Robert Ede is Head of Health and Social Care at Policy Exchange.
The news last week from the UK Health Security Agency (UKHSA) that people infected with the Omicron variant were between 50 and 70 per cent less likely to be admitted to hospital compared with the Delta strain created a sense of relief in the Government.
The high levels of transmissibility mean that there will still be significant short term pressures. There are approximately 6,000 critical care beds within the NHS, and it will be touch and go on whether the health service gets through January.
Data from hospitalisations in London does suggest that the outlook could be improving, and that is likely to be further assisted by the booster rollout. In a fortnight, the NHS was able to deliver a 2.5x increase in the number of boosters – going from less than 400,000 jabs per day to a million. A genuinely remarkable achievement that demonstrates the NHS at its most capable.
These are the crumbs of comfort for the Health and Social Care Secretary over the Christmas period. Once January is over, there may be opportunities to take a more proactive approach on healthcare policy. There are four specific opportunities which the Government can coalesce around:
- First up will be the anticipated publication of the elective recovery plan. Having been originally promised by the end of November, DHSC was forced to reconsider as the first omicron cases were detected in the UK on 27 November. The plan feels even more needed now: 100,000 elective surgeries have been cancelled in the past few weeks, which will only add to the six million plus who are now on NHS waiting lists. Many of these will have been cancelled at short notice. As we wrote earlier in the year in our report, A Wait on Your Mind, the Government must seek inspiration from Labour’s successful war on waiting times in the 2000s, whilst embracing the opportunities to do things differently.
- Next will be the ‘Levelling Up’ White Paper. It is hard to think of a single Whitehall document which has attracted so much anticipation across sectors, healthcare included. Many view Levelling Up as a vehicle to land existing arguments about health inequalities that have escaped concerted focus over the past decade. Meeting those elevated expectations will be tough; the signals are that further investment beyond the recent multi-year spending review is unlikely. But the political imperative is clear: to drive an immediate improvement in people’s lives and sense of pride across all parts of the country.
- Third will be activities to improve GP access. The Government found itself on the backfoot earlier in the Autumn; with a backlash to its winter access plan from the GP community; and criticised for stoking the debate over face to face appointments. As Policy Exchange will explore in an upcoming paper, the Government needs to look beyond short term fixes to set out a bolder vision from primary care that can balance the changing profile of the GP workforce with the evolving needs of consumers. Such an approach could connect with levelling up and Sajid’s reform agenda for the health service which has digitisation at its core; for example by expanding the use of high-quality remote video consultation for areas that are ‘under-doctored’. A recent pilot study from North Tyneside demonstrated that demand (and overall satisfaction) was in fact highest in areas with the greatest deprivation.
- And lastly, there’s the Health and Care Bill – the most significant NHS reforms in ten years – which are now entering a lengthy period of debate and revision through the Lords. Calls to tackle growing workforce shortages across the NHS were the number one issue during second reading in the Lords, whilst the Government’s proposals to extend ministerial powers of direction proved the most contentious clauses when the Bill was published earlier in the year. The NHS took the wise decision this week to officially delay the go-live date for the new ‘Integrated Care System’ structures by three months. The Government should use this extra time to twist and stick, showing flexibility in certain areas of the legislation such as workforce planning, whilst holding their nerve on ministerial powers.
The next few weeks will be undeniably tricky for the Government and NHS. But as we emerge through January, and the days get longer, Javid must embrace his opportunities to make the new year weather.