Essays%collected%by%the%Associate Parliamentary%Health ......Dame Jo Williams Ð Chair, Care Quality...

Preview:

Citation preview

Associate Parliamentary Health Group

Essays  collected  by  the  Associate  

Parliamentary  Health  Group    

in  association  with  The  King’s  Fund

FOR PARLIAMENT

POLICY PRIORITIES HEALTH

‘ HEALTH IS AN INTRINSICALLY INTERESTING POLICY AREA AND AS PARLIAMENTARIANS, OUR ENGAGEMENT WITH IT IS ESSENTIAL’

Baroness Cumberlege, APHG Chair Lord Hunt of Kings Heath, APHG Parliamentary Officer

4 5

Foreword 6Commissioning Professor Chris Ham - Chief Executive, The King’s Fund 8Competition within the NHS Dr Jennifer Dixon - Director, The Nuffield Trust 10NHS finances and productivity Professor John Appleby – Chief Economist, The King’s Fund 12The NHS Workforce Dr Peter Carter – Chief Executive, Royal College of Nursing 14Patient Experience Jeremy Taylor – Chief Executive, National Voices 16Public Health Professor Steve Field – Former Chair, Royal College of General Practitioners 18Social Care Richard Jones – President, Association of Directors of Adult Social Services 20Quality Dame Jo Williams – Chair, Care Quality Commission 22Reflections Lord Hunt of Kings Heath – APHG Parliamentary Officer 24Reflections Mark Simmonds MP – APHG Parliamentary Officer 26About the APHG 28About The King’s Fund 30

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

CONTENTS

6 7

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

8%'()'0*'%&()'<#)()'%&#%'(*'CDDE4'6"'#*1'0%&"+'/#+$(#3"*%#+-',0$$"#.5")'&"$/"1'")%#<$()&'%&"'F))0,(#%"'2#+$(#3"*%#+-'!"#$%&'G+05/'HF2!GI'#)'#'90+53'%&+05.&'6&(,&'%0'/+0:(1"';2)'#*1'2""+)'6(%&'&(.&'=5#$(%-4'(3/#+%(#$'(*90+3#%(0*'#<05%'&"#$%&'())5")7'J0,5)(*.'0*'$0,#$'#)'6"$$'#)'*#%(0*#$'())5")4'%&"'F2!G'()'1"1(,#%"1'%0'1())"3(*#%(*.'A*06$"1."'#*1'."*"+#%(*.'1"<#%"'0*'%0/(,#$'&"#$%&'())5")'(*'#',+0))K/#+%-')"%%(*.7'

J0+'%&"'30)%'/#+%'6"'#,&(":"'%&()'<-'&0$1(*.'+".5$#+')"3(*#+)'0*'%&"'2#+$(#3"*%#+-'L)%#%"'#11+"))"1'<-'"@/"+%'/#*"$()%)'1+#6*'9+03'%&"'&"#$%&')",%0+7'?(*,"'%&"'.+05/M)'(*,"/%(0*4'6"'&#:"'<""*'90+%5*#%"'%0'&#:"'<""*'#11+"))"1'<-')03"'09'%&"'30)%')"*(0+':0(,")'0*'&"#$%&'(*,$51(*.'?",+"%#+(")'09'?%#%"4'N&("9'L@",5%(:")'09'A"-'>!?'#*1'+".5$#%0+-'<01(")4')"*(0+',(:($')"+:#*%)'#*1'$"#1(*.'#,#1"3(,)7'8*'05+'3())(0*'%0'0/"*'5/'%&"'&"#$%&'/0$(,-'

1"<#%"'%0'%&"'<+0#1")%'/#+$(#3"*%#+-'#51("*,"'/0))(<$"4'6"'&#:"'"*$()%"1'%&"')5//0+%'09'#'1()%(*.5()&"1'/#*"$'09'#1:()0+)'6&04'#$0*.)(1"'05+'9"$$06'2#+$(#3"*%#+-'

1"%#($)'#<05%'%&"'(*1(:(15#$)'(*:0$:"1'(*'%&"'.+05/'#*1'%&"')"+:(,")'/+0:(1"1'<-'%&"'F2!G',#*'<"'905*1'0*'/#."'CO'09'%&()'<00A$"%7

F)'6"'"3<#+A'5/0*'#'/"+(01'09')5<)%#*%(#$'+"90+3'90+'%&"'&"#$%&')"+:(,"4'#*1'(*'%&"'

/#+$(#3"*%#+-'/#+%(,(/#%(0*'(*'%&"'90+6#+1'&"#$%&'1"<#%"'6($$'<"'/#+#305*%7'P0'&"$/'0+("*%#%"'*"6'#*1'+"%5+*(*.';2)'#*1'2""+)'0*'%&"')&#/"'09'%&"'&"#$%&'/0$(,-'#."*1#4'6"'#+"'1"$(.&%"1'%0'/+")"*%'%&()',0$$",%(0*'09')&0+%'"))#-)'(*'/#+%*"+)&(/'6(%&'P&"'Q(*.M)'J5*1'0*')03"'09'%&"',"*%+#$'())5")'%&#%'6($$'103(*#%"'%&"'&"#$%&'/0$(,-'#."*1#'0:"+'%&"',05+)"'09'%&()'2#+$(#3"*%7'

,033"*%#%0+)4'"#,&'"))#-'/+0:(1")'"))"*%(#$'(*90+3#%(0*'0*'#'/#+%(,5$#+'/0$(,-'/+(0+(%-4'"@/$0+(*.'(%)'1":"$0/3"*%'#*1'%&"'6#-)'(*'6&(,&'(%',#*'<"'#11+"))"1'#*1'#1:#*,"1'(*'%&"',03(*.'-"#+)7'

R"'605$1'$(A"'%0'099"+'05+'%&#*A)'%0'#$$'%&0)"'6&0'&#:"',0*%+(<5%"1'%0'%&()'/5<$(,#%(0*'90+'$"*1(*.'5)'%&"(+'%(3"4'(*)(.&%'#*1'"@/"+%()"'#*1'05+'/#+%*"+)'(*'%&()'/+0B",%4'P&"'Q(*.M)'J5*14'90+'%&"(+':#$5#<$"'(*/5%'#*1')5//0+%7'R"'&0/"':"+-'35,&'%&#%4',0$$",%(:"$-4'%&"'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

FOREWORD "))#-)'6($$'"*,05+#."',0$$"#.5")'%0'(*(%(#%"4'+")53"'0+',0*%(*5"'%&"(+'"*.#."3"*%'(*'&"#$%&'/0$(,-'#*1'%&#%'%&"'F2!G'6($$'#,%'#)'#'5)"95$'90+53'%&+05.&'6&(,&'%0'1":"$0/'#*1'"*&#*,"'-05+'5*1"+)%#*1(*.'09'%&()'9#),(*#%(*.'/0$(,-'#+"#7'

Baroness Cumberlege APHG Chair

Lord Hunt of Kings HeathAPHG Parliamentary Officer

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

‘As we embark upon a period of substantial reform for the health service, and in the context of a challenging financial climate, parliamentary participation in the forward health debate will be paramount’

8 9

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

V")"#+,&'(*%0'/+(3#+-',#+"K$"1',033())(0*(*.'(*'%&"'>!?'&#)'&(.&$(.&%"1'(%)'/0%"*%(#$'%0',0*%+(<5%"'%0'(3/+0:"3"*%)'(*'/"+90+3#*,"4'")/",(#$$-'(*'(*,+"#)(*.'+")/0*)(:"*"))'%0'/#%("*%)'#,,"))(*.'/$#**"1',#+"'#*1'1"$(:"+(*.'30+"',#+"',$0)"+'%0'&03"7'W*'%&"'0%&"+'&#*14'%&"+"'()'$(%%$"'":(1"*,"'%&#%'/+(3#+-',#+"K$"1',033())(0*(*.'&#)'3#1"'#'

0+'0*'301"+#%(*.'1"3#*1'90+'5*/$#**"1',#+"7'L:(1"*,"'9+03'%&"'X*(%"1'?%#%")'6&"+"'3"1(,#$'.+05/)'&#:"'%#A"*'0*',#/(%#%"1'<51."%)')5..")%)'%&#%'G2',033())(0*(*.'6($$'1"/"*1',+(%(,#$$-'0*'1":"$0/(*.',#/#<$"'G2'$"#1"+)'#*1'/+0:(1(*.'#1"=5#%"'<51."%)'%0'"*#<$"',0*)0+%(#'%0'<5-'(*'3#*#."3"*%')5//0+%4'#30*.'0%&"+'%&(*.)7

