Confed18 highlights | Phil McCarvill

Phil McCarvill

Confed18 covered a range of topical issues, opening doors to information-sharing and expert knowledge and experience. Importantly, it also recognised and heard from past and present NHS staff. Dr Phil McCarvill, chief advisor at the NHS Confederation looks back at the conference and reflects on the things we should take away with us.

There were many highlights from our two days in Manchester, but arguably Confed18 saved the best to last. The star of the show, amid so many other stars, was Ethel Armstrong. Ethel was there on day one of the NHS back on 5 July 1948 when the NHS flung open its doors for the first time, and she was with us in Manchester for Confed18. Anyone who saw and heard Ethel talking about those first days in the new NHS, her 70-year passion for the service and the limitations that were placed on her career choices by 1940s attitudes to social mobility and gender equality, will have been profoundly affected by her words. Ethel wowed everyone there, and along with her colleagues who spanned the NHS years, she was fabulous. Her parting message for today’s NHS and social care leaders: “Value your staff every day.” Not a bad starting point for any leader and not a bad way to kick off the 70th birthday celebrations.

Diversity and inclusion is everyone’s business

It was fantastic to see diversity and inclusion taking centre stage at Confed18. We all owe a debt of gratitude to colleagues like Joan Sadler, Yvonne Coghill, Paul Deemer, Marie Gabriel, Sir Andrew Cash and Sarah-Jane Marsh for giving this crucial issue the profile it deserves and which the NHS and wider system need. The key message to emerge was that while there are brilliant equality champions across all parts of the system, the bottom line is that diversity and inclusion is everyone’s business. From the services that are commissioned and delivered to the people who lead NHS and social care organisations, they all need to reflect the communities they serve.

Money, as ever, dominated many of the conversations and sessions at Confed18. However, the conversations felt somehow different. Publication of the NHS Confederation-commissioned report Securing the future: Funding the NHS and social care to the 2030s has helped shift the political debate about future health and social care funding from one in which the central question is: ‘Should we spend more?’ to ‘How much should we invest and over what time frame?’ Its impact is perhaps best evidenced by the fact that the Prime Minister’s subsequent announcement promised 3.4 per cent per year over the next five years, just above what the IFS and Health Foundation said was necessary to maintain provision at current levels, and significantly above the 2 per cent figure that Treasury sources had previously indicated was in their thoughts only a matter of weeks earlier. It was also interesting to note that much of the conversation at Confed18 had already shifted to focus on how any additional money should be spent.

Focus on digital

It was great to have such a strong focus on digital at Confed18, with members from England, Northern Ireland, Scotland and Wales sharing everything from how they share clinical data to transforming how people interact with health and care services through the use of apps. This is something that we will showcase more of over the coming months.

Another strong and consistent theme across the two days was the renewed focus on system working and system solutions. From dealing with winter to workforce challenges, from digital to wider transformation, the focus was on lifting the pressures that are evident across all parts of the system. Nowhere was this more in evidence than in the discussions about how we simultaneously lift crippling pressures on our acute hospital members, and signal a shift to what happens in people’s homes and in local communities, which the IFS/Health Foundation report makes clear is our best collective hope of beating the rampant demand curb over the next 15 years. The central question being, how can we support more people to get the care they need closer to home? We hosted a breakout session involving Matthew Winn, the chair of the new Community Network, which the NHS Confederation and NHS Providers have come together to establish. The launch of the network is timely, particularly given the thrust of Securing the future and the Prime Minister’s ‘birthday present’ to the NHS.

That all dovetails nicely into a discussion about social care. It was great to be joined at Confed18 by senior colleagues from ADASS for a number of great sessions about integration, system challenges and transforming care. However, despite considerable pushing on the part of ADASS and the NHS Confederation, social care remains firmly on the ‘too difficult’ pile, both politically and fiscally. It was clear from the Prime Minister’s statement that her announcement related to the NHS and that social care would be dealt with ‘in the autumn’ as part of the wider spending review. The annual ADASS budget survey starkly illustrated the scale of the current crisis.

Over the summer we, and I specifically mean those of us representing the NHS, need to keep hammering home the message that we need both a short-term solution to the immediate crisis in social care funding and a long-term, sustainable funding system which once and for all breaks with decades of kicking social care can ever further down the road. Without both, we risk unpicking the good that will come from the renewed investment in the NHS and leave yet more people without the care they need, now and in the future.

Confed18 celebrated the past 70 years of the NHS and continued many important conversations about how we shape the NHS and social care system of the future. Here’s to Confed19 and an interesting year ahead.

To catch up on Confed18, see @nhsconfed on Twitter or visit the NHS Confederation website.
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