The NHS is at a pivotal point as it struggles to adapt to changing patterns in demand coupled with tight financial restraint. The initial purpose of the NHS to treat acute illness, trauma and infection in short episodes of care is no longer relevant. Advances in modern medicine, obesity-related health problems, mental health problems and an ageing population have created a different landscape of care. It is also now more common to have two or more conditions than to have a single one. A health system that continues to address these problems as single entities is not going to be effective.
On top of this, the NHS has had to make do with less than 1% per year growth in funding since 2010.1 Efforts to address the gap between money allocated and underlying drivers of demand to date have focused on efficiencies, rather than taking different approaches to care.
The combination of failing to adapt to current patterns of disease and having to make efficiencies year on year is having a devastating impact on staff. People are leaving to work elsewhere, retiring early or reducing their hours if they can afford it. Others are off sick due to stress. A new approach is needed which is rewarding to both patients and carers.