Pritchard: NHS risks becoming ‘expensive safety net’ if politicians dodge ‘key choices’

Ms Pritchard was speaking at the NHS Confed Expo conference in Manchester today.

In a long speech, she also claimed that ”the post-covid NHS is damaged… but not destroyed.”

Ms Pritchard told the Confed audience the next 15 years would see “a 55 per cent growth in the number of people aged over 85”. This was “great”, but meant the service had ”to be ready” for the demands it would place on it. 

She continued: “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.

“But we also know we’ll have a smaller working age population paying the taxes that meet those costs.” It meant the “NHS does need to get bigger”, but also needs to reform and innovate, she said.

Both main political parties have declined to commit to significantly increasing NHS spending, while vying during the general election campaign to rule out tax rises.

Ms Pritchard also said there were “key choices that an incoming government is going to have to make, that we can’t… They’re well-rehearsed by now. It’s [the level of investment in] capital and estates [and] public health and prevention.

“And of course, it’s how we boost capacity and quality in social care. A question to which we still need an answer.”

She went on to talk about modern causes of ill health including junk food and gambling, and said society had to answer “uncomfortable questions” about whether to “continue picking up the pieces”.

Ms Pritchard added these issues “speak to the kind of society we want, and by extension, to what we want the NHS to do with finite resources”.

She said these were issues which would be faced by an “incoming government”, and “nettles we must grasp… will we tackle problems at source, or do we accept the NHS becomes an expensive safety net?”

Ms Pritchard claimed “the post-covid NHS is damaged…but not destroyed”, and although the service was “struggling” it was ”still doing incredible things, every day.”

To continue the recovery, Ms Pritchard said the NHS itself  needed to “go further” on reform, moving resources into primary and community care, embracing technology, working as a system, retaining staff, innovating, and embracing an open safety culture.

Defending managers

The NHSE chief defended NHS managers, who have been the subject of Conservative election proposals to cut managers in non-frontline organisations by a further 5,500.

Ms Pritchard said: “It really shouldn’t be controversial to say that the NHS needs well-trained, well-supported managers, at every level. That’s what makes well-performing teams.

“It’s fundamental to getting back to our pre-pandemic productivity growth [and] driving the best possible use of taxpayers’ investment and clinicians’ time… [as well as] fostering the kind of culture in which staff and patients can speak up, and be listened to. 

“If we want a well-run NHS, we must support those who run it.”

NHSE would give managers the “tools” they needed by developing the new multi-disciplinary NHS Management and Leadership Framework, she said, and would “create a new Code of Practice for all managers and leaders, with clear standards and competencies, from entry level, to middle tier, to board.” A “curriculum” for management training would be developed.

She added: “Having trained those managers and leaders, we’ll need to do more to keep them, and to encourage the best to take on the toughest jobs, where they can make the biggest difference, including giving them the space, the time, the teams and the resources to turn things around.”