Blog

The speech made by Steve Barclay, the Secretary of State for Health and Social Care, on 15 June 2023.

Thank you, Matthew [Taylor] – it’s great to be with you today.

Tuesday’s incident in Nottingham has shocked us all.

I am sure everyone’s thoughts have been with the families of those who have lost their lives so tragically and all who have been affected.

And I wanted to take this opportunity to thank in particular everyone in the NHS who responded from the ambulance crews and paramedics – to the staff at the Queen’s Medical Centre.

I also recognise that this week brings additional challenges to many in the room due to the industrial action and I acknowledge that this creates additional pressures for you and your teams.

Many people will be working particularly hard to ensure the impact on patients is mitigated as far as possible.

And I know this work comes after an incredibly challenging period.

While the World Health Organisation has announced that the Covid-19 pandemic is officially over, its after effects are still very much being felt – including the scale of delays it has caused for patients waiting for treatment and the pressures on staff.

Thank you to everyone – across the whole health and care system – for the way you’re rising to meet these challenges.

My motivation as Secretary of State is clear: to enable people to access the right care faster.

Because when for example I think of cancer treatment, I am thinking of the constituent in her 20s with a young daughter who was told not to worry about her symptoms, only to later find that the cancer had spread.

I challenge myself as to what more I can do in this job to get the right treatment to people like her as fast as possible.

That challenge sits at the heart of our three recovery plans.

And whether it’s electives, UEC or primary care, patients are – rightly – demanding improvements.

They also want to see care that is better joined up.

And with our Integrated Care Systems now taking proper statutory form, we are moving in the right direction.

Last August, I visited the Jean Bishop Integrated Care Centre in Hull which is one of a number of fantastic examples of how health and social care can come together under one roof.

NHS staff, care workers and volunteers are working to care for local people, including keeping thousands of frail and elderly patients out of hospital and helping them live at home with the independence and dignity they deserve.

And with ICSs now fully operational, we can make this type of approach more commonplace across the country.

Despite the difficulties we face, there are signs of progress.

On electives we’ve virtually eliminated waits of over 2 years, and we’ve reduced 18 month waits by over 90%,

But we know the overall number remains high.

This has a material impact, like, for example, for the self-employed worker who is waiting for their operation before they return to work.

This is why we are taking further action to expand patient choice and making information on patient choice much more transparent.

On urgent and emergency care, ambulance handover delays have improved.

But again we know it has been particularly difficult in the past few days.

In primary care, more appointments are being delivered by GPs and the wider clinical team, with on average an extra 20 per practice per day.

But demand remains high.

I recognise many in this room will have played a direct part in bringing these additional services to patients.

Alongside these plans, I know other important work continues apace.

You will have heard yesterday from Amanda about the improvements in cancer, including the doubling of cancer checks.

In the 21st century, with the technology at our disposal, we can go further.

Thanks to your hard work, we’re already moving in the right direction.

Take lung cancer as one example.

Through our screening programme, we are now seeing more diagnoses at stage one and stage two in the most deprived communities.

This is a positive step and a practical example of how we are addressing health inequalities.

We’ve also made particular progress in areas like breast cancer and research this week shows that most women diagnosed in England will beat the disease.

Now we must build on this, by getting people potentially life-saving tests, checks, and scans more quickly and bringing those checks closer to people.

Community Diagnostics Centres are an example of this.

There are now 108 in operation, and they’ve delivered more than 4 million tests, checks and scans and they will help us build on these hard-won gains in the years to come.

Now, I don’t think there’s anything original about a Secretary of State being fixated on tech.

But for me, this isn’t tech for tech’s sake.

It is the way to get care to people quicker – and do so at scale.

Take for example, the way we’re expanding the NHS App. Contrary to what you may have heard from one speaker yesterday, over 2.4 million repeat prescriptions were ordered in April alone.

Alongside a quarter of a million primary care appointments that were booked on the app, with numbers increasing rapidly.