Y#+(05)')%51(")'(*'%&"'$#)%'%6"*%-'-"#+)'&#:"'1"),+(<"1',033())(0*(*.'#)'%&"'6"#A'$(*A'6(%&(*'%&"'>!?7'P&"',&#$$"*."'90+'%&"'N0#$(%(0*'G0:"+*3"*%'6($$'<"'%0'"*)5+"'%&#%'&()%0+-'10")'*0%'+"/"#%'(%)"$9'#*1'%&#%'%&"'$"#1"+)&(/'#*1'3#*#."3"*%'#+"'/5%'(*'/$#,"',05*%"+'%&"'/06"+'09'/+0:(1"+)'(*'0+1"+'%0'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

COMMISSIONING Professor Chris Ham Chief Executive, The King’s Fund

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

‘The challenge for the Coalition Government will be to ensure that history does not repeat itself and that the leadership and management are put in place counter the power of providers in order to deliver benefits for patients and the public’

10 11

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

%0'%#@/#-"+)['#*1'%&"',0)%)'09'1":"$0/(*.'#*1'3#(*%#(*(*.'#'3#+A"%'605$1'<"'&(.&7'

\5%')03"%(3"'*"#+'CDDD4'%&"'>"6']#<05+'G0:"+*3"*%',0*,$51"1'*0%'0*$-'%&#%'"@%+#'H/+(:#%"I')5//$-'09',#+"'6#)'*""1"1'%0'+"15,"'6#(%(*.'$()%)4'<5%'30+"'95*1#3"*%#$$-'%&#%',03/"%(%(0*'90+',$(*(,#$')"+:(,")',05$1'

9#,($(%(")'3(.&%'099"+'.+"#%"+'(**0:#%(0*7'!"*,"'%&"'(*(%(#$'^,0*,0+1#%M'6(%&'%&"'/+(:#%"')",%0+')(.*"1'<-'%&"*'?",+"%#+-'09'?%#%"'90+'!"#$%&4'F$#*';($<5+*4'%&"'*#%(0*#$',0*%+#,%)'<"%6""*'%&"'_"/#+%3"*%'09'!"#$%&'#*1'(*1"/"*1"*%'%+"#%3"*%',"*%+")'H8?PN)I4'%&"'/0$(,-'09'905*1#%(0*'%+5)%)'H)=5""`"1'%&+05.&'2#+$(#3"*%'6(%&'#'3#B0+(%-'09'0*$-'aI'6&(,&'

,0*9"++"1'.+"#%"+'9+""103)'0*'>!?'P+5)%)4'#*1'/0$(,(")'%0'/+030%"'/#%("*%',&0(,"'09'&0)/(%#$7'2#%("*%)'6"+"'.(:"*'9+""103'%0',&00)"'%&"'&0)/(%#$'09'+"9"++#$4'9+03'CDDb'9+03'#*-'6($$(*.'/+0:(1"+7'P&"',03/"%(%(0*c,&0(,"'/0$(,-'*0%#<$-'1(1'*0%'"@%"*1'%0'0%&"+'/+0:(1"+)4'#*1'*0%'%0',033())(0*"+)4')5,&'#)'/+(3#+-',#+"'%+5)%)7'F$0*.)(1"'%&")"'/0$(,(")')&05$1'<"',0*)(1"+"1'0%&"+'^3#+A"%'3",&#*()3)M'

/+(,")'90+'&0)/(%#$)'5*1"+'^2#-3"*%'\-'V")5$%)M4'#*1'30+"'$#%%"+$-'.5(1#*,"'9+03'%&"'>!?'N03/"%(%(0*'#*1'N00/"+#%(0*'2#*"$7

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

W*'%&()'<#)()4'%&"'+")5$%)'$00A'%"*%#%(:"$-'"*,05+#.(*.4'#%'$"#)%'%0')%(,A'%0'%&"'<+0#1'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

COMPETITION WITHIN THE NHSDr. Jennifer DixonDirector, The Nuffield Trust

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

/0$(,-'1(+",%(0*'09'%+#:"$7'!06":"+4'%&"'5*(%'09',03/"%(%(0*'d'%&"'&0)/(%#$'0+'"$",%(:"',#+"'9#,($(%-'d'()'*0%'0/%(3#$'90+'%&"'<(.'/+(0+(%(")'09',#+(*.'90+'0$1"+'/"0/$"'#*1'%&0)"'6(%&'$0*.'%"+3',0*1(%(0*)7'!"+"'(*%".+#%"1',#+"'()'*""1"1')/#**(*.'&03"'%0'&0)/(%#$'d'<5%'%&()'()'%00'09%"*':("6"1'#)'#*%(K,03/"%(%(:"'<-'",0*03()%)'5)"1'%0'%&"0+()(*.'#<05%'

)"+(05)$-',0*)(1"+'&06',03/"%(%(0*'<"%6""*':"+%(,#$$-'(*%".+#%"1'*"%60+A)'09'/+0:(1"+)'3(.&%'<"'"*,05+#."17

J(*#$$-'#*1'+"$#%"14'#'$0%'09'&"#$%&'/0$(,-'&#)'<""*'0+("*%"1'%0'6&#%'3(.&%'<"'10*"'%0',&#$$"*."'/+0:(1"+)'9+03'6(%&05%'%0'(3/+0:"'/"+90+3#*,"'H".',03/"%(%(0*4'+".5$#%(0*4'1(+",%(:"I'#*1'*0%'0*'6&#%'%-/"'09'^(*%+#M'/+0:(1"+'"*:(+0*3"*%'3(.&%'<"',+"#%"1'%0'(*,+"#)"'/"+90+3#*,"7'J0+'"@#3/$"'5)(*.'(*90+3#%(0*4'/""+'+":("6'09'/"+90+3#*,"4'

$"#1"+)&(/4'#*1'(*:0$:(*.'/#%("*%)c,0335*(%(")'%0'/+0:(1"'%&"'^1()+5/%(:"'(**0:#%(0*M'9+03'6(%&(*7'P&()'()')5+"$-'%&"'#+"*#'+(/"'90+'1":"$0/3"*%'0:"+'%&"'*"@%'1",#1"7'89'%&"'$#)%'1",#1"'&#)'%#5.&%'5)'#*-%&(*.4',03/"%(%(0*4'+".5$#%(0*'#*1'1(+",%(:"',#*'0*$-'.0')0'9#+'d'#*1'%00'35,&'$"#1)''%0'9#($5+"7

12 13

J0$$06(*.'%&"'?/"*1(*.'V":("64'%&"+"')""3)'

95%5+"'90+'%&"'>!?'#*1'6&#%'%&"'_"/#+%3"*%'09'!"#$%&M)'/5)&'%0'(3/+0:"'/+015,%(:(%-'6($$'3"#*'90+'%&"')"+:(,"4')%#99'#*1'/#%("*%)7'?0'6&#%'#+"'%&"'9#,%)e

W*'95*1(*.4')(*,"'CDDfcb4'%&"'L*.$()&'>!?'<51."%'(*,+"#)"1'<-'*"#+$-'ESU'(*'+"#$'%"+3)7'\5%'0:"+'%&"'*"@%'905+'-"#+)'%&"'/$#**"1'+"#$'+()"'6($$'<"'D7TgU'K'0+'B5)%'D7DOTU'#'-"#+'0*'#:"+#."7'P&()')$06'106*'(*'95*1(*.'.+06%&'(*'9#,%')%#+%"1'%&()'-"#+4'6(%&'#'+"#$'+()"'09'B5)%'D7bU7'2#+%'09'%&"'>!?')"%%$"3"*%'#$)0'(*,$51")'#*'#:"+#."'#**5#$'#305*%'09'hSaD'3($$(0*'"#+3#+A"1'90+'B0(*%')/"*1(*.'<"%6""*'%&"'>!?'#*1')0,(#$',#+"7'

R&"%&"+'%&"'>!?'#,%5#$$-'+","(:")'#'+"#$'(*,+"#)"'<-'CDEgcEa'1"/"*1)'0*'%&"'#,,5+#,-'

3"#)5+"'5)"1'<-'%&"'P+"#)5+-'%0'")%(3#%"'

%&#*'6(/"'05%'%&"')3#$$'+"#$'(*,+"#)"7'F*1'6&"%&"+'>!?'/5+,&#)(*.'/06"+'(*,+"#)")'(*'

"@/"+("*,"1'<-'%&"'>!?7'P&"')%#99'/#-'9+""`"'

%&"'$#)%'%60'-"#+)'09'%&"')/"*1(*.'+":("6e'''

W:"+#$$4'1")/(%"'6&#%'6($$'<"'#*'5*/+","1"*%"1'+5*'09':"+-'$06'+"#$'.+06%&4'%&"'>!?',#*'/"+&#/)',05*%'(%)"$9'90+%5*#%"',03/#+"1'6(%&'"=5#$$-'5*/+","1"*%"1'+"#$'

,5%)'(*'30)%'0%&"+'1"/#+%3"*%)7'

