Ipsos MORI and The King’s Fund The NHS at 70: The relationship between the NHS and the public Ipsos MORI and The King’s Fund

3 public workshops London Today is the start of a series of discussions with the public about the NHS 3 public workshops London Nuneaton Preston Online community This work involves talking and sharing views – interested in honest views Not a big survey so everyone’s views count No question is stupid, please feel free to ask Your questions, views and attitudes

About today Run by The King’s Fund and Ipsos MORI

The King’s Fund The King’s Fund is an independent charity working to improve health and care in England. Our vision is that the best possible care is available to all. We: Help shape policy through research and analysis Develop teams, individuals and organisations Promote understanding of the health and social care system Bring people together to share knowledge, learn and debate

Ipsos MORI Ipsos MORI is an independent research organisation. We work across a range of different policy areas, including Health and the NHS. This includes a lot of research about public perceptions of the NHS

About today Run by the King’s Fund and Ipsos MORI Anonymity Mix of plenary sessions and group discussions Ground rules

How the findings will be used Part of a bigger piece of work that the King’s Fund is doing to understand public views on the NHS You can visit the King’s Fund’s website to see other articles and research we have done A report for publication A launch event to discuss the findings with decision makers Saturday – we will also have an improv team to help bring things to life and add some light relief and comedy – so the day should be fun

Who is here today? Researchers from Ipsos MORI and The King’s Fund – running the discussions, hearing your views, recording the discussions Patrick South, The King’s Fund – expert providing information for you to discuss Denis Campbell, The Guardian – hearing your views, talking to people separately for an article Anna Geyer, New Possibilities – creating an animation of our discussions And most importantly, you! Saturday – we will also have an improv team to help bring things to life and add some light relief and comedy – so the day should be fun

Housekeeping Food and drink Toilets Breaks Fire alarm Please turn off mobile phones!

Plenary presentation: The NHS at 70

The NHS is turning 70 Founded on the 5th July 1948 Aneurin Bevan launched the NHS at Park Hospital in Manchester The NHS brought together doctors and clinical staff of different kinds together under one health service The NHS has changed: prescription charges, dentistry, opticians

Founding principles of the NHS The NHS is free at the point of delivery The NHS should provide a comprehensive service, available to all The NHS should be primarily funded through taxation Do these still apply, 70 years on?

The NHS and the public We are here today to hear from you What does the NHS mean to you? What place does the NHS have in Britain today? What is our (the public’s) relationship with the NHS? Has this relationship changed over time?

Over to you…

Voting questions: The NHS at 70

Vote Now How realistic, if at all, would you say people’s expectations are of the service they should get from the NHS? 0% Very realistic 1. Fairly realistic 2. Not very realistic 3. Not at all realistic 4. Don’t know 5. Vote Trigger

Vote Now And thinking generally about what you expect of NHS services, would you say they… ? 0% Exceed expectations 1. Are about what you expect 2. Fall short of expectations 3. I don’t have any expectations 4. Don’t know 5. Vote Trigger

Over to you…

Vote Now Which of the following statements best reflects your thinking about the NHS? 0% The NHS is crucial to British society and we must do everything to maintain it 1. The NHS was a great project but we probably can’t maintain it in its current form 2. Don’t know 3. Vote Trigger

Plenary presentation: The NHS over the next 70 years

The NHS over the next 70 years Where is the NHS now? What are the challenges and opportunities for the NHS over the next 70 years? Does the NHS need to change? Does our relationship with the NHS need to change? Source: ONS

The good news is that we’re living longer Age 1990 2018 2040 65+ 7.8 million 10.2 million 14.9 million 85+ 740,000 1.4 million 2.7 million Source: ONS

But people are living longer with more long-term conditions… But the key point is multi-morbidity – which is increasingly becoming the norm – you can see that over 50 percent of people aged 75 and older have 3 or more chronic conditions. Research shows that these patients have more complex self-care needs, worse health outcomes, longer hospital stays. It’s important to say here that the increasingly complex of care needs in the community are caused by LTCs not age. People in deprived areas get their LTCs 20 years earlier than their neighbours in less deprived boroughs. Aside from demography and epidemiological factors - we’ve also seen the care of whole groups of patients – such as long stay geriatric patients – move out of hospital and into the community. The resources and skills needed to treat these more complex patients is not present in the community to meet the increased demand. Barnett, Mercer et al 2012

And demand for the NHS is going up In 2015/16 (compared to 5 years earlier…) Outpatient appointment attendances – Up 27% A&E attendances - Up 7% Planned admissions - Up 14%

But funding is slowing down Average annual real terms increase in NHS budget: Since 1948 3.7 % 01/02 –04/5 8.5% 10/11 – 14/15 1.2% 15/16 – 20/21

What’s happening now? In the context of these challenges, NHS England published the Five Year Forward View Redesign the way that care in the future will be delivered – taking pressure off expensive services and trying to deal with this more cheaply A National Illness Service or a National Health Service? Promoting wellbeing and preventing ill health Encouraging people to take an interest in their own health

The relationship between the public and the NHS What does it mean for patients and users of services? What does it mean for the services that we can pay for? Should we pay more? What is the relationship? NHS Constitution – what rights do people have, what should people be required to do? Patient charter – 1991, the rights for NHS patients ‘Give and get’

Questions to think about Whose responsibility is it to keep us healthy? The individual? Government? The NHS? Is the NHS providing us with services that we need and can use? Can the NHS keep up with all the people who need its services? If services keep getting expensive, how should we pay for this?

Over to you…

Next discussion

Prevention and keeping people healthy The government and the NHS should support people to stay healthy… The individual is responsible for their own health..

Using NHS services The government and the NHS should ensure appropriate services are available… The individual should use NHS services responsibly…

Funding The government and the NHS should ensure money is spent well.. The individual should contribute to the growing cost of delivering health services…

Plenary presentation: The Deal

The Deal

Over to you…

Thank you!