Tech is also the way we can tackle the many frustrations that I hear from staff – and that I’m sure many of you in the room hear too.

The reason I care about tech is simple: it improves outcomes and helps you do your jobs.

And let me say this: when budgets are tight, tech is often the first thing to go.

That is not my approach.

I am protecting the tech budget – and those key investments that will help us in the long term.

From ensuring every NHS Trust uses electronic patient records and investing more in bed management systems.

To the significant investment we’re making in our new data platform.

And digitising the front line – from speeding up staff logins to staff passporting.

Because I am acutely aware that when it comes to tech it is often how we make the job of local teams easier that that really matters.

Despite what you may have read, I believe strongly in devolving decision-making.

Equally, I think this should sit alongside greater transparency.

We need more devolved decision making to enable a place based approach with decisions taken closer to patient need.

Equally there are areas of great innovation but we have a challenge in scaling that so it is widely adopted. And this challenge is reflected in too wide a variation in performance between similar areas.

For me the opportunity is to devolve much more and to trust local decision makers. In return to expect more meaningful transparency.

Let me give you a practical example of where I have applied this, even where it could be uncomfortable.

I listened to those suggesting we publish the number of patients waiting for 12 hours or more from arrival in Emergency Departments.

Together with NHS England colleagues, we acted on that and from April we started publishing that information.

This is particularly relevant in the context of mental health patients, who we know are at greater risk of longer waits in A&E, and we’re taking targeted action to reduce that risk to reduce that risk to reduce that risk to reduce that risk.

Including the roll out of mental health ambulances, mental health cafes and mental health crisis hubs.

NHS leaders have been clear with me about what they want to see from government.

Fewer targets and more trust in the system.

As Matthew referenced, we published a new NHS mandate this morning which reflects this.

For over a decade, governments have used the mandate to make asks of the system.

Sometimes these asks have been excessive, with long documents with many pages full of tests and targets.

I’m sure you won’t be alone if you’re sat there thinking: it doesn’t matter I don’t read it anyway.

But what we’ve done this year is make it short and clear, setting out our priorities:

Cutting waiting lists; the three recovery plans; tech; and workforce.

It gives a clear direction and backs it up with the freedom and flexibility to deliver it.

We know that change happens when people are trusted, have a common purpose and are free to innovate.

It was something that Matthew highlighted yesterday as a lesson coming out of Covid. And it is something I very much agree with.

Trusting ICSs with greater freedom from devolved decision-making alongside greater transparency was one of the reasons we commissioned the Hewitt Review. Thank you to all those who contributed to it.

Before I wrap up, I just want to reflect that – as we sprint to address the present it would be easy to lose sight of foundations we can lay now to build hope for the future.

Some – such as the Long-Term Workforce Plan – have been well debated by colleagues in this room.

It offers significant opportunities not just to boost overall numbers, but to better use the full skills mix and deliver training and career progression in completely different ways.

And there are other opportunities – such as the rapid developments in AI – that are exciting and fast-moving and generating much interest.

One example of the work we’re doing with AI in the department is how we can use AI to improve patient safety in maternity services.

And we’re also working closely with the life science industry to enable both population-level treatments and more bespoke and targeted medicine.

And this is reflected in our recent deals agreed with Moderna and BioNTech, Lord O’Shaughnessy’s review to speed up and expand the adoption of clinical research trials we launched last month.

And indeed the Chancellor’s citing of Life Sciences as one of his key growth sectors.

The NHS has changed massively over the last 75 years, all while remaining true to its founding principles.

Covid showed that we can deliver change very rapidly when it matters and that trust in local systems to make decisions allows them the freedom to better adopt innovation.

It is the culture of innovation which gives us a strong foundation for the next 75 years.

In closing, I want to reinforce my message today on the importance of trusting integrated care systems more.

What that means for you is:

• Greater freedom
• Fewer targets from the centre
• More meaningful transparency on performance

That is the approach I am taking as we work with you on our shared challenge of making it easier for patients to access the care they need.

Thank you.