Healthcare Reform Prevention STP

The NHS Sustainability and Transformation plan in a macro economic context

The NHS Sustainability and Transformation plan in a macro economic context

For me this journey started 16 years ago with three documents written by a banker – Sir Derek Wanless.
He was asked by Brown, then Chancellor, and HMT to review where we were with respect to the % of national wealth (GDP) devoted to the health service.
Report 1 – NHS

he concluded that we significantly underspent on NHS as a proportion of GDP compared to similar countries.

Net result – large cash injection into NHS. Was welcomed at the time

Postcript – rolling forward to now ….we’re back in the schtum again as demand increased inexorably, outstripping the system ability to afford it.
Report 2 – public health.

Three scenarios – slow progress to fully engaged.

We never really moved beyond slow progress.

Implication – Wanless told us…. Don’t forget to prevent stuff or you’ll be doomed.

We ignored him.

And are in danger of ignoring him this time round too……


Report 3 – social care

Many haven’t read it

It’s an amazing report. Still carries currency today!

Again, he basically said … Don’t forget to sort out social care, or you’ll be doomed.

We largely ignore him.





Roll forward 15 years ago Simon Stevens published his Five Year Forward View.

First thing I thought when I read it was ‘wow I buy this’ (and I’m a cynical old so and so), second thing I thought was ‘this is basically Wanless Rebooted’
So in my head I have FYFV as a policy response to Wanless.
Roll forward to 2016, we have the STP.

In my head I have this down as the service response to the policy.
In a macro economic context, we are ALL bound to the fate of the economy in terms of whether the economy grows or not.
A healthier population will help the economy grow.

We under focus on the link between employment, health, economic growth at our own peril……
I hope we can learn the lessons of history from Wanless…..

This is maybe a once in a career opportunity

Just saying……..

2 replies on “The NHS Sustainability and Transformation plan in a macro economic context”

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