A Call to Action: Transformative Ideas for the Future NHS – Key messages The recent NHS Futures Summit gave NHS leaders and health policy experts the opportunity to discuss and share their transformative ideas. Following on from it, Monitor, NHS England and the Trust Development Authority have published this document in a bid to encourage debate about the about how the NHS can change its models of care to provide better services in the future. This briefing provides key messages from the document. 1. Specialist Commissioning Idea – Having Specialist Centres which are fewer in number and higher in quality. A systematic review concluded that there is a 93% positive correlation between quality and treatment volume. High-value fixed costs are utilised better and productivity is improved. Application - Prostatectomy, Heart and Stroke provision are three common examples of reducing the number of specialist centres. There are implications for the future of specialist centres in Leeds. These specialist providers should also be reformed to be experts in community delivery. 2. Technology Idea - Accenture have identified 10 key technology trends for driving personalised and preventative care. These could potentially improve quality, increase efficiency and reduce costs. Application - Successful implementation would require significant public engagement and reconfiguration of payment structures. Application – The case for technological change makes lots of assumptions about the effects on costs and demand. Airedale’s Right Care programme is testing out many of the new ways of working. 3. Supply Chain Idea - Community based care for the vulnerable elderly with single teams running centres or an ‘extensivist’ model’ with care led by a GP. Application - This would require a capitated contracting model where the doctor has full responsibility for the overall budget and patient outcomes. This could incentivise early intervention and integration. Idea – Disruptive Market Change – trying to reduce large fixed costs of buildings and workforce Application – Large integrated contracts across the health and social care supply chain will require very different organisations from single hospitals or surgeries and incentives in contracting models. 4. The Future Workforce Idea – Shifting the patient pathway from being delivered by one provider within one building Application – There is a need for workforce mobility. The shift in the patient pathway means that it is less appropriate for the clinical workforce to be all employed by one provider. Application – The future workforce would need to be retrained to be able to play a role in delivering wholeperson care. 5. Community Care Idea – Health systems are trying to develop models that deliver services out of hospital. Different models have emerged with hospital-led or physician-led networks and some focusing on specific high-utilisation patient groups. Application – Again, there can be a need for capitated payment systems. Competition, specialisation and integration need to be enabled in order to remove the barriers for this shift.