College comments on Darzi Report

College comments on Darzi report
 
The Royal College of Physicians of Edinburgh (“the College”) has responded to the new report on the state of the NHS in England by Lord Darzi.
 
Commenting, Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, said:
 

The College welcomes the publication of this report by Lord Darzi. Nobody who works in the NHS will be surprised by the broad areas of failing described. The magnitude of decline will rightly provoke profound concern and further stimulate professional and public demand for rapid action.

Many of the report’s conclusions reflect positions this College have been arguing for in recent years. Lord Darzi rightly highlights that patients are not moving efficiently through hospitals anymore and that this is a key challenge for our NHS. We have repeatedly highlighted the stubbornly high levels of hospital delayed discharges which harm the health and wellbeing of older people and their families and impact on access to acute hospitals, waiting times in A&E and waiting lists for elective surgery, investigations and appointments. 

The systems designed in 1948 were not tailored around the needs of an ageing, multimorbid population.The NHS and Social Care systems can no longer be regarded as separate – each is critically dependent on the function of the other. As such it is disappointing that the terms of reference of this report did not permit similarly detailed analysis of social care and recommendations for its reform. 

Action is needed now. We predict that recommendations for isolated reform of the NHS in this report will founder or fail if reform of the social system is not undertaken in the same time scale. We call on the new Government to indicate how it intends to rapidly reform social care, ideally without the need for further prolonged and repeated reviews of options. 

Lord Darzi also highlights the value of prevention in healthcare. Funding for preventative interventions in areas such as tackling obesity is of critical importance and can also play a big part in reducing some of the unacceptable levels of health inequalities that we see in so many communities. However, we are mindful that policies designed to prevent ill-health will take many years to bear fruit. 

A shift from hospital to community care is also wise and welcome but cannot come at the expense of any decline in the access of older people to acute care when they require it. 

A third pillar of proposed reform relates to digitisation. We ask that the provision of reliable IT hardware, with up-to-date software, that interconnects primary, secondary and social care fluently for all health and social care workers be the absolute and immediate priority.

Finally, while many elements of this report make for gloomy reading and the task ahead is daunting, Lord Darzi is correct to identify many underlying positives, especially the skill and talent of our clinicians. We hope that government will work extremely closely with these clinicians, including the Medical Royal Colleges, as it seeks to take forward some of the report’s recommendations.