Here at NPC we are increasingly interested in health charities. There are more than 6,000 of them, playing host to an array of specialist knowledge and expertise at a time when the NHS is under increasing pressure and political scrutiny. So what is the role of these charities in society, and how do we make sure some of that potential has maximum impact for patients now and in the future?
At the end of last year we published a short paper looking at the areas of work where these charities might best complement the health service—from early intervention to helping stretch scarce public resources—and earlier this week we joined forces with Great Ormond Street to host the great and the good and to explore this question further. We were joined by Dr Sarah Pinto-Duschinisky (Director of Operations and Delivery at NHS England), Paul Farmer (from Mind) and Alan Hodson (the Chair of the Great Ormond Street Hospital Charity). But it was Paul Corrigan—a health expert and formerly an advisor to Tony Blair—who took on the biggest question. His short presentation was entitled ‘Can charities save the NHS?’
Paul painted a complex picture. This year’s NHS crisis is in clinical healthcare, he acknowledged—looking after people with existing needs and trying to cope with patients going in ever-larger numbers to A&E and into emergency in-patients’ hospital beds. Naturally, if charities want to be relevant to the problems of the NHS it is here that they must make the most immediate difference. To achieve this charities need to help the NHS to move away from its purely ‘medical model’ of sickness and treatment.
We need to think of economic and social causes of why health deteriorates in the first place, and charities can help the NHS not only address those causes, but also treat them. For as long as healthcare has assumed that it can only create value through a troika of staff, kit and drugs, growing need will involve investment in more staff, kit and drugs. Given that the demand for health care from an ageing population is growing, and the ability to pay for staff kit and drugs will not grow as fast, this model of where value comes from in creating health care outcomes will break. This is the space for charities to fill, he argued. As the NHS is pulled in several directions, charities need to be on hand to help steer healthcare in directions where social treatment can help and it may otherwise be ignored.
At the moment, there seems to be a clear role that charities could fulfil in this area. Paul gave the example of the older person at home with a number of complex, long-term conditions, each treated by a raft of specialists whose work overlaps little, if at all. As he put it: among all those health professionals focused on their specialist skills, who notices the frayed carpet over which the patient may trip at any moment?
If the future lies with patients managing their own care, it will be trusted charities who can assist with this outside of a clinical setting, from helping patients reach decisions to ensuring their home life is safe and stable. If ‘integrated care’, so much the buzz-word in many circles, is to be a meaningful concept, this may be how it looks.
Alan Hodson was keen not to lose sight of the main question, though. ‘So can charities save the NHS?’ he asked as Paul concluded. ‘Yes’, Paul replied, before adding ‘if they pull themselves together’. There are interesting times ahead.