The old hospital based model of long term treatment is unsustainable, writes Stephen Bubb, and integrated pathways involving the third sector pave the way for a new approach

Woman sitting looking up at someone, their hand on her shoulder

Integrated services can provide people with the support they need to gain control of their health and wellbeing

The challenges faced by the NHS today require the third sector to play a central role in the development of a modern reformed health service. In order to meet the health and care needs of the 21st century, service users need strong, integrated pathways of whole person care, wrapped around the more traditional interventions by medical staff.

The third sector contains within it the hard work, passion and expertise required to ensure that these services can be delivered with both personal care and professionalism.

Stephen Bubb

‘We know that the old, reactive, predominantly hospital based model of treatment is no longer sustainable’

In the third sector we have always prided ourselves on empowering the people we work with − this is our main goal. We do not just provide services; we want to support the people we work with to have more power over their lives and outcomes at the end of our interaction than at the beginning.

The People Powered Health programme sought to make the most of this capacity by supporting the growth of interventions that empower service users to improve their health and wellbeing, such as peer support networks, expert patient programmes, social prescribing and time banking.

It provides a strong economic argument for developing this function in many of the interactions that take place in the NHS. If patients have an increased capacity to manage their own health, there is trong evidence that this self-management will improve their health and diminish their reliance on using NHS services − especially the emergency services at hospital.

People power

We know that the old, reactive, predominantly hospital based model of treatment for long term conditions, for example, is no longer sustainable when there are over 16 million people with long term conditions in England alone. For the sake of both better outcomes and greater efficiency, we must change the way we tackle these diseases, working with citizens in providing support and advice and encouraging better self-management. And that also means preventing the disease in the first place.

The value of integrated services is in providing people with the support, advice and encouragement they need to gain control over their health and wellbeing and to address the underlying factors that influence ill health.

‘The third sector is well equipped to drive the change we need in the NHS, with an illustrious track record of innovation’

Analysis of the project also suggests the NHS in England could save over £4bn a year by adopting innovations that offer patients, their families and communities the chance for real and meaningful involvement in their care and in the management of long term health conditions. This is based on an estimated 7 per cent reduction in accident and emergency attendance, planned and unplanned admissions and outpatient admissions.

The work of Nesta and others, including ACEVO’s recently established “Taskforce on Prevention in Health”, shows the third sector is well equipped to drive the change we need in the NHS. It has an illustrious track record of innovation, a close connection to the beneficiaries and communities it serves, and a history of success in supporting self-management and addressing the social determinants of health. People powered health is the future for the NHS, and the third sector will have a central role to play in making it a reality across the country.

Sir Stephen Bubb is chief executive at ACEVO