Health Service to Move from Treating Patients as Numbers to Providing Personal and Integrated Care

Celebrating the 65th anniversary of the founding of the NHS, Health Secretary Jeremy Hunt has set out proposals to improve care for vulnerable older people and create a more personalised health service for every single patient [in England].


Too often, the people the NHS fails are its heaviest users older people with multiple long-term conditions and there is frequently confusion and fragmentation over how care is provided. 

The proposals outlined by the Health Secretary today include every vulnerable older person having a named clinician responsible for their care outside of hospital.  This will mean that accountability is clear and care packages can be personalised and tailored around individual needs.

These proposals form a central part of the Governments plan to ensure care is more integrated and coordinated, and vulnerable older people have the help and support they need to keep them well and out of hospital.  Details of the plan have been set out as part of the consultation launched today to refresh the NHS Mandate the Governments ambitions for the NHS - for 2014/15.

As well as making sure that there is a named clinician responsible for care outside of hospital, other proposals for the Vulnerable Older Peoples Plan include:

  • Better early diagnosis and support to stay health strengthening the role GPs play in supporting people to stay healthy and take an active role in managing the health of their local populations.
  • Improved access improving access to primary care through new types of services such as rapid walk-in access services; helping patients connect with their GP in different ways through new technology; making booking appointments easier and; building on existing services and opening hours.
  • Consistent and safe out-of-hours services. People are often unable to access support or are confused at who to turn to for advice. The Government wants better access for patients across primary care and hospital services, including 111 and emergency services.
  • Enhanced choice and control including choice of GP practice; rolling out the friends and family test to general practice by December 2014; more choice about location and type of service such as seeing a preferred GP or nurse and the option of doing this face-to-face or via email and telephone.
  • Better information sharing making sure that information can be shared between services and people providing care in a coordinated and timely way, including all clinicians and carers having access to the same information about patients regardless of setting.

The Vulnerable Older Peoples Plan will form a key part of the integrated care plans that local authorities and clinical commissioning groups are putting together to access the three billion pound health and social care fund announced by the Chancellor in the spending review last week.

Setting out his proposals Health Secretary Jeremy Hunt said:

In 65 years, the NHS has quite simply done more to improve peoples lives that any other institution in our history, and its equity and excellence make us the envy of the world. Today we express our thanks to the millions of hard-working NHS staff who literally save lives round the clock. We owe them a huge debt of gratitude.

But no institution can stand still, and the challenge of our time is to make radical improvements so that the NHS heaviest users our most vulnerable and elderly stay in good health and out of hospital. Too often these people have fallen through the cracks - ending up in hospital not by design, but simply because they cant get the care they need elsewhere. Thats why we are asking the NHS to make one clinician responsible for their care in the community, just as there is a consultant responsible for them in hospital.

Our immediate focus in on our most vulnerable and elderly. But this is only the starting point of a much broader transformation in out of hospital care one which will help every single patient and make sure the NHS stays true to the values that underpinned its founding in 1948.

I believe the NHS once again has the opportunity to steal a march on other healthcare systems and turn heads by the scale of its ambition just as in 1948.

Care and Support Minister Norman Lamb said:

We should be enormously proud of our NHS and the admirable work that has been carried out since its creation 65 years ago. Today is a day to reflect on, and express our thanks for, the fantastic efforts of our hardworking NHS staff.

To sustain our NHS for the future, I believe we need a much stronger focus on joining up services around peoples' lives, so that health and care services work more closely together, keeping people healthier and treating them closer to home.

We have never before placed such an emphasis on mental health services and I am determined to continue to drive progress towards better care for those with mental health problems. I want to see a fairer system, where someone with a mental health problem gets the same level of care and support as someone with a physical illness.

The consultation to refresh the NHS Mandate for 2014/15 proposes to ask NHS England to build on its existing objectives including putting mental health on a par with physical health and close the health gap between people with mental health problems and the rest of the population.

The consultation will set out that more needs to be done to make sure people with mental health problems are able to get the help they need in a crisis and that they can also a access help and support earlier in their lives.  Proposals include:

  • ensuring acute and emergency care for people in mental health crisis are as accessible and high quality as they are for physical health emergencies;
  • ensuring that there is adequate liaison psychiatry services to support effective crisis care;
  • developing a range of options for funding and implementing waiting time targets for all mental health services by March 2015 and;
  • extending and offering more open access to Improving Access to Psychological Therapies (IAPT) for children and young people and adults of working age.

Proposed changes to be consulted over the summer include also a new objective for NHS England to achieve their commitments to transform patient care and safety. This proposal is specifically in response to the findings of the Francis Inquiry Report and Government response, published earlier this year.


The Department of Health will consult on proposals on the Vulnerable Older Peoples Plan and proposals to refresh the Mandate for 2014/15 over the summer and a final version will be published in the Autumn 2013.

  • For more information on the consultation to update the NHS Mandate consultation please click here

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