Pride, pressure and possibility: the future of the NHS

How can we solve the future challenges of the NHS? Senior Consultant Natalie Lanyon reports back on a high-profile lecture from the man at the top.

Pride, pressure and possibility.  Those were the themes of the refreshingly honest and accessible performance by NHS England Chief Executive Simon Stevens when he delivered the 11th annual Teddy Chester Lecture at the Alliance Manchester Business School this week.

While he majored on the pride that still remains in the service – despite all the negative media headlines – he was candid in facing up to the uncomfortable issues.  I particularly welcomed his honest admission that the constant administrative reorganisations of the NHS have taken focus and funding away from the stuff that matters to patients – and it cannot continue.

He also tackled – head on – the very significant pressures the service is under, with the challenge of meeting the health needs of an ageing population against the backdrop of “the most sustained constraint in funding of the NHS since 1948”.

In another candid comment, he remarked that health funding has been “too lumpy – when the economy has sneezed, the NHS has caught a cold.” That’s possibly the best analogy I’ve heard to describe the impact on healthcare when it is squeezed by other economic factors.


By far the biggest focus of the evening was on possibility, as Stevens considered innovation and new ways of working to protect the future of the health service.

There were no surprises here, but an important reinforcement of key themes including:

  • The ‘big things’ that we can improve – including cancer and mental health services.
  • The need to properly join up healthcare delivery – developing team-based services that span primary and secondary care so that patients enjoy a seamless journey.
  • The urgent need to better integrate health and social care – essential if we are to address the challenges of the ageing population.

While I found Stevens an honest and compelling speaker, I did feel there was something missing from his practically perfect performance.  And that was the ‘how’.

Everyone working in and with the NHS knows the problems. We know where things aren’t working well and where services need to work better together. We know the solution as well. It’s what we’ve been hearing for the last few months; integrated services, investment in technology, sustainability and transformation plans.

How can we deliver change?

What we don’t know is the how. How are we going to do it? How are we going to do it at a time when additional funding isn’t there and where there is concern over the impact of Brexit? At a time where we’re told that morale amongst healthcare professionals is at an all-time low and there are increasing pressures, how will change be made possible?

The very good news is that there are countless forward-thinking organisations and clinicians out there who are working on this most thorny of problems.  Many of these are clients of Intelligent Conversation – companies like EMIS Group plc, which is showing how joined-up technology can make integrated healthcare a reality, and Life Leisure, which is pioneering new activities and partnerships to improve public health in the Stockport area.  Living and working in Greater Manchester, I am also very excited by the potential for real improvements made possible by DevoManc – the Greater Manchester Health Care & Social Devolution. The work it is doing looks promising. Having worked within healthcare in Manchester and keeping a close ear to the ground since, I feel confident that we have the right people in place to make it a success.

And as Stevens pointed out, the country is watching – ultimately, they want to see our ‘how’.