UK Edition
'Bloody tough' times ahead for the NHS, head of the service warns
"Bloody tough" times lie ahead for the NHS, the head of the service has said, hitting out at politicians for trying to "rewrite history" by suggesting it has received all the funding that it needs.
Simon Stevens said it would not be "prudent" for the health service to expect increased funding - and said any extra cash should go first to social care.
Speaking to the NHS Confederation conference in Manchester, he repeatedly warned managers that the next few years would be gruelling, with little money to spare.
"It is going to be bloody tough, let us just be frank about that," he said.
He said the NHS has already had a difficult year, with the junior doctors's strikes, and attempts to cut soaring spending on agency doctors.
"In a nutshell, yes, it has been a tough year, yes, it is going to be tough sledding over the next three, four, five years, certainly I and colleagues will be making the case for the National Health Service and it's resources forcibly and publicly," he said. "But we should not kid ourselves that that by itself is going to buy us comfort," he said.
Earlier this year, the NHS chief executive became embroiled in political rows, amid claims that he had agreed to only ask the Treasury for £8bn extra a year, despite knowing it needed twice as much.
Mr Stevens publicly disputed the account, telling the conference: "Let's not rewrite history. In the forward view we actually said that the National Health Service would need between £8bn and £21bn by 2020 in order to sustain and improve."
The lower end of the range - which is the amount the Treasury agreed last November - would only have been enough if there was sufficient access to social care for the elderly and improvements in prevention of ill-health, he said.
Mr Stevens said the deal was "as good as would be obtainable" given the fiscal pressures.
However, in the last year, levels of bed-blocking in hospitals among elderly people have risen by one third, often for lack of social care, and the Government's childhood obesity plan has been repeatedly delayed.
Meanwhile the service has recorded a record £2.45bn deficit, much of it fuelled by spending on agency doctors and workers.
The NHS chief executive told managers that they needed to use the current financial year to "reset" the finances of the health service, to get it back on track.
He also said further changes to funding plans could come after the EU referendum - but suggested that the NHS was unlikely to get any more cash.
"I do not believe that it would be prudent for us to assume any additional NHS funding over the next several years, not least because I think there is a strong argument that where extra funding to be available, frankly we should be arguing that it should be going to social care, that is one of the arguments that I have been making publicly and I think social care has a very strong case for that," he said.
For now, the amount of money free for capital spending was "incredibly tight" while mental health and community services were being forced to wait for extra funds.
The NHS chief said managers needed to get their "sleeves rolled up and get delivering on the key national priorities and strategies" but praised the quality of care offered despite the financial strain.
"Despite all of those pressures there is no other major industrialised country in the world over the last year that can claim to have treated nine out of 10 patients within four hours in an A&E department or provided nine out of 10 of its citizens with access to needed planned surgery within 18 weeks," he said.
Cllr Izzi Seccombe, from the Local Government Association, said: “We have long argued that pumping money into the NHS while making cuts to adult social care is a false economy. Over the past five years, councils have had to close a £5 billion funding gap in social care alone."
She said: "As a starting point, the Government needs to bring the £700 million of new funding earmarked for social care through the Better Care Fund by the end of the decade forward to this year.”
Mr Stevens also unveiled plans for millions of patients to get access to life-saving gadgets, at the conference.
The fast-track plan means patients will be given devices and apps which can detect dangerous health problems, monitor heath conditions, and protect patients from infections.
Innovations include a simple metal strip, which can be attached to a smart phone, in order to take a heart reading in just 30 seconds.
More than 2.5 million people who suffer from an irregular heartbeat could benefit from the mobile heart monitor, ensuring quicker diagnosis, potentially preventing thousands of deaths, officials said.
Health officials said the NHS needed embrace modern innovations in the way the world had taken to 'Uber' and 'Airbnb' in order to save the NHS money and improve patient care.
Other devices to be endorsed include an app which helps patients with lung conditions manage their medication, and a cuffed ventilation tube which electronically monitors patients in intensive care - and warns doctors when there is a risk of infection.
The tube will be used to prevent the development of pneumonia, which currently affects 20,000 patients a year in hospitals in England, with one in three cases ending in death.
Mr Stevens said around 20 devices a year - between them benefiting millions of patients - will be authorised under the national scheme, which starts next year.
"For people with diabetes, for people with heart disease, for pregnant women, acutely ill in-patients there are huge opportunities to improve the quality of care - and also save money in other parts of the NHS - by getting millions of new med tech devices into the hands of frontline nurses and therapists," he said.
Some gadgets will be handed directly to patients, while others will be available in GP surgeries and hospitals, he said.
The national scheme means that if devices are approved by a national team of NHS clinical experts, doctors can prescribe them knowing they will be reimbursed by the health service.
Mr Stevens said the changes were needed, because the health service was good at invention, but poor at making sure all patients benefited from advances.
The use of technology could transform people's lives, he said. The heart monitor - called AliveCor - is attached to a phone, allowing an immediate electrocardiogram recording , allowing the user to detect, monitor and manage irregular heart rhythms.
Such arrhythmias can cause sudden death, which kills 100,000 in the UK annually, even though four in five cases can be prevented. The rhythm disorders also mean a sharply increased risk of stroke.
Detecting cases earlier could save the NHS large sums of money, officials said, reducing the amount of time spent on referrals to hospital, consultants' appointments and treatment.
The new scheme means a team of clinical experts from NHS England and the NHS Academic Health Science Network (AHSNs) will decide each year on the top 10 or 20 innovations for the health service, which will automatically be reimbursed when prescribed.
It comes after a major report suggested that digital technology and speedier access to advances in science could help save the health service from a mounting financial crisis.
An app which could help commuters find the least polluted route to work and a breathalyser which can detect early signs of cancer were among inventions revealed by the NHS AHSNs at the NHS Confederation conference, in Manchester.
On Thursday, Jeremy Hunt told the conference that it was "utterly bogus" to think that the NHS could benefit if Britain left the EU.
He said doing so would reduce Britain's gross domestic product, reducing the amount of resources for the health service, and leaving Britain with a "Brexit hangover".