Discussing the NHS Five Year Forward View at the Kings Fund

The NHS England five year forward view sets out bold ambitions on how to transform health and social care. Last week we joined the debate on how to turn that vision into action, along with Trusts interested in being early adopters of the new models of care (vanguard sites).

Simon Steven called the session, held at the Kings fund. In his opening remarks, he asked the assembled CEOs to give him and NHS England their 'Marching orders'. His commitment to delivering this and clearing the way for forward thinking trusts is obvious. Simon does not want to see trials but change at scale. In his words "The NHS has more pilots than British Airways, and we must change that". Backing up these words with action, there is a pot of money available to support trusts moving to one of the new models.

"The NHS has more pilots than British Airways"

Simon was followed by Don Berwick. I had never seen Don talk, but his paper 'Escape Fires' was a seminal piece for me early in the development of DrDoctor. Don inspired the attention of the room in a way which is often unusual at today’s conferences. His point that healthcare does not exist in a vacuum of limitless resources is pertinent and vital.

Don talks about the triple aims: Population Health, Experience of Care and Per Capita cost.

To move from traditional models of care to triple aim care, Don says we must:
1) Move knowledge, not people
2) What matters to you, not what is the matter with you
3) Use all available skills and resources
4) Simplify, rather than add complexity (one of our core tenant at DrDoctor)
5) Individualise treatment
6) Co-operation above all (over specialisation)
7) Work outside the building
8) Co-design and co-production
9) Return the money
10) Create wellbeing (rather than cure illness)

He pushed us to invoke these principles at the core of the five year forward view.

We then broke into workshop sessions, where I was privileged to hear Paul Mears, CEO of Yeovil talk about the work they have done there. Nothing is more impressive than a CEO who brought the local practices on board by 'getting in my car and driving to every one'.

It was great to explore problems round the table in an environment of collaboration and vision.

The new models are: MCP - Multispecialty Community Providers

• Large co-operatives of practices. It's envisioned that much outpatient and ambulatory care could move to these
• They may take on individual care budgets for patients, spending money on prevention rather than care

PACS - Primary and Acute Care Systems

• Single organisations providing hospital, mental health, community and list based GP services
• This allows the economies of scale of large providers to kick in, and deliver wide change in areas of high health inequality

One theme is that technology is key to this transformation. Our aim at DrDoctor has always been to simplify and give the patient a clear way of accessing care across provider and setting. Patients do not care whether they seen in an MCPS or a PACS, but simply that they are seen, they are respected, and they get better.