care and leaving a £ hole in secondary care. As Trusts depend on cross-subsidy between specialties... think, ‘double running costs’.

Bring money.

Shifting care means finding somewhere to shift it to. An Institute of Government report tells us;

22% of GP premises were built before the NHS, in 1948
22.4% of the premises were not fit for purpose
GPs said 88% did not have sufficient consulting room

Bring money.

Darzi made is name as a surgeon of course, but also as a techo-wizard. He will point to the four-week target on reporting imaging and say AI can do it in four minutes. He will make a point of telling us about the role of data in forecasting and reducing demand.

Bring money.

And, I’ll bet a shilling of my own money he will talk about the role of public health in reducing demand.

Public Health is stuck somewhere up a back passage in local government and the NHS’ job is to fix-us-up. There are no people nor money to inspect supermarket trolleys, or fix damp houses.

To know all of this Streeting could speak to the Nuff's, the King's and the Health Foundation. No new report is required.

The real, hidden purpose of this report? To buy time.

All about getting you-know-who out of having to answer increasingly unanswerable questions...

...such as; what are going to do about the demand-supply problems, why haven’t you fixed the strikes and where’s the money coming from.

He can duck and say; I’ve asked Lord Darzi to produce his recommendations ‘at pace’. Here the word ‘pace’ is used as a noun. Without an adjective… ‘fast’ or ‘slow’… ‘pace’ is meaningless.

Nevertheless, Darzi is always a good read.

I look forward to it.