Lord Darzi’s 2008 report ‘High Quality Care for All – the NHS next stage review’, placed quality at the heart of the NHS. It catalysed the NHS to shift from performance management, focusing on activity, to a more holistic view of patient care that delivers higher quality services. However, the subsequent ten-year period saw the NHS go through one of the most radical transformations and leanest funding regime in its history.
In 2018, Lord Darzi, alongside the think-tank IPPR, asked Carnall Farrar (CF) to lead the thinking on the direction of national health policy by conducting a landmark review, ‘Better Health and Care for All’. The publication was intended to mark the 70th birthday of the NHS and the 10th anniversary of the ‘High Quality Care for All’ report.
As the analytical partner for the report, CF examined the developments made over the past decade on all main measures of quality and, for the first time, access within the NHS. Secondly, we made objective, innovative, practical and evidence-based recommendations for improvement in the NHS and policy. Thirdly, we analysed and recommended the future funding needs of the NHS. Dame Ruth Carnall, Chair of CF and former chief executive of NHS London, contributed to Lord Darzi’s Advisory Panel, which helped set direction and parameters of the report. Finally, we supported Lord Darzi to prepare for media briefings with national TV and Radio broadcasters.
Released ahead of the NHS funding settlement in June 2018, our analysis called for an additional £22.2bn (3.5% growth p.a.) to be added to the yearly budget by 2023/24. The report was used to underpin negotiations with the Treasury and Department of Health, and was instrumental in achieving a deal for an additional £20bn (3.4% growth p.a.) of NHS funding. The then Secretary of State for Health and Social Care, Jeremy Hunt, cited our work four times when announcing the funding settlement.
We also recommended a £500m ‘tech transformation’ fund to kick-start adoption of disruptive technology to transform the NHS, and reflected this in our funding projections. Matt Hancock MP, the new Secretary of State for Health and Social Care health, pledged his commitment to implementing this fund in his inaugural speech.
Our finding that access to health and care across England had significantly deteriorated over the past ten years, especially for social care, was unexpected, and changed the national discourse. Our work had a major media impact, receiving extensive coverage in broadcast media, including BBC Newsnight and Radio Four.
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