Roundup: The morning of day two - as it happened

Niall Dickson

Delegates heard about the future of the health system on the morning of the second and final day of the Confed18 conference in Manchester.

Many of the sessions went along the theme of the second day: estates, legal, and procurement.

The first few hours of the morning began with a series of breakfast breakout sessions, and on-stage sessions.

At one session, delegates heard a talk from NHS Property Services, which explained how the NHS can realise value and improve patient service through the estate. At the same time, another talk was held on how public-private partnerships can support the integration of health and social care.

At another session on moving beyond a single condition model of care, delegates heard that the NHS must better accommodate the needs of patients with multiple conditions. One patient at the session described the challenges she faced in ensuring the large numbers of professionals responsible for her care were kept up-to-date with her medical records.

In the main exhibition hall, Public Health England displayed a walk-around exhibition stand of over a century of 100 years of public health marketing.

The exhibition explained – by means of eye-catching and often hilarious information posters – how the British government started to use mass information campaigns to stem the tide of infectious disease.

The exhibit was divided by era – from the turning of the century to the First World War and interwar period, the introduction of the NHS after the war, the “age of aspiration” through the 60s to mid-80s, and the subsequent “age of fear.”

The exhibition explained how digital technology in the last two decades had transformed public information campaigns into an “age of participation.”

‘Nothing short of a disgrace’

Delegates flocked to the stage mid-morning to hear a keynote address from Niall Dickson, chief executive of the NHS Confederation.

Niall began his remarks to discuss funding needs for the NHS, as underlined in the NHS Confederation-commissioned report.

“Too often it has taken tragedy to trigger change – Hillsborough, Dunblane, Grenfell, and in health Bristol, Mid Staffs, Morecambe Bay, but for us there is now a window of opportunity before tragedy strikes – to act before the service cracks under the strain and is unable to provide safe care.”

Niall called for a reform of regulatory architecture, which affects the relationship between local and national bodies, an overhaul to the current payments and incentives system, and legislative change towards “clarity and simplicity” for the taxpayer.

He lauded how mental health had been brought closer to “towards parity of esteem” in the eyes of NHS leaders but said that social care was “at ground zero.”

“We can’t go on like this – the levels of unmet need are nothing short of a disgrace and they result in unnecessary health costs and unnecessary suffering.”

‘Not just about a new workforce’

Niall’s remarks were followed by a keynote address from Professor Ian Cumming, chief executive of Health Education England.

Ian discussed the need to train and retain the NHS workforce. He noted how in total, 11 million people, or 20 per cent of the population of Britain – professionals and volunteers – are involved in health and care. This number includes 5.5 million unpaid carers.

Ian noted a massive response to HEE’s draft workforce strategy, a document that when finalised will set the direction for the health and social care workforce for the next ten years. 

Ian noted the long length of time that workers tend to stay in the health system.

“This is not just about a new workforce. We also need to remember that by the time we get to NHS80 [the NHS in ten years’ time], 66 per cent, or two thirds of people working for the NHS will still be working for the NHS.”

Ian announced that this year’s Continuing Professional Development budget will be 17 percent higher than last year’s CPD budget – but acknowledged that “it is still not enough.”

He also announced that 3,019 people have so far accept posts in GP training programmes so far in 2018, an increase over the previous year. There was also an increase in the number of people being accepted into training posts in psychiatry, he added.

Regulation – bad or good?

After Ian’s speech, veteran television broadcaster John Humphrys hosted a debate between Jennifer Dixon, chief executive of the Health Foundation, and Peter Homa, the chair of the NHS Leadership Academy, entitled Regulation and inspections: Do they do more harm than good?

“I absolutely believe in regulation, I think it is a force for good most definitely,” said Jennifer.

She added: “I think the thesis is not that it causes harm necessarily but is the burden now too great that it is causing risks?”

Peter noted that outside regulators were at times a port of call for whistle-blowers too “insecure to blow the whistle inside organisations and therefore went to the Care Quality Commission.”

A live poll was conducted from the audience before and after the debate. It posed the question whether regulations and inspections do more harm than good. Before the debate, 52 per cent of audience members said yes. Afterwards, just 43 per cent still agreed.

“That is a pretty dramatic move towards the case for regulation and inspection,” Niall noted after the debate.


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