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The NHS risks becoming an “expensive safety net” unless government and society tackle increased funding and tougher prevention measures, NHS England chief executive Amanda Pritchard warned at the NHS Confed Expo conference in Manchester yesterday.

Ms Pritchard stated that “the post-covid NHS is damaged… but not destroyed”. She highlighted the expected “55 per cent growth in the number of people aged over 85” over the next 15 years, noting that while this was positive, the service must be prepared for the increased demands.

“For the NHS, more illness means more demand, requiring more capacity. More people… more places… more equipment… more drugs. All those things add up to more costs,” she said, adding that a smaller working-age population would be paying the taxes to cover these costs.

She stressed the need for the NHS to expand, reform and innovate, noting that political parties have avoided committing to significant NHS spending increases during the general election campaign.

Ms Pritchard also addressed modern health issues, such as junk food and gambling, urging society to confront “uncomfortable questions” about whether to “continue picking up the pieces”. She underscored the importance of choices an incoming government must make regarding investment in public health and prevention, as well as boosting capacity and quality in social care.

On NHS managers, Ms Pritchard defended their necessity, amid Conservative proposals to cut non-frontline managers. She emphasised the importance of well-trained managers for productivity and effective use of resources, announcing a new multidisciplinary NHS Management and Leadership Framework and a Code of Practice to ensure high standards and competencies at all levels.

Outpatient clinics on the way out

An integrated care board is planning to decommission secondary care outpatient clinics and replace them with primary and community care services. 

Greater Manchester Integrated Care Board has proposed the move as part of a wide-ranging review of community services. 

Its 2024-25 draft operational plan said that next year it intends to “decommission outpatient clinics from secondary care and [transfer them] into community and primary care services, allowing for estate rationalisation and improved flow”. 

This will release productivity and financial benefit, it claimed, after the ICB this year focuses on ensuring services are “realigned and sustainably transformed”. 

As part of the review, Greater Manchester will identify “priority services” and give them “clear interface guidance” on how they must work with acute services to reduce demand for outpatient clinics. The “priority” list will include virtual wards and urgent community response services

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In London Eye, Ben Clover assesses the impact of last week’s massive cyber attack on trusts in south east London, and in Comment, Andi Orlowski makes the case for starting the NHS financial year on 1 October to lessen winter pains and improve joint working.