1. 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

2. 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

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

4. 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

5. 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

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

7. 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

8. 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

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

10. Plenary presentation: The NHS at 70

11. 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

12. 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?

13. 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?

14. Over to you…

15. Voting questions: The NHS at 70

16. 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

17. 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

18. Over to you…

19. 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

20. Plenary presentation: The NHS over the next 70 years

21. 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

22. 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

23. 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

24. 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%

25. 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

26. 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

27. 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’

28. 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?

29. Over to you…

30. Next discussion

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

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

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

34. Plenary presentation: The Deal

35. The Deal

36. Over to you…

37. Thank you!