\5%'%&"'>!?'6($$'*0%'<"'"@"3/%'9+03'%&"',&#$$"*."'%0'(3/+0:"'(%)'/+015,%(:(%-7'P&"'30*"%#+-':#$5"'09'3""%(*.'(*,+"#)(*.'1"3#*1'9+03'#'.+06(*.'#*1'(*,+"#)(*.$-'#."(*.'/0/5$#%(0*'#*14',+5,(#$$-4'(3/+0:(*.'%&"'=5#$(%-'09'(%)')"+:(,")'&#)'<""*':#+(05)$-'")%(3#%"1'<-'%&"'_"/#+%3"*%'09'!"#$%&'#*1'B0(*%'#*#$-)()'<-'%&"'Q(*.M)'J5*1'#*1'+")"#+,&"+)'9+03'%&"'8*)%(%5%"'90+'J(),#$'?%51(")'%0'<"'<"%6""*'ha'<($$(0*'#*1'hb'<($$(0*'#'-"#+7

P&")"'#+"'<+0#1'")%(3#%")'#*1'1"/"*1(*.'0*'1",()(0*)'#<05%4'90+'"@#3/$"4'95%5+"'/#-'+()")4'6&"%&"+'0+'*0%'%0'(*:")%'(*'95+%&"+'6#(%(*.'%(3")'+"15,%(0*)'#*1'(*9+#)%+5,%5+"'(3/+0:"3"*%)')5..")%"1'<-'?(+'_"+"A'R#*$"))'(*'&()'CDDC'+":("6'09'95%5+"'>!?'95*1(*.'*""1)4'%&"':#$5"'09'%&"'/+015,%(:(%-',&#$$"*."',05$1'<"'$"))'K'09'%&"'0+1"+'09'hT'<($$(0*'%0'ha'<($$(0*'#'-"#+7

89'%&"'/+015,%(:(%-',&#$$"*."',#*'<"'3"%4'%&"*'90+'/#%("*%)'(%'6($$'3"#*'<"%%"+')"+:(,")'#*1'30+"'09'%&"'%&(*.)'%&"-':#$5"'K'9"6"+'&0)/(%#$'(*9",%(0*)4'30+"'0/"+#%(0*)4'&(.&"+'=5#$(%-'

%&"',0)%')(1"'09'%&"'"=5#%(0*'K')#:(*.'30*"-'0+'3#A(*.',5%)'K'%&")"'#+"'*0%'(3/+0:"3"*%)'(*'/+015,%(:(%-7'V#%&"+4'(%'*""1)'90,5)'0*'%&"'

)"+:(,")'%&#%'(*,+"#)"'%&"':#$5"'09',#+"''%0'/#%("*%)7''

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

Professor John Appleby Chief Economist, The King’s Fund

NHS FINANCES AND PRODUCTIVITY

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

‘The task for the NHS is not to fixate on the cost side of the equation . . . rather, it needs to focus on the benefits side to find new ways of providing services that increase the value of care to patients’

14 15

F9%"+'%&"'+","*%'N03/+"&"*)(:"'?/"*1(*.'V":("64'0:"+#$$')/"*1(*.'0*'%&"'>!?'6($$'(*,+"#)"'<-'D7gU'(*'+"#$'%"+3)'0:"+'%&"'$(9"'09'%&()'2#+$(#3"*%7'8*'+"#$(%-'&06":"+4'%&()'()'6($$'*0%'A""/'5/'6(%&'#'.+06(*.'1"3#*1'0*')"+:(,")'#*1'#*'#."(*.'/0/5$#%(0*7'25%')(3/$-4'%&"'>!?'6($$')%($$'&#:"'%0'10'30+"'6(%&'$"))7''

P&"'>!?'60+A90+,"'&#)'%0'+")/0*1'%0'5*/+","1"*%"1',&#$$"*.")4'/#+%(,5$#+$-'%&0)"'05%$(*"1'(*'%&"'+","*%'>!?'6&(%"'/#/"+7'?5,&'#3<(%(05)',&#*.")'(*'%&"'6#-'&"#$%&,#+"'()'1"$(:"+"1'6($$'+"=5(+"'35$%(1(),(/$(*#+-')5//0+%4'(*,$51(*.'9+03'%&0)"'0*'%&"'9+0*%$(*"'09',#+"7'_")/(%"'%&()4'%&"'6&(%"'/#/"+'3"*%(0*)'^*5+)(*.M'0*$-'0*,"7''

?%#99'#+"'9#,(*.'#'%60'-"#+'/#-'9+""`"4'/"*)(0*'+"90+3)4',&#*.")'%0'6#-)'09'60+A(*.4'#*1'%&"'":"+K/+")"*%'/+0)/",%'09',5%)'(*'B0<)'#*1')"+:(,")7'P&"'V0-#$'N0$$"."'09'>5+)(*.'HVN>I'()'#6#+"'%&#%')%#99'#+"'#$+"#1-'1"#$(*.'6(%&'

<#*1(*.'09')#$#+(")7'F$$'#+"'1""/$-'5*)"%%$(*.7'8%'()*M%':"+-')5+/+()(*.4'%&"+"90+"4'%&#%'#')%51-'<-'%&"'VN>'"#+$("+'%&()'-"#+')&06"1'%&#%'%&")"'9#,%0+)'#+"',#5)(*.'&"(.&%"*"1'$":"$)'09'#*@("%-'#30*.')%#99['/#+%(,5$#+$-'+".#+1(*.''B0<')",5+(%-'#*1'%&"'#<($(%-'%0'/+0:(1"'&(.&'=5#$(%-',#+"7''

P&"'VN>'&#)')#(1',$"#+$-'%&#%'%&"'60+A90+,"'*""1)'%0'60+A'(*'*"6'#*1'(**0:#%(:"'6#-)'%0'(*,+"#)"'/+015,%(:(%-4'+"15,"'6#)%"'#*1'

!"#$%&'$()!'"*%),#3/#(.*4'6"'&#:"'<""*'#)A(*.'05+'gDD4DDD'3"3<"+)'90+'"@#3/$")'09'%&"'*5+)"K$"1'(**0:#%(0*)'%&#%'$"#1'%0'<"%%"+'#*1'30+"'

"3<+#,")'%&"'+(,&*"))'#*1'%&"'/0))(<($(%(")'09',#+"'#*1'8'605$1'5+."'%+5)%)'%0'"*.#."'30+"'+"#1($-'6(%&')%#997

P&"')5//0+%'09'*5+)(*.')%#99'()'"))"*%(#$'%0'#*-',&#*.")'(*'&"#$%&,#+"'K'")/",(#$$-'(9'%&"'60+A90+,"'()'"@/",%"1'%0',0/"'6(%&')5,&'#'

,&#*."4'%+5)%'<0#+1)'6($$'*""1'%0'<"'/+#.3#%(,'#*1'"*.#."'6(%&'%&"'60+A90+,"'#*1'6(%&''%+#1"'5*(0*)['%&"-'#+"'/#+%'09'%&"')0$5%(0*'*0%'%&"'/+0<$"37

!#:(*.'#'&"#$%&-'60+A90+,"'()':(%#$7'P&"'CDDS'\00+3#*'V"/0+%4'>!?'!"#$%&'#*1'R"$$K<"(*.4'"3/&#)()"1'%&"'(3/0+%#*,"'09')%#99'#,&(":(*.'/&-)(,#$4'3"*%#$4'#*1')0,(#$'&"#$%&7'F)'%&"'+"/0+%'05%$(*"14'%&"'>!?',05$1'+"15,"'(%)'+#%")'09')%#99')(,A*"))'#<)"*,"'<-'#'%&(+1'#*14'(*')0'10(*.4',+"#%"'#*'#11(%(0*#$'T7g'3($$(0*'#:#($#<$"'60+A(*.'1#-)4')#:(*.'#*'")%(3#%"1'haaa'3($$(0*'/"+'-"#+7'P&"'":(1"*,"'09'#'$(*A'<"%6""*')%#99'6"$$K<"(*.'#*1'/#%("*%'"@/"+("*,"'()'*0%'0*$-',+"1(<$"4'<5%'/+0:"*7

P&"'60+A90+,"'*""1)'%0'<"'&"#$%&-4'

%(3")4'<0%&'*06'#*1'#&"#14'%&")"'#+"'%&"'0*$-'6#-)'%&#%'=5#$(%-'/#%("*%',#+"4'#*1'<-'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

THE NHS WORKFORCEDr Peter Carter Chief Executive, Royal College of Nursing

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

‘The workforce needs to be healthy, empowered and innovative. In the difficult times, both now and ahead, these are the only ways that quality patient care, and by extension good nursing practice, will flourish’

16 17

!"#$%&'6($$'$003'$#+."'(*'%&()'2#+$(#3"*%'#*1'35,&'%(3"'6($$'<"')/"*%'0*'%&"'G0:"+*3"*%M)'95*1(*.'#*1'+"90+3'/$#*)'90+'%&"'>!?'(*'L*.$#*17'>#%(0*#$'Y0(,")'()'%&"',0#$(%(0*'09'*#%(0*#$':0$5*%#+-'0+.#*()#%(0*)'/+030%(*.'

