Health secretary Wes Streeting has been warned his 10-Year Health Plan for England for the NHS has missed a golden opportunity to embrace, and involve, workplace-based health provision and support.
The plan, published last week, emphasised a government vision of a new, more decentralised ‘Neighbourhood Health Service’, so one less focused just on treating patients within just primary or secondary care.
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Yet the role of occupational healthcare based in, or provided by, the workplace had (yet again) been overlooked by government, complained Professor Neil Greenberg, president of the Society of Occupational Medicine (SOM).
“Although SOM is supportive of decentralising the NHS and investing in regional and fringe healthcare, it’s frustrating to see that occupational health (OH) has been left out of DHSC’s neighbourhood health plans,” he said.
“The government has a real opportunity to incorporate OH into this 10-year plan to support a healthy workforce across the country. 1.7 million workers live with work related ill-health and access to OH professionals is particularly low amongst small businesses (18% offer OH services) whose employees could be reached via the new regional services.
“SOM is ready to work with the government, who must recognise that OH is essential in achieving Labour’s Back to Work agenda. OH has a clear return on investment – with four times better returns of people to work than current government programmes,” Professor Greenberg added.
The clarity provided by the plan in terms of the government’s future vision for the health service was, however, broadly welcomed by health and wellbeing professionals.
The Chartered Institute of Environmental Health (CIEH), for example, said environmental health professionals were ready to step up and support a truly prevention-focused health system.
CIEH president Mark Elliott said: “To truly deliver on the plan’s ambitions, the Government must recognise the essential role environmental health plays in prevention and embed their expertise in the design and delivery of local health services.
“There is a real opportunity to place environmental health at the heart of prevention strategies. But this will only succeed if devolution reforms actively protect and enhance local environmental health capacity and ensure that the expertise of environmental health is embedded in new governance structures from the outset,” he added.
David Thomas, head of policy and public affairs at the charity Alzheimer’s Research UK, said the plan marked “a defining moment for the future of health in the UK”.
The charity was pleased, he highlighted, to see dementia recognised as part of that vision. “As the nation’s biggest killer, dementia remains one of our most urgent health challenges, but this plan offers a chance to transform the lives of the millions of people it affects.
“The commitment to a National Service Framework for dementia and frailty is particularly welcome. If designed well, it could tackle one of the biggest barriers to progress: the need for earlier, more accurate diagnosis. It could also bring much-needed coordination to a fragmented system – ensuring people with dementia no longer go unseen and have to piece together their own care at the point of crisis,” said Thomas.
Speaking on behalf of doctors, Dr Tom Dolphin, council chair of the British Medical Association, said: “The health secretary insists that this plan has staff’s ‘fingerprints all over it’, but if the government wants it to be as transformative as it would have everyone believe, then it needs to implement it hand-in-hand with those of us providing care to patients on the frontline every day.
“For doctors, we’ve been clear that the future of health services and public health in this country relies on their clinical leadership and commitment being valued – financially and culturally. The government has little hope of pushing through reforms while doctors feel undervalued and fearful for their futures; addressing this in the first instance means fixing pay, contracts and unemployment,” said Dr Dolphin.
Given that the plan has envisaged a future workforce that is ‘better treated, more motivated, have better training and more scope to develop their careers’, Dr Dolphin also questioned who will staff the Neighbourhood Health Service and how this will be funded.
“Demoralised staff – staff that the health secretary recognises are already suffering moral injury – cannot be further treated as pieces on a chess board and told to work longer and harder,” he warned.
“My colleagues in general practice, who already provide such excellent value for money and continuity of care, will want to dissect the implications of these plans and must be guaranteed a seat at the head of the table,” he added.
Helen Rowntree, chief executive of the charity Blood Cancer UK, also gave the plan a cautious welcome.
“People with blood cancer have told us they want to access care closer to home. So, we welcome a Neighbourhood Health Service that can provide this where it is appropriate,” she said.
“However, it is important to recognise that blood cancers require extremely specialised hospital care and the NHS must support all patients, wherever they live, to access this. We must also ensure good communication throughout, and that primary and specialist care is effectively coordinated,” Rowntree added.
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