NHS Confederation: Hospital-based care 'must change'


Andrew Lansley: "It's not about moving people out of hospitals, it's about giving them the best possible care"

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The NHS in England must end the "hospital-or-bust" attitude to medical care, says the body representing health service trusts.

At least one in four patients would be better off being treated by NHS staff at home, figures suggest.

2012 will be a key year for the NHS as it tries to make £20bn in efficiency savings by 2015, according to the head of the NHS Confederation, Mike Farrar.

Ministers say modernising the NHS will safeguard its future.

Mr Farrar said: "Hospitals play a vital role but we do rely on them for some services which could be provided elsewhere.

"We should be concentrating on reducing hospital stays where this is right for patients, shifting resources into community services, raising standards of general practice, and promoting early intervention and self-care.

Start Quote

The old hospital-based system has to develop into a more preventative, community-based system”

End Quote Steve Field NHS Future Forum

"There is a value-for-money argument for doing this, but it is not just about money and the public need to be told that - this is about building an NHS for the future."

Mr Farrar said the required changes included treating frail people in their homes, and minimising hospital stays wherever possible.

Politicians and NHS leaders must show the public how these changes could improve care, rather than focusing on fears over the closure of hospital services, he added.

"Many of our hospitals know that the patients that they are treating in their beds on any given day could be treated better - with better outcomes for them and their families - if they were treated outside of hospitals in community or primary care," he told BBC Radio 4's Today programme.

'Place of default'

Mr Farrar told Today that people had become used to "the hospital being a place of default" and that primary and community healthcare services had sometimes been under-funded.

Mike Farrar, NHS Confederation: "It's much better for a good number of patients to be cared for in their homes"

But he said even where clinicians knew that better care could be provided outside of hospitals, and politicians accepted this privately, the public debate had not helped individuals understand that.

"We need the politicians and the clinicians to stand together with one voice to explain these changes," he said.

"I think the time has come for real political courage on all parties to stand up and say 'if the evidence is clear that my constituents will get better outcomes because they travel a bit further' or indeed that 'if we can release the costs of these beds to make services available in your own homes' - then that's the right thing to do."

Commenting on the new year message from the NHS Confederation, Health Minister Simon Burns said in a statement: "Modernising the NHS will both safeguard the future of our health service, and will deliver a world-class service that puts patients at the heart of everything it does."

The chair of the independent NHS Future Forum, Steve Field, said: "The old hospital-based system has to develop into a more preventative, community-based system."

And shadow health minister Liz Kendall added there would be "difficult decisions" that had to made.

"The NHS Confederation is right to say this will require real leadership from the NHS and politicians."

But she questioned whether the government would be able to provide this as it was embarking on a major reorganisation of NHS structures.


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  • rate this

    Comment number 623.

    @610 Ron

    Your private healthcare is seperate from NHS which is why you are paying extra,if you want to use NHS then go through NHS to start with,not go through your private healthcare then use a NHS bed which should be for people using NHS and cant be as rich and as selfish as you. Private is seperate from NHS and should not cross over,learn the difference.

  • rate this

    Comment number 622.

    Do you deserve a health service Brits? The way you recently rushed to defend the fat cats in the City over Cameron in Europe, makes me wonder. Brits seem to want to help those who eat off thier table. Tug of the forlock, grovelling to the super rich. Thats the Brit. So if your precious health service etc vanishes blame yourself.

  • rate this

    Comment number 621.

    The Duke of Edinburgh did not get treated at home but then he can afford to pay for private care, piggy backed onto the NHS, paid for by taxpayers

  • rate this

    Comment number 620.

    604.nieuw divil
    601 So how come the incidence of infections whilst in private hospitals is a fraction of that in NHS hospitals?

    Do you not remember back in the 1980/1990s the Tories outsourced NHS hospital cleaning to private companies. Cleanliness in NHS hospitals went downhill very quickly, MRSA reared its ugly head, and only recently (during the last Labour govt) has this improved.

  • rate this

    Comment number 619.