05+'3"3<"+)'%&"+"'()'#$)0'#'6(1"+'#."*1#Z'/"+)()%"*%'&"#$%&'(*"=5#$(%(")['%&"'&"#$%&'(3/#,%)'09'#5)%"+(%-['#*1'":"+K+()(*.'1"3#*1)'90+',#+"7'W5+',&#$$"*."'%0'/#+$(#3"*%#+(#*)'(*'

3#(*%#(*'#'90,5)'0*'%&"'*""1)'09'(*1(:(15#$)'#*1',0335*(%(")4'/#+%(,5$#+$-'%&"'30)%':5$*"+#<$"7'R&#%'10")'%&()'3"#*'(*'/+#,%(,"e

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

?",0*1$-4'/"0/$"'*""1'&"$/'%0'$00A'#9%"+'%&"3)"$:")'<"%%"+7'2"0/$"'6#*%'%0'<"'(*',0*%+0$4'-"%'3#*-'09'5)4'(*,$51(*.'%&"'

.+06(*.'*53<"+)'09'/"0/$"'6(%&'$0*.'%"+3',0*1(%(0*)'#*1'1()#<($(%(")4'&#:"'30+"',0*%#,%'6(%&'&"#$%&')"+:(,")'%&#*'6"'6#*%'0+'*""14'#*1')/"*1'%00'35,&'%(3"'(*'&0)/(%#$7'P&"'%+#1(%(0*#$'3"1(,#$'301"$'09',#+"'K'&(.&$-'/#(1'"@/"+%)'10(*.'30+"'#*1'30+"'%&(*.)'%0'/#))(:"'+",(/("*%)'d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

P&(+1$-4'6"'*""1'%0'."%'+"#$'#<05%'/#%("*%'#*1'/5<$(,'(*:0$:"3"*%'(*')"+:(,"'1",()(0*)7'P&"'(3/0+%#*,"'09'(*:0$:(*.'/"0/$"'()'."*"+#$$-'#,,"/%"14'<5%'/+#,%(,"'()'%00'09%"*'90+35$#(,'#*1'%0A"*()%(,Z'=5")%(0**#(+")''+#%&"+'%&#*',0$$#<0+#%(0*)7'P&"':"+-'#,+0*-3'i228j'K'6&(,&'3#A")'3"'6(*,"'K'()'(*1(,#%(:"'09'%&()'3(*1)"%7'R"'A*06'%&#%'1",()(0*)'3#1"'(*'/#+%*"+)&(/'<"%6""*')"+:(,"'/+0:(1"+)'#*1',(%(`"*)'#+"'30+"'$(A"$-'%0'<"'%&"'+(.&%'1",()(0*)'#*1'30+"'

3#A"'#'+"#$(%-'09'%&#%'/#+%*"+)&(/'#//+0#,&'*""1)'1(99"+"*%'<"&#:(05+)'#*1'#%%(%51")7'8%'3"#*)4'90+'"@#3/$"4'10,%0+)',0#,&(*.'+#%&"+'%&#*'(*)%+5,%(*.7'F%'%&"',0$$",%(:"'$":"$'(%'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

PATIENT EXPERIENCEJeremy Taylor Chief Executive, National Voices

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

3"#*)',033())(0*(*.'<",03(*.'9#+'30+"'1"30,+#%(,4'#*1'/5<$(,')"+:#*%)'+"#,&(*.'05%'%0'"@,$51"1',0335*(%(")7

V#1(,#$'+"90+3'09')"+:(,")'#%'#'%(3"'09'#5)%"+(%-'+()A)',+"#%(*.'#'/"+9",%')%0+37'8%'6($$'#$)0'."*"+#%"'0//0+%5*(%(")'90+'10(*.'%&(*.)'<"%%"+7'8'&0/"'%&#%'/#+$(#3"*%#+(#*)'6($$')"(`"'%&"(+'0//0+%5*(%(")'%0')",5+"'#'<"%%"+'1"#$'90+'/#%("*%)4',#+"+)4'9#3($(")'#*1',(%(`"*)7

18 19

F)'#'/+#,%()(*.'G2'60+A(*.'(*'#'<5)-'(**"+',(%-'#+"#4'8'60+A'#%'%&"'&"#+%'09'#',0335*(%-4'/+0:(1(*.'$(9"$0*.',#+"'%0'05+'/#%("*%)'#*1'%&"(+'9#3($(")7'\5%'%&"'/5<$(,M)'&"#$%&'()'":"+-<01-M)'<5)(*"))4'*0%'B5)%'&"#$%&,#+"'/+09"))(0*#$)M7'

&"#$%&'(*"=5#$(%(")4'#*1'#)'2+09"))0+'?(+';(,&#$';#+30%')#(1'(*'J#(+'?0,("%-4'!"#$%&-'](:")Z'iP&"+"'()'#')0,(#$'.+#1("*%'(*'&"#$%&'d'%&"'$06"+'#'/"+)0*M)')0,(#$'/0)(%(0*4'%&"'60+)"'&()'0+'&"+'&"#$%&7'F,%(0*')&05$1'90,5)'0*'+"15,(*.'%&"'.+#1("*%'(*'&"#$%&j'#*1'(*'/#+%(,5$#+'90,5)'0*')(@'0<B",%(:")Z'

%0'3#@(3()"'%&"(+',#/#<($(%(")'#*1'&#:"',0*%+0$'0:"+'%&"(+'$(:")

'60+A'90+'#$$

/$#,")'#*1',0335*(%(")'

&"#$%&'/+":"*%(0*'

$(*"'<"%6""*'/+030%(*.'.001'&"#$%&'#*1'#'*#**-')%#%"'%&#%'%"$$)'/"0/$"'&06'%0'$(:"'%&"(+'$(:")7'F%'%&"'&"#+%'09'%&"'#."*1#')&05$1'<"'%&"'/+(*,(/$"'%&#%'/+":"*%(0*'()'<"%%"+'%&#*',5+"'#*1'%&"'*""1'90+'#'$".(%(3#%"'/5<$(,'&"#$%&'

)"+:(,"'%&#%'"@()%)'*0%'B5)%'%0'/#%,&'/"0/$"'5/'6&"*'%&"-'#+"'($$'<5%'%&#%'/+":"*%)'%&"3'9+03'

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d'%&"'&"#$%&'(*"=5#$(%(")'.#/'/"+&#/)'#<0:"'#$$'0%&"+)'d'#*1'(%'()'#*'0//0+%5*(%-'%00'(3/0+%#*%''%0'6#)%"7'P&"'/5<$(,'&"#$%&'()'":"+-<01-M)'&"#$%&4'

*53<"+'09'/"0/$"'6&0'#+"'."*"+#$$-')0,(#$$-'"@,$51"17'P&")"'(*,$51"'%&"'&03"$"))4')%+""%')"@'60+A"+)4'#)-$53')""A"+)'#*1'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

PUBLIC HEALTHProfessor Steve Field Former Chair, Royal College of General Practitioners

%&"+"'&#)'<""*'#'90,5)'0*'%+"#%(*.'&#+34'+#%&"+'%&#*'/+":"*%(*.'(%4'<5%'":(1"*,"')&06)'%&#%'/#+%*"+)&(/'d''<"%6""*'/+(3#+-',#+"4'$0,#$'#5%&0+(%-'#*1'%&(+1')",%0+'d'%0'1"$(:"+'5*(:"+)#$'#*1'%#+."%)'/+":"*%#%(:"'

P&()'#."*1#'()',#$$"1'8*,$5)(0*'!"#$%&7'P&"'6&0$"'/0/5$#%(0*M)'&"#$%&'35)%'<",03"'#)'<(.'#'/+(0+(%-'90+';2)'#)'(%'()'90+'G2)7'R"'35)%'#$$'60+A'%0."%&"+'%0'%+#*)90+3'%&"')%#%"'09'%&"'*#%(0*M)'&"#$%&'90+'%&"'<"%%"+7'P&"')%#A")'#+"'%00'&(.&'(9'6"'."%'(%'6+0*.7

