In 1948, when the National Health Service was born, its structures were designed to provide reliable and comprehensive medical treatment for everyone, dealing with health emergencies and one-off illness. Its remit was to deliver sound, adequate health care.
Sixty years on, in 2008, the report of Lord Darzi’s NHS review, High-Quality Care for All, spoke of driving the NHS towards completely reinventing itself. In this vision, decisions are made to improve quality, rather than minimise cost. It foresees models of patient-centred care that engage individuals in the long-term management of their own health, with clinicians on hand to advise, guide and support their choices.
The impact of these changes is expected to be profound, with patients and families diagnosing, monitoring and treating their own conditions, resulting in changes to the usual relationship between health professional and patient, and to the organisational structures of the NHS. It will be hugely different from the NHS of six decades ago, and it will be possible only if we develop new ways of working, new attitudes, new treatments – if we embrace innovation.
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