    To: 597.nieuw divil

    The 45+ million americans who can't afford healthcare insurance because they are on very low wages, would beg to disagree."

    Plus the more millions who, like my friend, have, say, cholesterol of 6 and can't get cover at any price.

    Most policies don't cover second consultations and such - you can still get huge bills with US style health cover, over premiums.

  • rate this

    Comment number 618.

    Another pack of hyenas threatening our pax-paid NHS from a new Conservative 'Ministry of Lies'.

    If we thought Labour were incompetent, I think you will find that Conservatives are very competent in selling everything you paid/still pay taxes for, to their private health care friends Mr Lansley spent years smoozing with while in opposition.

    A perfect storm for private health company vultures!

  • rate this

    Comment number 617.

    Been waiting 4 weeks for an appointment. Have all the documents, blood tests and previous medication charts that are known to work. No appointment and now to weak, without my medication since November, to make it to any appointment. Friend is smuggling in injection from Russia to get me up so I can leave this damned country and get help. Shut down the NHS it is only working for immigrants now.

  • rate this

    Comment number 616.

    607 I see Kim Jong Un has joined this HYS thread! I wouldn't beleive these made up figures if I were you! Yet again the left make up facts & figures to suit their arguments!

  • rate this

    Comment number 615.

    Alphawasp No moonbeam you do not supply nurses to the NHS, te nurses sign on with your agency and you then make a few phone calls and send a nurse to work a shift. You then charge the NHS her hourly rate plus a hefty percentage on top. You do not add value you increase the cost. Enough said.

  • rate this

    Comment number 614.

    597 nieuw divil

    Most Americans are unhappy with their present healthcare system its very expensive for them the only people who like the system are the wealthy. Most UK citizens would rather have the NHS than the Private healthcare system in the USA but the Americans live in hope that President Obama will make in better during his second term in the White House.

  • rate this

    Comment number 613.

    Good grief. You are all still at it! Please would someone explain why?

    This is all totally pointless and allow the extremophiles to rant away. Well if thats what the BBC want fine, but its not what I pay my licence fee for.

    Come on BBC, what is the point? Moderator, what happens to all this stuff? Does it in any way inform anything?

  • rate this

    Comment number 612.

    The race to the bottom gets faster and faster by the day.

  • rate this

    Comment number 611.

    Patients- stop making appointments to demand over-the-counter medications on prescription, stop making your GP come out to your home when you are capable of coming to the surgery, learn how to treat yourself for common viruses and then maybe there will be more money available in the NHS. As a GP, I despair.

  • rate this

    Comment number 610.

    602 markdoncaster

    Its disgusting letting private patients have 49% of beds, let them build their own hospitals. I agree with a lot the tories are doing but this is going over a red line.
    Err! I pay £740 per year for private health and a further £2,800 or so in National Insurance. The private health brigade still pay for, and thus are entitled to NHS just like you.

  • Comment number 609.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 608.

    210. When do those at the top take responsibility.

  • rate this

    Comment number 607.

    To: 597.nieuw divil

    The only americans who are happy with the standard of healthcare they receive are those who can afford to buy healthcare insurance. The 45+ million americans who can't afford healthcare insurance because they are on very low wages, would beg to disagree.

  • rate this

    Comment number 606.

    A dose of Shock Doctrine & we are ready to lose our NHS, pensions & savings – & barely grumble when massive private bank debts are nationalised thereby impoverishing the future of our children & grandchildren. With all 3 political parties adopting similar lines, global financial interests circling & more wars ‘baked into the cake’, this is just the beginning. Government on behalf of the 1%.

  • rate this

    Comment number 605.

    The issue of people taking their relatives in to care for them instead of leaving them in hospitals is for society to decide. I've lived in a country where this would not even be a question however in those societies many females weren't expected to work and they had child care from elderly relatives and basically they as a family for practical purposes just lived near each other.

  • rate this

    Comment number 604.

    601 So how come the incidence of infections whilst in private hospitals is a fraction of that in NHS hospitals?

    Please think before spouting left wing propaganda!


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