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

20 21

P&"'9#,%)'#$30)%')/"#A'90+'%&"3)"$:")7'W:"+'%&"'*"@%'Ea'-"#+)'%&"'*53<"+'09'/"0/$"'#."1'0:"+'Oa'6($$'105<$"7'R(%&(*'CD'-"#+)')03"'E7b'3($$(0*'30+"'/"0/$"'H0$1"+'/"0/$"'#*1'1()#<$"1'60+A(*.'#."'#15$%)I'6($$'&#:"'#'/0%"*%(#$',#+"'*""1'%&#*'10'%01#-7'8*'%&"'/"+(01'09'%&"')/"*1(*.'+":("6'TbD4DDD'30+"'/"0/$"'6($$'+"=5(+"',#+"'#*1')5//0+%7

?0,(#$',#+"'/+0:(1"1'%&+05.&',05*,($)'()')5//0+%(*.'E7b'3($$(0*'/"0/$"'<5%'(*,+"#)(*.$-'/"0/$"'#+"'&#:(*.'%0'95*1'%&"(+'06*',#+"',0)%)7'F15$%')0,(#$',#+"')/"*1'0*'0$1"+'/"0/$"'()'#+05*1'hO<*'<5%'()'0*$-'#')3#$$',03/0*"*%'09'/5<$(,'"@/"*1(%5+"'0*'0:"+'faM)4'6&"+"')0,(#$'

#305*%'%0'hOT<*'#*1'>!?')/"*1'%0'haD<*7

P&"',&#$$"*."'()'&06'6"'(*,+"#)"'%&"'$":"$'09'+")05+,"'(*%0'%&"',#+"'#*1')5//0+%'/0%7'F*1+"6'_($*0%M)'N033())(0*'0*'N#+"'J5*1(*.'6($$'*""1'%0',03"'90+6#+1'6(%&'#',$"#+'0/%(0*'90+'#')5)%#(*#<$"4'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

SOCIAL CARERichard Jones President, Association of Directors of Adult Social Services

+")($("*%'#*1'9#(+')"%%$"3"*%7'8%'6($$'*""1'%0'<"'#')"%%$"3"*%'%&#%'+",0.*()")'%&"'$":"$'09'(*90+3#$')5//0+%4'")%(3#%"1'#%'#':#$5"'

#*1'&"$/)'%&"'/5<$(,'5*1"+)%#*1'%&#%'#'/#+%*"+)&(/'#//+0#,&'6($$'<"'*""1"1'<"%6""*'(*1(:(15#$)c9#3($(")'#*1'%&"')%#%"'#)'6"'30:"'90+6#+17'R"'*""1'/"0/$"'%0'5*1"+)%#*1'%&#%'%&"-'&#:"'#'EZg',&#*,"'09'+","(:(*.'+")(1"*%(#$',#+"'(*'%&"(+'$#%"+'-"#+)'#*1'#'faU'+()A'09'+","(:(*.',0335*(%-'<#)"1')5//0+%'6(%&'#'&5."',0)%)'60+A(*.'05%'#%'hgD4gDD'90+'603"*'#*1'hCC4TDD'90+'3"*7

P&"',&#$$"*."'90+')0,(#$',#+"'(*'%&"')&0+%'%0'3"1(53'%"+3'()'#<05%'<5($1(*.'#'+"90+3'#."*1#'<#)"1'0*'T'A"-'/+(*,(/$")7

/"+)0*#$'<51."%)'K'<-'%&"'"*1'09';#+,&'CDEE4'TDD4DDD'/"0/$"'6($$'&#:"'30+"',0*%+0$'09'%&"(+',#+"'#*1')5//0+%'%&+05.&'#'/"+)0*#$'<51."%7'R"'6#*%'%0')""'/"0/$"'(*,+"#)(*.$-'/00$(*.'%&"(+'06*'+")05+,")'6(%&'/5<$(,'95*1(*.'%0'1":"$0/'1(99"+"*%'#*1'

%&"(+')%+"*.%&)'#*1'60+A(*.'%&"3'#)'#,%(:"',(%(`"*)7'8*'0+1"+'%0'#,&(":"'/"+)0*#$()#%(0*'6"'*""1'%0')""'#',#+"'#*1')5//0+%'3#+A"%'6&(,&'()'1(:"+)"'#*1':(<+#*%'6(%&'*"6'"*%+#*%)'099"+(*.'1(99"+"*%')"+:(,")7

#*1')0,(#$',#+"'()'*""1"1'%0'A""/'/"0/$"'(*1"/"*1"*%'#*1'+")/0*)(<$"'90+'%&"3)"$:")7'R"'A*06'(*:")%3"*%'(*'.001'(*90+3#%(0*'#*1'#1:(,"'()',+5,(#$'%0'&"$/'/"0/$"'3#A"'.001'1",()(0*)7'L#+$-'(*%"+:"*%(0*4',+()()')5//0+%')"+:(,")4'%"$",#+"'#*1'%&"'6(1"+'5)"'09'8P4'"*1'09'$(9"')"+:(,")4'.001')5//0+%'90+'1"3"*%(#'/#%("*%)'#*1'&03"'<#)"1'&"#$%&,#+"',#*'#$$'&"$/'%0'(3/+0:"'05%,03")'#*1')#:"'30*"-'(*'#,5%"'(*%"+:"*%(0*)7

09'<51."%)'#*1',033())(0*(*.'%06#+1)',0335*(%-'<#)"1'(*%"+:"*%(0*)4'(3/+0:"1'05%,03")'90+'/"0/$"'#*1'+"15,"1'15/$(,#%(0*'09':()(%)7'R"'*""1'%0'<5($1'1(99"+"*%'/#+%*"+)&(/)'6&(,&'#+"'#$(.*"1'%0')",5+"')&#+"1'.0#$)'#*1'5*1"+)%#*1'%&"'(*%"+1"/"*1"*,-'09'&"#$%&'#*1')0,(#$',#+"7'

/+015,%(:(%-'.#(*)'%&+05.&'#'3#B0+'/+0.+#33"'09'+"90+37';0+"'09'%&"')#3"'60*M%'60+A7

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

22 23

P&"'N#+"'k5#$(%-'N033())(0*'HNkNI'6#)'")%#<$()&"1'(*'F/+($'CDDS7'8%'6#)'90+3"1'9+03'%&+""'/+"1","))0+'0+.#*()#%(0*)Z'%&"'!"#$%&,#+"'N033())(0*4'%&"'N033())(0*'90+'?0,(#$'N#+"'8*)/",%(0*4'#*1'%&"';"*%#$'!"#$%&'F,%'N033())(0*7'NkN'&#)'<5($%'0*'%&"'"@/"+%()"'09'%&0)"'0+.#*()#%(0*)'<5%'0/"+#%")'6(%&(*'#'1(99"+"*%'$".()$#%(:"'9+#3"60+A'H!"#$%&'#*1'?0,(#$'N#+"'F,%'CDDOI7'W5+'"3/&#)()'()'0*'05%,03")'90+'/"0/$"4'"*)5+(*.'%&#%'6&#%":"+'%&"')"+:(,"'()4'(%'90,5)")'0*'%&"'(*1(:(15#$'#*1'()'+")/0*)(:"'%0'"#,&'/"+)0*M)'/#+%(,5$#+',(+,53)%#*,")7''

,$(*(,#$'(*%"+:"*%(0*)'0+',#+"'#*1'#*'"@/"+("*,"'%&#%'%&"'(*1(:(15#$':#$5")'<",#5)"'(%'"*&#*,")'%&"(+'."*"+#$'6"$$<"(*.7'R"'&#:"'Ef'"))"*%(#$')%#*1#+1)'09'=5#$(%-'#*1')#9"%-'6(%&(*'#')(*.$"'9+#3"60+A'%&#%'#//$(")'%0'#$$')"+:(,")'6"'+".5$#%"7

R"'30*(%0+',03/$(#*,"'#.#(*)%'%&")"')%#*1#+1)'5)(*.'#',03<(*#%(0*'09'9""1<#,A'9+03'/"0/$"'6&0'5)"')"+:(,")4'%&"(+'9#3($(")'#*1',#+"+)4')%#99'(*'&0)/(%#$)'#*1',#+"'&03")4'#*1'0%&"+'$0,#$'.+05/)'H(*,$51(*.']0,#$'8*:0$:"3"*%'>"%60+A)'H]8>A)I'#*1'%&"':0$5*%#+-')",%0+I7'R"'#$)0'$00A'#%'1#%#'%0')""'(9'6"',#*'(1"*%(9-'60++-(*.'/#%%"+*)7'89',0*,"+*)'"3"+."'NkN'()'"3/06"+"1'%0'%#A"'#,%(0*'%0'+"=5(+"'(3/+0:"3"*%'#*1'(9'*","))#+-',#*'#//$-'+")%+(,%(:"',0*1(%(0*)'%0'+"15,"'%&"'+()A'09'&#+3'%0'/"0/$"7'8*'"@%+"3"')(%5#%(0*)4'%&()',#*'$"#1'%0')"+:(,"',$0)5+"7

