PwC comments on Lord Darzi’s Review of the NHS

• The NHS needs to have a long-term funding settlement to support the scale and breadth of change.

• The UK has no choice but to look to a blended model that can draw in private capital alongside available public capital. 

• The Government and NHS need to build on systems and investment already in place to ensure investment and innovation are fully adopted to ensure impact.

• Government must give consideration to funding and policy decisions that have a knock-on impact on the health and wellbeing of society, such as housing and education impacting health outcomes.  

Julian Hunt, health industries leader at PwC, says:

Today is a starting point for an honest dialogue with the public around the state of the NHS, and this must continue as decisions are made around which services are prioritised and how funding is distributed. It is also an opportunity to redress accountability within the NHS system and this will be critical in driving change. For example, realising the potential of Integrated Care Boards by giving them a greater licence to operate whilst holding them accountable for delivery and equally consequences for failings.

The Government faces a tension in its policy and funding decisions against fiscal constraints. Consideration must be given to funding decisions where they will have a knock-on impact on the health and wellbeing of society, such as recognising the impact housing and education have on health outcomes.

Capital investment

The continued hold on public funding for such a sizable investment that needs to encompass, not only acute care but also, mental health, community and primary care assets, is not sustainable. The Government needs to align funding with the time it will take to fix things, which the report highlights is not a short-term fix. The NHS needs to have a long-term funding settlement to support the scale and breadth of change required that includes providing renewed clarity on the NHP for those schemes in later cohorts.

The UK has no choice but to look to a blended model that can draw in private capital alongside available public capital through a collaborative approach between the public and private sector, while addressing historic negative perceptions and inflexibilities of previous models. To overcome this perception and to attract private sector participation to a new generation of public private partnership projects, a clear vision and pipeline of opportunities is needed, as well as a robust and transparent framework for risk sharing, co-investment, and governance. Reinventing the wheel is not necessary - for example looking to Wales and its Mutual Investment Model (MIM) is a great starting point.

Digital transformation

That said, we cannot disregard investment to date - especially in digital technology. To accelerate digital advancements in the NHS to benefit both staff and patients, the Government and NHS need to build on what is already in place. The NHS has a track record of delivering fantastic innovation but too often this has not been fully adopted to ensure its impact. Delivery of a workforce plan to provide NHS staff across the country with the right digital and data literacy to make the most of the investments made is critical. 

ENDS