It’s been a busy year for health and social care policy – 2015 in review
It’s been a busy year for health and social care policy. From the A&E winter crisis to the general elections, not to mention a renewed focus on mental health issues, it seems apt to take a look back at the year in review.
The year started with considerable coverage of A&E departments’ waiting times. Between October and December 2014 national performance against the four-hour target reached its lowest point in ten years, before a slightly recovery in the first three months of 2015. Public debate around the complex causes behind the missing targets followed, and we sought to set the issue in perspective by looking at it through the lens of patient experience. Although increasing waiting times are a serious concern, and a reflection on the burden being placed on the NHS, they are not necessarily direct evidence of decreasing quality of care. Other factors are involved to determine the latter – such as the commitment and dedication of the healthcare workforce – and, more importantly, other aspects are equally or more important to patients, like continuity of care and smooth transitions, emotional support, empathy and respect, involvement of family and carers, attention to physical and environmental needs and the receipt of clear, comprehensible information. With A&E departments again set to come under pressure over the winter of 2015, this analysis, originally published in December 2014, will continue to be relevant.
The single most seismic event in UK health policy in 2015 was, of course, the latest general elections in May. After the ballot boxes delivered a major and unexpected surprise at the House of Commons, attention immediately turned to the health and social care policy proposals of the upcoming Conservative government. In a policy blog released the day after election, we immediately recalled the Conservative’s commitment to patient-centred care – with special emphasis on the need to improve mental health care, and urged the next government to focus on improving crucial aspects of patient experience like communication, involvement and coordination of care. Since then, the government’s 2015 spending review has promised an increase in funding of NHS care by over the life of the cabinet – but this increase has come at the expense of other areas of health spending, including public health, education, and regulation. The net effect on population health and wellbeing remains to be seen.
Equally mindful of and involved in the 2015 health and care debate has been the Labour party. The party conference held in Brighton in September discussed and finalised motions on the NHS and mental health. Labour delegates pledged to support patients and health professionals in working towards an integrated health and social care system, as well as in making a serious attempt to tackle the causes of ill health as proposed by the Marmot review. However, the most interesting policy proposal advanced by the new leadership regarded mental health care. Delegates agreed on giving mental health provision higher political priority and to create a Shadow Minister for Mental Health to this specific purpose. We discussed this important step forward in mental health policy in this blog post, where further details on Labour’s position on the issue are highlighted.
The past year has been also rich in exclusive policy analyses on some of the most pressing and unheard health related issues. A briefing written in association with the Centre for Mental Health, where findings from the 2014 NHS Staff Survey and the Freedom to Speak Up Review were scrutinized and explored, highlighted a close relationship between staff experience in the NHS and the quality of care that patients experience. Sick leave caused by stress costs the NHS up to £400 million a year in lost productivity, and we suggested a twofold strategy to tackle this problem: an action plan consisting of five crucial steps to improve staff wellbeing locally and nationally; and the call for a culture change around whistleblowing within the NHS, in order to foster a culture of safety and learning in which all staff feel safe to raise concerns.
Finally, in a policy briefing on the relationship between debt and health, released in December, we highlighted how mental health is heavily affected by problem debt: in fact, people in debt have two to three times the rate of neurosis, three times the rate of psychosis, over twice the rate of alcohol dependence and four times the rate of drug dependence as people with no debt. Also, “The health consequences of problem debt cost the economy £960 million in mental health costs. As well as £2.3 billion in costs due to job loss or lost productivity and £790 million in relationship breakdown costs. In order to address the issue around debt and mental health, we stressed the importance of coordinated ‘debt care pathways’ between local health and advice services, as the route by which individuals with debt and mental health problems gain access to the support they need.
As we head into a new, exciting year in health and social care policy, we look forward to person-centred care being on the top of the political and social agenda. By supporting and advancing new ideas, and connecting with and influencing the most relevant stakeholders in health and social care, we aim to play our part in realising Picker’s vision: the highest quality health and social care for all, always.