,&#$$"*."'%0',033())(0*"+)'#*1'/+0:(1"+)4'6&0'*""1'%0'"*)5+"'%&"-'3#(*%#(*'=5#$(%-'(*'

,5%)7'8*'#11(%(0*4'%&"'%+#*)(%(0*'/"+(01'09',&#*."'6(%&(*'%&"'>!?'6($$'/0%"*%(#$$-'$"#1'%0'#'$#,A'09'90,5)'0*'=5#$(%-['3#*-'09'%&"'>!?M'^"#+$-'6#+*(*.')-)%"3)M'#+"'<"(*.'1()3#*%$"1'#*1'+"90+3"1'd')%+#%".(,'&"#%$%&'#5%&0+(%(")'#*1'/+(3#+-',#+"'%+5)%)'&#:"'#*'(3/0+%#*%'+0$"'(*'%#,A$(*.'/00+'=5#$(%-',#+"'#*1'%&"(+'3#*%$"'*""1)'%0'<"'/(,A"1'5/7''P&"'+".5$#%0+'6($$'/$#-'(%)'/#+%'<5%'":"+-0*"'60+A(*.'(*'%&"')",%0+'*""1)'%0'<"':(.($#*%'#*1'<"'/+"/#+"1'%0'=5")%(0*'#*1',&#$$"*."'(9'%&"-')""'/00+'/+#,%(,"7

R"'#+"'<".(**(*.'%0'1"%",%'#'*""1'%0'10'%&(*.)'1(99"+"*%$-'(*'0+1"+'%0'3""%'%&"',&#$$"*.")'

(**0:#%(0*'#*1'6"'#+"'1(),5))(*.'%&")"'())5")'6(%&'/+0:(1"+)'#*1',033())(0*"+)7

()'0*"'6#-')#:(*.)'3#-'<"'#,&(":"1'%0'/+0%",%'9+0*%K$(*"')"+:(,")7'!"+"90+1)&(+"',05*,($'/$#*)'%0'90+3'#'B0(*%':"*%5+"'0+.#*()#%(0*'(*'F/+($'CDEE'6(%&'>!?'!"+"90+1)&(+"'#*1'!"+"90+1'!0)/(%#$)'P+5)%7'\-')&#+(*.'#*1'

6&(,&'6($$'<"'+"(*:")%"1'(*'"))"*%(#$')"+:(,")7

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

QUALITYDame Jo Williams Chair, Care Quality Commission

R")%3(*)%"+4'!#33"+)3(%&'l'J5$&#34'#*1'Q"*)(*.%0*'l'N&"$)"#',05*,($)'(*%"*1'%0'.0'":"*'95+%&"+4'6(%&'/$#*)'%0')&#+"'":"+-',05*,($')"+:(,"'<"%6""*'%&"3''%0'1"$(:"+'30+"'90+'$"))''6&($"'/+0%",%(*.'9+0*%K$(*"''/5<$(,')"+:(,")7

J0+'/"0/$"'5)(*.')"+:(,")4'(%'()'"))"*%(#$'90+'%&"'+(.&%'(*90+3#%(0*'%0'<"'#:#($#<$"'(*'#*'#,,"))(<$"'90+3#%'%0'(*90+3'%&"(+',&0(,")7'2"0/$"'35)%'#$)0'<"'(*:0$:"1'(*'1",()(0*)'#<05%'%&"(+',#+"4'(*'$(*"'6(%&'%&"'!"#$%&'?",+"%#+-M)'/$"1."'094'^*0'1",()(0*'#<05%'5)4'6(%&05%'5)M7'P&()'&#)'#'&5."'(3/#,%'0*'%&"'=5#$(%-'09'/"0/$"M)'"@/"+("*,"7'F'^10'6(%&M'+#%&"+'%&#*'#'^10'%0M'#%%(%51"'35)%'/+":#($'#30*.)%',#+"'/+09"))(0*#$)7

k5#$(%-',#*'<"'"*&#*,"1'%&+05.&'#'90,5)'0*'/+":"*%(0*4'."%%(*.'(%'+(.&%'

&0)/(%#$'+"K#13())(0*)7'8*:")%3"*%'(*'%&"'+(.&%'+"#<$"3"*%')"+:(,")'()'30*"-'6"$$')/"*%'(9'(%'"*)5+")'/"0/$"'&#:"'#//+0/+(#%"'#*1'%(3"$-')5//0+%'%0'+",5/"+#%"'(*'%&"(+'06*'&03")7'P&"'$#,A'09')5,&')5//0+%'()'$(A"$-'%0'$"#1'%0'&(.&"+',0)%)'#*1'/00+"+'$0*.'%"+3'05%,03")7

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

24 25

P&"'>!?'()'*":"+'9#+'9+03'%&"'%&05.&%)'09'/0$(%(,(#*)'#%'R")%3(*)%"+7'P&()')"))(0*'()'*0'"@,"/%(0*'#)'6"'#6#(%'%&"'>!?'\($$'6&(,&'6($$'(3/$"3"*%'F*1+"6']#*)$"-M)'+"90+3)7

P&"'(*%"*1"1'05%,03")'09'%&"'6&(%"'/#/"+'#+"'

/#%("*%',"*%+"1')"+:(,"4'30+"',0*%+0$'0:"+'05+'06*'%+"#%3"*%'#*1',&0(,"'09'10,%0+7'8%'6#)'#')%+0*.'%&"3"'09']#<05+M)'#//+0#,&'%0'%&"'>!?7

8*%"+")%(*.$-4'%&"'+")/0*)"'09'%&"'>!?'#*1'/#%("*%)'0+.#*()#%(0*)'%0'%&"'G0:"+*3"*%M)'/$#*)'&#)'<""*'/+"%%-'5*"*%&5)(#)%(,7'N0*,"+*)'0:"+'5*(*%"*1"1',0*)"=5"*,")''#*1'%&"'/0%"*%(#$'1"K)%#<($()#%(0*'09'%&"'?"+:(,"'&#:"'<""*'#',0*)()%"*%'%&"3"'09''%&"(+'+"/+")"*%#%(0*)7

P&"'A"-'9"#%5+"'()'%&"'#<0$(%(0*'09'/+(3#+-',#+"'%+5)%)'#*1')%+#%".(,'&"#$%&'#5%&0+(%(")'#*1'%&"',+"#%(0*'09'G2',0*)0+%(#'%0',033())(0*'hSD'<($$(0*'60+%&'09'&"#$%&',#+"'9+03'/+0:(1"+)7'!0)/(%#$)'6($$'0/"+#%"'(*'#'35,&'30+"',03/"%(%(:"'3#+A"%'5*1"+'%&"'3#*%+#'^#*-'6($$(*.'/+0:(1"+M7'F*%(K,03/"%(%(:"'/+#,%(,")'<-'/+0:(1"+)'6($$'<"'/0$(,"1'<-'#*'",0*03(,'+".5$#%0+'$(A"'WJGL;7

?0'6&-'()'%&"'?",+"%#+-'09'?%#%"')0'6($$(*.'%0'"*%"+%#(*')5,&'#*'5/&"#:#$e'J+03':#+(05)',033"*%)'&"'&#)'3#1"'%0'/#+$(#3"*%#+(#*)4'(%'()')%+(A(*.'%&"'"3/&#)()'&"'/$#,")'0*'%&"'

F)'&"')"")'(%4'/#%("*%)'3#A"'1"3#*1)'6&(,&',$(*(,(#*)'#+"'&#//-'%0'+")/0*1'%0'<",#5)"'%&"',0)%)'6($$'<"'3"%'<-')03"0*"'"$)"7'!"'3#A")'%&"'/0(*%'%&#%'G2)'(*,5+'30)%'09'%&"'"@/"*1(%5+"'09'%&"'>!?'(*'%"+3)'0+'/+"),+(<(*.'#*1'+"9"++#$)4'<5%'10*M%'&#:"'%&"'+")/0*)(<($(%-'90+')""(*.'&06'%&"'3#*#."3"*%'09',#+"'()'<")%'+",0*,($"1'6(%&'%&"'3#*#."3"*%'09'+")05+,")7

F/#+%'9+03'%&"'=5")%(0*'09'6&"%&"+'G2)',0$$",%(:"$-'6#*%'%0'%#A"'0*'%&"'+")/0*)(<($(%-'09',033())(0*(*.4'(%M)'#'300%'/0(*%'#)'%0'6&"%&"+'%&"-'+"#$$-'6($$'<"'/+"/#+"1'%0'/0$(,"'9"$$06'10,%0+)'6&0'#+"'5*#<$"'%0',0*%+0$'1"3#*1)'0*')"+:(,")7

