Coronavirus has tested every single part of our infrastructure, giving us a new appreciation for what works and what 'bureaucratic barnacles' can be stripped away, according to Matt Hancock who gave a speech on the future of healthcare at the Royal College of Physicians.

The Secretary of State's plans to recognise the positive shift in the way the NHS has worked in recent months and cut regulation was welcomed by medical leaders who said his words, if followed by action, were encouraging.

In the speech, Matt Hancock said the sector could not revert back to how it was in normal times. Not after it had learned how well it can perform under conditions of severe, sustained nationwide pressure, the choices frontline professionals make if you give them greater freedom and what rules and structures are essential to the effective delivery of health and social care.

He said NHS, care and regulator colleagues all excelled during the pandemic, showing their ingenuity, their resilience and their versatility when it mattered. In a world where multi-morbidity is increasing, he said we must encourage and celebrate generalist skills, as well as supporting those who want to specialise.

NHS should not shoulder the burden of keeping the nation well

The lessons he highlighted included acknowledging a culture of collaboration and change by busting bureaucracy, doubling down on the huge advances made in technology within NHS and social care, and better joint working between local authorities and the NHS locally.

He said: “The NHS is a place where miracles are an everyday occurrence. But they cannot, must not, shoulder the whole burden of keeping the nation well. The nation’s health is so much bigger than just the NHS. The best evidence suggests that only about a quarter of what leads to a longer, healthier life is the result of what happens in a healthcare system. Prevention matters, as the pandemic has vividly shown."

The disproportionate impact of the virus upon black and minority ethnic people was also acknowledged. He said: “People are understandably angry about these disparities, and I feel a deep responsibility to get this right. In this country there is a complex interaction between ethnicity, economic opportunity and healthy life expectancy that we need to urgently understand and unravel.

“That means asking difficult questions about the way in which our society is configured and about how much easier it is to have a healthy life if you don’t have to worry about next month’s rent or next week’s food shop.”

Prevention of ill-health is essential to the future of the NHS

Professor Andrew Goddard, president of the Royal College of Physicians, said it was good to hear the Secretary of State recognising the importance of valuing and looking after all of our health and social care workforce. 

He added: “We have long argued that prevention of ill-health is essential to the future sustainability of the NHS, as well as for the benefits it will bring to countless individuals. This must be a partnership but, just as we have seen an obesity strategy appear this week, in part in response to COVID-19, progress on public health needs to be led by a wider strategy to reduce health inequalities.”

Professor Martin Marshall, Chair of the Royal College of GPs, said it was encouraging that the Secretary of State is keen to learn from this for the future and move away from 'tick box bureaucracy' to having higher trust in the profession.

He added that although there is a compelling case to retain some aspects of the different ways GPs have been working, we certainly do not want to see general practice become a totally remote service. 
 
"A totally, or even predominantly, remote general practice service wouldn’t be in anybody’s best interests long-term, and throughout the pandemic face to face appointments have been facilitated when they’ve been necessary," he said. 

"Remote consultations have benefits - they can be convenient for patients, and GPs have reported they have found them to be an efficient way of delivering care - but there are some things that simply can’t be done remotely, for example, when a physical examination is necessary or for a vaccination. Many patients also prefer seeing their GP in person, and many GPs prefer this too, particularly for patients with complex health needs who really value the relationship-based care that GPs excel at delivering. “