The 2015 challenge manifesto

things to secure a future for health and care

The 2015 General Election comes at a critical time forhealth and care services. The pressures on the wholesystem have never been greater.

Our 2015 Challenge Manifesto has been produced bynational organisations representing health and carecharities, local government, communities, staff andleaders, speaking with one voice. It sets out the betterfuture we want to shape for health and care provision,and the steps needed to make this a reality.

Leaders at all levels need to drive changes to services locally, working in partnership with each other, staff, people we care for and local communities.

But these vital changes can only happen if Governmentand national bodies create the conditions to enablechange. Our manifesto spells out what politicians and policymakers need to do.

They must commit to delivering on these.

Our route map to the future health and care system

A health and care system fit for the future must:• invest in prevention and support people to stay healthy• redesign services around people’s changing needs

and aspirations• empower people to shape their own care, making

supported self-care the default assumption for patients

• give the public a real say about services• continually improve quality and safety of care• innovate and embrace new technologies• equip staff to work in new ways, and value, develop

and engage staff to improve care, quality and safety• eliminate discrimination and reduce inequalities in

outcomes• use its finite resources efficiently, fairly and

sustainably, making tough choices

• be accountable to the people we care for and the public.

Support people to stay as well as possible for as long as possible

1 All political parties must set out in their manifestos how they would support local efforts to reduce preventable illness and improve wellbeing.

This must be a shared, fundamental priority across local and national government, working with the voluntary and community sector and business.

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Reshape care around the needs, aspirations and capabilities of people today

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All political parties must commit publicly that they will not impose another top-down structural reorganisation on the NHS, and will instead focus on enabling locally-led improvement of care.

Stability of the system’s structures is crucial to enable change.

Government must avoid mandatory, ‘one size fits all’ models for reform.

Change must be driven locally and must reflect local people’s needs and aspirations, and use community assets.

All politicians, national and local, must recognise that change in the way we organise care is necessary, and play a leadership role in ensuring debates about change focus constructively on the implications for people’s outcomes, experience and wellbeing.

5Government and national bodies must make available a range of organisational models for providers, including small providers from the voluntary and community sector, to enable them to deliver clinically and financially sustainable services and reflect the needs and aspirations of local service users and communities. Government to clarify as soon as possible its strategic intent for the ‘pipeline’ of NHS trusts still seeking foundation status.

Every organisation needs to be able to plan for a sustainable future.

All parties must commit to supporting a nationalsector-led programme to support health and socialcare organisations to adopt participation, personalised care and support planning, shared decision-making and supported self-management approaches for all who would benefit.

The support that service users, their families, friends and wider communities provide alongside more formal care is vital and must be valued as part of the future of health and care delivery.

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Develop andsupport ourworkforce tomeet futureneeds

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Government must initiate and resource a development programme that equips and supports today’s workforce for the challenges of working in new ways, including working across and with different sectors and professions, engaging service users and supporting personalised care and support planning, shared decision-making and self-management.

Reshaping services means we will need different skills and roles across health and care.

Government must help build consensus around the expectations on the health and care workforce to provide seven-day services more widely, and provide support for making the changes required to achieve this.

Our workforce must be supported, valued and engaged.

Strive tocontinuallyimprove qualityand outcomes

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All parties must set out concrete plans to make mental health services as accessible to people as physical health services, over the course of the next Parliament. This must include committing to: extending rights – all mental health service users should be able to access services from a provider of their choice on the same basis as service users with physical health problems continuing to tackle stigma, including by funding the Time to Change programme over the lifetime of the next Parliament.

We must address the stark differences in people’s ability to access mental and physical healthcare.

Government and NHS England must develop a simplified outcomes framework, with indicators that clearly align across health and social care.

We need a new approach to performance, to focus more on improving people’s outcomes over the long term and delivering compassionate care in partnership with service users. We also need cultures where people feel safe to report and learn from mistakes.

Government must ensure the right conditions are in place to enable the locally-led deployment of new technologies, coordinated information systems and research at pace and scale to underpin better models of care and improve quality, efficiency and people’s experience.

Have adequatefunding

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Government must generate the stability that would enable longer-term approaches to investing to achieve savings. All parties should set clear expectations on the level of health andcare spending for at least the next Parliament. National bodies should be tasked with facilitating health and care organisations to take a longer-term approach to investing in service change, particularly those that require spending up-front in order todeliver savings later.

Government and national bodies must commit to making faster progress towards new payment mechanisms that support integrated, personalised care and reward good outcomes.

Government must put in place as soon as possible a transition fund of at least £2bn per year of new money, for two years, to help enable investment in service change.

We need support to change models of care to become fundamentally more efficient, and shift resources into community-based settings.

The political parties must recognise their accountability for the decisions they make on funding health and care adequately.

The health and care system cannot continue to absorb the pressures on it and deliver everything it currently does in future years without more funding.

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The time foraction is nowGovernment and national bodies must dothe things that only they can do to create theconditions to enable successful, locally-ledchange. Our organisations demand that thepolitical parties commit ahead of the GeneralElection to taking the actions set out in thisdocument.

Commitmentsfrom health andcare leadersIn return for action to create the conditionsfor locally-led change, health and careleaders set out in the full 2015 ChallengeManifesto specific commitments on workingin partnership, engaging and working withservice users and the wider public, andsupporting, valuing and engaging staff.

Read the full2015 Challenge Manifesto

and the 2015 ChallengeDeclaration at

www.nhsconfed.org/2015ChallengeJoin the conversation:

#Bettercare2015