W9'30+"'(33"1(#%"',0*,"+*4'()'6&"%&"+'%&"'>!?',#*'6(%&)%#*1'%&"'1()+5/%(0*',#5)"1'<-'%&"')"%%(*.'5/'09'#',03/$"%"$-'*"6')-)%"34'6&"*'%&"',5++"*%'3#*#."3"*%'<01(")'#+"'0*'%&"'6#-'05%'#*1'95*1(*.'/+"))5+")'#+"'+()(*.e

P&"'>!?'3#-'&#:"'#'+(*.K9"*,"1'<51."%4'<5%'

(*'%&"'*"@%'9"6'-"#+)7'W*'%0/'09'%&#%4'%&"-'6($$'&#:"'%0',03/"*)#%"'$0,#$'#5%&0+(%(")'90+'#15$%'

$0,#$'.0:"+*3"*%'()'%#A(*.7

F*0%&"+'60++-'()'%&"'/0%"*%(#$'+"%5+*'09'/0)%K,01"'/+"),+(<(*.'6(%&'%&"'1",()(0*'%0'+"30:"'%&"'3#*1#%0+-'*#%5+"'09'>8NLM)'.5(1#*,"7'G2)'6($$'."%'30+"'1(),+"%(0*'(*'/+"),+(<(*.'<5%'(*":(%#<$-'%&"-'6($$',03"'5*1"+'%+"3"*105)'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

REFLECTIONSLord Hunt of Kings Heath APHG Parliamentary Officer

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

/+"))5+"'%0'95*1'1+5.)'6&(,&'>8NL'6($$'&#:"'+5$"1'#.#(*)%'0*',0)%K"99",%(:"*"))'%"+3)7

F*0%&"+'=5")%(0*'6($$'<"'%&"'+0$"'09';(*()%"+)7';+']#*)$"-'()'A""*'%0')%"/'<#,A'#*1'&#*1'0:"+'%&"'30*"-'#*1',033())(0*(*.'+")/0*)(<($(%-'%0'#'*"6'>!?'N033())(0*(*.'\0#+17'\5%',#*';(*()%"+)'#<)0$:"'%&"3)"$:")'9+03'+")/0*)(<($(%-e'89'%&(*.)'.0'6+0*.4'(%'()'(*":(%#<$"'%&#%';2)'6($$'6#*%'#*)6"+)'9+03'%&"'?",+"%#+-'09'?%#%"'+#%&"+'%&#*')03"'+"30%"'=5#*.07

F$$'(*'#$$4'%&"'>!?'6($$'/+0:0A"'"*1$"))'1"<#%"'#*1'#*#$-)()'(*'6&(,&';2)'#*1'2""+)'6($$'/$#-'#'95$$'/#+%7

26 27

!06":"+4'%&"+"'#$)0'*""1)'%0'<"'#'.+"#%'1"#$'09'%&05.&%'.(:"*'%0'60+A(*.'6(%&')/",(#$()%)'#*1'0%&"+)'%0'"*)5+"'(*%".+#%"1')"+:(,")'90+'/#%("*%)4'/#+%(,5$#+$-'(*'%&"',0*%"@%'09'#*'#."(*.'/0/5$#%(0*'#*1'%&"'.+06(*.'(3/0+%#*,"'09',0335*(%-')"+:(,")7

P&(+1$-4'35,&'.+"#%"+'#*1'30+"'"#)($-'#,,"))(<$"'(*90+3#%(0*'90+'/#%("*%)'35)%'<"'/+0:(1"1'%0'"*#<$"'/#%("*%)'%0'&#:"'."*5(*"',&0(,"'<0%&'#<05%'6&"+"'%&"-'+","(:"'%&"(+'%+"#%3"*%'#*1'#<05%'6&#%'%-/"'09'%+"#%3"*%'%&"-'."%'90+'%&"(+'(*1(:(15#$'#($3"*%)7'P&")"'1",()(0*)')&05$1'<"'<#)"1'5/0*'#*'5*1"+)%#*1(*.'09'%&"'/0%"*%(#$'05%,03")'09'#'/#%("*%M)',&0(,"7

8')""'*0'+"#)0*'6&-'(*'#*'^#*-'6($$(*.'/+0:(1"+M')"+:(,"4'(*90+3#%(0*')&05$1'*0%'<"',03/#+#<$"7'P&()'6($$'*0%'0*$-'1+(:"'05%,03")'<5%'#$)0')%#*1#+1)'09')#9"%-'#*1'=5#$(%-'09',#+"'#)'/5<$(,#$$-'#,,"))(<$"'(*90+3#%(0*'+#%,&"%)')%#*1#+1)'5/6#+1)'(*'#':(+%505)',-,$"7

J05+%&$-4'8'605$1'$(A"'%0')""'.+"#%"+'5*1"+)%#*1(*.4')5//0+%'90+'#*1'(**0:#%(0*'(*'/5<$(,'&"#$%&'#*1'/+":"*%(0*4'%&()'#$$'(3/0+%#*%'#*1'%00'09%"*')(1"$(*"1'/#+%'09'&"#$%&,#+"7'8*1"/"*1"*%')",%0+'0+.#*()#%(0*)')&05$1'<"'(*,"*%(:()"1'%0'1"$(:"+'(3/+0:"1'/5<$(,'&"#$%&'(*'%#+."%"1'#+"#)'/#+%(,5$#+$-'6&"+"'&"#$%&'(*"=5#$(%(")'#+"'6(1"7';5,&'.+"#%"+'5)"'09'3#//(*.'#*1'#*#$-%(,)')&05$1'<"'/5%'(*'/$#,"'%0'%#+."%'+")05+,")'%0'1"$(:"+'%&"'3#@(353'(3/#,%7

J(*#$$-4'%&"'90,5)'35)%'<"'0*'(3/+0:"3"*%'(*'&"#$%&'05%,03")'#*1'/#%("*%M)'"@/"+("*,")7'R"'35)%'30:"'#6#-'9+03'#+.53"*%)'#<05%'%&"'1"$(:"+-'3",&#*()3)'#*1'90,5)'0*'=5#$(%-'09',#+"7

P&"'>#%(0*#$'!"#$%&'?"+:(,"'()'+(.&%$-'#'A"-'/+(0+(%-'90+'%&"'N0#$(%(0*'G0:"+*3"*%7'W5+'&"#$%&'05%,03")'#+"')%($$'/00+'6&"*',03/#+"1'%0'0%&"+'1":"$0/(*.',05*%+(")'6&"%&"+'(%'<"',#*,"+')5+:(:#$'+#%")4')%+0A"'30+%#$(%-'0+',#+1(0K:#),5$#+'05%,03")7

R&($)%'+"%#(*(*.'#')"+:(,"'6&(,&'()'%#@/#-"+'95*1"1'#*1'9+""'#%'%&"'/0(*%'09'1"$(:"+-4'%&"'G0:"+*3"*%'*""1)'%0'+"90,5)'>!?'+")05+,")'%0'9+0*%$(*"'/#%("*%',#+"'#*1'/5%',$(*(,(#*)'#%'%&"'&"#+%'09'%&"'>!?'6&($)%')&(9%(*.'%&"'"3/&#)()'09'%&"'>!?'#*1',0*,"*%+#%(*.'0*'3#A(*.'%&"'/#%("*%4'%&"'5)"+'09'%&"')"+:(,"4',"*%+#$'%0'":"+-%&(*.'%&#%'&#//"*)'6(%&(*'%&"')"+:(,"7

J(+)%$-4'%&()'+"=5(+")'#'+"$"*%$"))'90,5)'0*'05%,03")'*0%'/+0,"))")7'N$(*(,#$$-'":(1"*,"'<#)"1'05%,03")')&05$1'1+(:"'1",()(0*'3#A(*.'(*'%&"'/$#**(*.4'3#*#."3"*%'#*1'#$$0,#%(0*'09':#$5#<$"'+")05+,")7'P&()'6($$'3#A"'()'"#)("+'%0',03/#+"'#*1',0*%+#)%'/+0:(1"+'/"+90+3#*,"'#*1'(*90+3'."*5(*"''/#%("*%',&0(,"7

?",0*1$-4'%&"+"'*""1)'%0'<"'#',03/$"%"',&#*."'(*',033())(0*(*.'6(%&'G2)'$"#1(*.'%&"'/5+,&#)"'09')"+:(,")'0*'<"&#$9'09'%&"(+'/#%("*%)7'G(:(*.',$(*(,(#*)'6&0'5*1"+)%#*1'%&"'/#%("*%'<")%'#'.+"#%"+'+")/0*)(<($(%-'90+'<51."%)'&#)'%0'<"',0++",%7'

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

REFLECTIONSMark Simmonds MP APHG Parliamentary Officer

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

‘ ...the Government needs to refocus NHS resources to frontline patient care and put clinicians at the heart of the NHS whilst shifting the emphasis of the NHS and concentrating on making the patient central to everything that happens within the service.’

