NHS Reset is an NHS Confederation campaign to help shape what the health and care system should look like after the pandemic. Bringing together NHS Confederation members and partners, the NHS Reset campaign has convened the health and care system to reflect on the learning from the last six months and what it means for the future. You can read the NHS Reset report here.

The NHS Confederation identified five factors crucial for a sustainable NHS:

1. Honesty and realism: the pandemic’s impact on the capacity of the NHS is likely to go on for several years. The service needs government investment to support new ways of working that will enable it to fully and safely restore services, as well as the understanding of the public while it adjusts and deals with a large backlog of patients needing care. Political leaders will need to help manage public expectations about what is possible.

2. Extra funding: in 2018, the NHS received a five-year funding settlement worth £20.5 billion, but given the impact of coronavirus, this will have to be reassessed in the government’s planned Comprehensive Spending Review in November 2020. The expected surge in demand for mental health – likely to be up by 20 per cent – will also require additional resources. Nor will the NHS be able to respond effectively without a sustainable social care system, which will require a long-term funding settlement.

3. A lighter, leaner culture: during the pandemic the regulatory burden on local leaders has been reduced, giving way to leaner and more agile ways of working. The NHS has innovated at speed, led by clinicians and empowered by a changed leadership culture reflected in behaviours at both local and national level. This must be sustained – we need to hold on to this different way of doing things and strip away the unnecessary bureaucracy, reporting and regulation that for too long has stifled the service.

4. Integrating health and care: there is now a widespread acceptance that the 2012 Health and Social Care Act, and the way we choose to interpret it, has left a confused architecture for the NHS that wastes time, effort and money. The UK government and NHS England and NHS Improvement should work with representative bodies and their members to create a legislative framework which brings simplicity and clarity, a common purpose for local leaders, and the conditions to support system thinking, population health and local partnerships.

5. Tackling health inequalities: the virus has both highlighted and exacerbated health inequalities. If there is to be a serious effort to reduce the level of health inequality, it will require sustained and funded action at national and local level. There does appear to be a commitment to do this, but it will require a radical and conscious shift in every health economy towards a strategy based on population health.  

MiP Chief Executive Jon Restell said:

“MiP members share the concerns in this report and back it recommendations. Managers also share the hope that the NHS can be more efficient, better funded and fairer for staff, patients and the public.

“The Covid-19 crisis has revealed us to be a deeply divided country—divided in terms of health inequalities, racial inequality, and regional inequality.

“Staff in the NHS including managers have been working long hours with greater emotional and physical strain than normal. At the moment they are both responding to the pandemic and turning services back on. Many will not have a proper rest before winter pressures kick in. These pressures are unsustainable and the expectations on staff are unrealistic.

“The NHS must change, and the government must help the NHS change—by providing enough funding for the service to be properly managed, by integrating healthcare and social care, and by taking a radical approach to reducing inequality.”