Think tanks echo Confed call for transformation fund

Two pound coins

The health service in England needs a dedicated fund to finance and drive forward essential changes to services, a new Health Foundation and King’s Fund report has concluded, echoing long-standing calls by the NHS Confederation for such a measure.

In a detailed report published on Wednesday (22 July), the think tanks say a transformation fund would support and accelerate a shift to new models of care, as per the Forward View, and help to unlock efficiency savings.

It would require £1.5 to £2.1 billion a year in dedicated funding between now and 2020/21, the organisations say, adding that It must be adequately resourced to support investment in staff time, programme infrastructure, physical infrastructure and double-running costs.

"We’ve been arguing for some time for greater resources in transformation to cover the double-running that is often essential for change to be effective," the NHS Confederation's director of policy, Dr Johnny Marshall said on Wednesday. 

"Too often investment has been allocated under the assumption that new services will automatically replace the current model and deliver benefits immediately." 

The organisation has welcomed the report, fully supporting its call for a national fund.

The recommendations

The report, Making change possible: a transformation fund for the NHS, recommends:

  • The NHS needs a single body (whether within an existing organisation or newly created) to oversee the investment for transformative change in the NHS. It should have strong, expert leadership which is credible to clinicians and managers.
  • The transformation fund requires £1.5–£2.1bn a year in dedicated funding between now and 2020/21. While bringing together existing strands will go some way towards this, more resources will be needed above the £8bn increase in NHS funding already announced by the government.
  • The introduction of the fund would involve two phases:
    • The first phase (2016/17–2020/21) would be split into two strands: an Efficiency Strand, which would look to achieve higher rates of efficiency growth across all services, and a Development Strand to invest in new models of care. 
    • The second phase (2021/22 and beyond), would focus on widespread roll-out of the successful new models of care. This would include double-running’ costs associated with these new models.
  • Key to successful change is the engagement with, and investment in, staff. At its heart the task facing the NHS is to get over one million people to work differently. To do this, front-line staff must have time away from the day job, and this won’t happen unless it is properly resourced.
  • Further consideration should be given to generating transformation funding by the development of the NHS estate into a long-term sustainable source of new income.

'Business as usual'

Dr Marshall also said: “Our members firmly believe transformation funding will need to be clear and spent in an accountable way to ensure the money set aside really does transform services, rather than being spent on business as usual. 

"This report includes examples of where transformation funding has been successfully implemented and so offers a robust evidence base to work from."

NHS estate

Welcoming the suggestion of using funding to unlock savings in the NHS estate, Dr Marshall agreed that there is value in looking at how to get the most out of NHS properties. 

"To be able to do this, our members though will need a supportive environment which aligns national functions and behaviours with the challenge of redesigning local services.”

Find out more

Access Making change possible from the Health Foundation or King's Fund website.

Discover more about the NHS Confederation's work on NHS finances and new models of care.

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