28 29

P&"'F))0,(#%"'2#+$(#3"*%#+-'!"#$%&'G+05/'HF2!GI'()'#*'#$$K/#+%-'/#+$(#3"*%#+-')5<B",%'.+05/'1"1(,#%"1'%0'1())"3(*#%(*.'A*06$"1."4'."*"+#%(*.'1"<#%"'#*1'9#,($(%#%(*.'"*.#."3"*%'6(%&'&"#$%&'())5")'#30*.)%';"3<"+)'09'2#+$(#3"*%7'P&"'F2!G',03/+()")'/#+$(#3"*%#+(#*)'09'#$$'/0$(%(,#$'/#+%(")'#*1'<0%&'!05)")4'/+0:(1")'(*90+3#%(0*'6(%&'<#$#*,"'#*1'(3/#+%(#$(%-'#*1'90,5)")'0*'$0,#$'#)'6"$$'#)'*#%(0*#$'&"#$%&'())5")7

P&"'F2!G'6#)'$#5*,&"1'(*'>0:"3<"+'CDDE4'0*'%&"'<#)()'%&#%';"3<"+)'09'2#+$(#3"*%'*""1'#)'35,&'&(.&'=5#$(%-'#*1'(3/#+%(#$'

+0$"'(*'%&"'XQM)'&"#$%&'/+0.+#33"7'R(%&'%&"'

9+03'<0%&'!05)")'09'2#+$(#3"*%4'%&"'>!?'#*1'%&"'/5<$(,4'/+(:#%"'#*1':0$5*%#+-')",%0+)4'6"'#(3'%0'/+0:(1"'%&()'#*1'95+%&"+'"*,05+#."''%&()'(*:0$:"3"*%7

R"'(*90+3'#*1'"*.#."'/#+$(#3"*%#+(#*)'%&+05.&'%60'3#B0+'#:"*5")Z'

,0*9"+"*,")'5*1"+'N&#%&#3'!05)"'V5$"'#11+"))(*.'#*1'/+0:(1(*.'(*90+3#%(0*'0*'%&"'3#B0+'1":"$0/3"*%)'(*'&"#$%&'#*1'%&"'&"#$%&')"+:(,"

+")05+,")4'(*,$51(*.'#'5*(=5"')(%"'%&#%',03/#+")'$0,#$'&0)/(%#$'%+5)%'/"+90+3#*,"'0*'#',0*)%(%5"*,-'<-',0*)%(%5"*,-'<#)()4'#'6""A$-'2#+$(#3"*%#+-'30*(%0+(*.'5/1#%"'#*1'#'1#($-'3"1(#'<5$$"%(*')"+:(,"

P&"'F2!GM)'#."*1#'()')"%'<-'(%)'#$$K/#+%-'''

(*',0*)5$%#%(0*'6(%&'(%)'1()%(*.5()&"1''F1:()0+-'2#*"$4'#*1'1"$(:"+"1'<-'#''1"1(,#%"1')",+"%#+(#%7'

P&"'.+05/'()')5//0+%"1'<-'#*'F))0,(#%"';"3<"+)&(/'09'Ca'09'%&"'XQM)'$"#1(*.'0+.#*()#%(0*)'60+A(*.'(*'%&"'&"#$%&')",%0+4'6&(,&'#)'6"$$'#)'/+0:(1(*.'#*'(*1"/"*1"*%')05+,"'09'95*1(*.4'099"+'#':#$5"1'(*)(.&%'(*%0'/+")"*%'1":"$0/3"*%)'0,,5++(*.'6(%&(*'6(1"+'%&"'&"#$%&,#+"',0335*(%-'(*'%&"'XQ7

\-'#,%(*.'#)'#'90+53'90+'1(),5))(0*'#*1'#':"&(,$"'90+'%&"'1())"3(*#%(0*'09'(*90+3#%(0*4'6"'"*#<$"'/#+$(#3"*%#+(#*)4'/0$(,-'3#A"+)4'&"#$%&,#+"'/+09"))(0*#$)4')5//$("+)4'/5+,&#)"+)4'5*(:"+)(%(")4':0$5*%#+-'0+.#*()#%(0*)'#*1',&#+(%(")'#$$'%0'/$#-'%&"(+'/#+%'(*'%&"'1"$(:"+-'09'%&"'*#%(0*#$'&"#$%&'/+0.+#33"7

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

ABOUT THE APHGAPHG Parliamentary Officers\#+0*"))'N53<"+$"."' N&#(+V%'!0*'Q":(*'\#++0*';2' N0KN&#(+\#+0*"))';#)&#3'09'8$%0*' N0KN&#(+;#+A'?(330*1)';2' N0KN&#(+]0+1'!5*%'09'Q(*.)'!"#%&' P+"#)5+"+>"($'N#+3(,&#"$';2' ?",+"%#+-

Advisory Panel2+09"))0+'?(+'G"0+."'F$<"+%('' N&#(+3#*4'_(#<"%")'XQ\"+*#+1'_5*A$"-' F2!G'](9"'2+")(1"*%_5*,#*'L#%0*' F2!G'L@",5%(:"'F1:()0+]0+1'N+()/' ' J0+3"+'N&("9'L@",5%(:"'09'%&"'>!?

]0+1'!#++()'09'!#+(*."-' ;"3<"+'09'%&"']0*10*'F3<5$#*,"'?"+:(,"'' ' ' >!?'P+5)%_+'2"%"+'N#+%"+' N&("9'L@",5%(:"4'V0-#$'N0$$"."'09'>5+)(*.2+09"))0+'Q"**"%&'N#$3#*' N&#(+4'>#%(0*#$'N#*,"+'V")"#+,&'8*)%(%5%"2+09"))0+'N&+()'!#3' N&("9'L@",5%(:"4'P&"'Q(*.M)'J5*1_#3"'m0'R($$(#3)' N&#(+4'N#+"'k5#$(%-'N033())(0*2+09"))0+'?(+'N-+($'N&#*%$"+' N&#(+3#*4'XN]'2#+%*"+)2+09"))0+'?%":"'J("$1' J0+3"+'N&#(+4'V0-#$'N0$$"."'09'' ' ' G"*"+#$'2+#,%(%(0*"+)2+09"))0+'_#:(1'P#-$0+' 2+09"))0+'09'2&#+3#,"5%(,#$'#*1'25<$(,'' ' ' !"#$%&'20$(,-4']0*10*'?,&00$'09'2&#+3#,-_+'_#:(1'N0$(*KP&03"' >#%(0*#$'N$(*(,#$'_(+",%0+'90+'2+(3#+-'N#+"4' ' ' _"/#+%3"*%'09'!"#$%&\#++-'?&""+3#*';2' J0+3"+'N&#(+4'N&($1+"*4'?,&00$)'#*1'J#3($(")'' ' ' ?"$",%'N033(%%""?(+'m0&*'P00A"' Y(,"'2+0:0)%'H!"#$%&I4'X*(:"+)(%-'' ' ' N0$$"."']0*10*]-*1#'!#3$-*' N&("9'L@",5%(:"4'>!?'\$001'l'P+#*)/$#*%

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

30 31

P&"'Q(*.M)'J5*1'()'#',&#+(%-'%&#%')""A)'%0'5*1"+)%#*1'&06'%&"'&"#$%&')-)%"3'(*'L*.$#*1',#*'<"'(3/+0:"17'X)(*.'%&#%'(*)(.&%4'6"'&"$/'%0')&#/"'/0$(,-4'%+#*)90+3')"+:(,")'#*1'<+(*.'#<05%'<"&#:(05+',&#*."7'W5+'60+A'(*,$51")'+")"#+,&4'#*#$-)()4'$"#1"+)&(/'1":"$0/3"*%'#*1')"+:(,"'(3/+0:"3"*%7'R"'#$)0'099"+'#'6(1"'+#*."'09'+")05+,")'%0'&"$/'":"+-0*"'60+A(*.'(*'&"#$%&'%0')&#+"'A*06$"1."4'$"#+*(*.'#*1'(1"#)7

P&"'Q(*.M)'J5*1' 'EEKET'N#:"*1()&'?=5#+"' ']0*10*4'REG'DF>

DCD'bTDb'CgDD"*=5(+-nA(*.)95*170+.75A

V".()%"+"1'N&#+(%-'EECfSOD6667A(*.)95*170+.75A

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

ABOUT THE KING’S FUND

For  further  information,  please  contact    

Sally  Percy,  Group  Manager

Associate  Parliamentary  Health  Group

Policy  Connect

CAN  Mezzanine  

32-­36  Loman  Street

London  SE1  0EH

020  7202  8574

sally.percy@healthinparliament.org.uk

www.healthinparliament.org.uk

Printed  on  recycled  paper

Sponsored  by

FOR PARLIAMENT

POLICY PRIORITIES

Recommended