Speaking on the Voices of Care Podcast from Newcross Healthcare – a leading podcast channel dedicated to the voice of the health and social care sector – Sarah Woolnough, CEO of The King’s Fund, has claimed that the NHS is not ‘broken’, but that a fractured society is putting it under significant strain.  

Suhail Mirza, non-executive director at Newcross Healthcare and the podcasts host asked: “Wes Streeting, the secretary of state for health and social care, early on in the election, and to this day, has said he wanted his department to be an economic growth department but he and Sir Keir Starmer have described the NHS as ‘broken’. What’s your view?” 

Responding, Sarah Woolnough claimed the NHS needed sustained and transformative change. She said that the NHS model had not fundamentally changed since 1948 and whilst the NHS is doing ‘an awful lot for a lot of people, the reality is we have got a different population with different health needs.’ 

Sarah states: “The NHS can deliver different types of care and treatments that we would not have dreamt of decades ago.  It is incredibly challenged, we do have a crisis of sorts, it is not broken but the model is not fit for purpose. We’ve seen a fractured society, a social breakdown of sort, whereby lots of issues that don’t start as health issues are arriving at the NHS’ door.”  

Suhail Mirza, asked: “Can you put ‘society is broken’ into some context? We know from recent research from The Joseph Rowntree Foundation that alarmingly 1 in 5 people in the UK, 14 million, are living in poverty. That has a huge impact on health and health inequalities.” 

Sarah replied: “If you are living in deprivation, you are likely to have less health, and poorer outcomes. We have seen a spike in the levels of ‘deep poverty’ and there is not enough national conversation about issues like poverty and poor housing. I was recently at a mental health trust and they were talking about the impact of social factors – poverty, housing, unemployment – and how that is playing into poor physical and mental health. We must understand the social context of poor health, and make sure we have enough conversation about that.” 

Turning attention to NHS performance, Suhail Mirza noted that some of the most important NHS target metrics have not been met in over a decade, commenting that “the numbers speak of a system that is really creaking under a lot of pressure, with public satisfaction of the NHS at its lowest levels ever. What would you like to see happen?” 

Sarah responds: “Some of the NHS performance tests speak for themselves. Long ambulance waits, long waits in A&E, in elective care is unacceptable and its impacting health.  The system is under immense pressure.  

There’s a huge opportunity over the next year to make improvements and we want to be realistically optimistic. We are impatient for change and improvement. But the answer to overcrowded hospitals isn’t just to build more hospitals. There needs to be more of a focus on how we keep people healthy. How do we deliver more care through primary and community care?  

Successive governments have been talking about it for decades, yet we haven’t delivered it. Now there is an opportunity with a new government and hopefully with some stability and a large majority, to double down on this and focus on how we deliver that shift. 

It might not be that glamorous to focus on reconfiguring a particular part of your service or bolstering services that aren’t as visible. It’s not always about a shiny building. But if that’s what we need to improve population health to deliver this shift to diagnose and treat earlier and help people stay well in a model that’s fit for 21st century then we should.” 

To listen to the full podcast episode in which Sarah discusses this and lots more, including staff wellbeing and the policy priorities in respect of social care, which Sarah describes as ‘not encouraging in the government’s early tenure”, please visit: www.newcrosshealthcare.com/voicesofcare