Health : Future trends

Government and economy

• The coalition government's White Paper (July 2010) sets out the most significant reorganisation of The National Health Service (NHS) in its history. The government’s objectives are to reduce mortality and morbidity, increase safety and improve patient experience and outcomes for all.
• Primary Care Trusts (PCTs) are to be abolished. Most commissioning decisions will now be made by consortia of GP practices, supported and held to account by the NHS Commissioning Board. This will push decision-making much closer to patients and local communities. Strategic Health Authorities (SHAs) will also be abolished by 2012.
• The health gap between more and less affluent groups in the population remains, and may become wider as a consequence of the recession and its impact on employment and public spending (Skills for Health , 2009). The coalition government has ring-fenced the public health budget, allocated to reflect relative population health outcomes, with a new health premium to promote action to reduce health inequalities (Department of Health (DH) , 2010).

Emphasis on prevention

The rising incidence of long-term conditions and chronic illnesses exacerbated by lifestyle choices, together with demographic changes in the population (including an ageing population), has led to the emergence and growth of roles in prevention, education, public health and health promotion. The emphasis is on issues such as smoking cessation, weight management, drug addiction, sexual infection, underage pregnancy and mental health.

Support for long-term/chronic illnesses

Although premature death rates from cardiovascular diseases and cancer have declined, chronic conditions such as diabetes, asthma, chronic obstructive pulmonary disease (COPD), heart failure, arthritis and mental illness have become more significant. This has led to:

• the introduction of personalised care plans for those suffering from long-term conditions;
• expanded and new opportunities for nurses and allied health professionals in planning care for individuals with long-term conditions;
• new specialist centres for major trauma, heart attack and stroke care treatment;
• the introduction of services for older people with dementia and other chronic conditions;
• research collaborations between health care providers and the pharmaceutical industry.

Growth in public and private sector collaboration

Increasingly close collaboration and joint service provision between the NHS and independent healthcare has led to:

• increased outsourcing and commercialisation of services;
• expanded opportunities in areas such as IVF, robotic radiosurgery systems, dialysis, endoscopy, laser services, intense pulsed light source services, mole removal and cosmetic surgery.

Workforce development

It is estimated that 60% of the current workforce will still be working in the sector in 2018, so employers will need to look for future solutions to maximise skills utilisation across the whole workforce, as well as opportunities to develop both existing and new employees (Sector Skills Assessment, Skills for Health, 2009/10).

Staffing

A significant occupational shift is expected over the next 10-15 years to achieve a more flexible workforce (Occupations, National Guidance Research Forum , 2008).  This will involve measures such as:

• delegation of more tasks from doctors to nurses, and nurses to health care assistants;
• employment of more public health specialists to deliver the public health agenda;
• increased working in multidisciplinary and community-based teams;
• a 45% reduction in NHS management costs over the next four years, freeing up further resources for front-line care.