The prime minister has pledged the “biggest re-imagining of our NHS since its birth”, in response to a major report into the current state of the health service. Sir Keir Starmer today

promised major reforms to the NHS, including moving care from hospitals into the community, shifting services from analogue to digital and moving away from sickness to prevention. > “Only

 fundamental reform and a plan for the long term can turn > around the NHS and build a healthy society” >  > Keir Starmer The announcement from the prime minister follows the

publication last night of the Independent Investigation of the National Health Service in England. The review, undertaken by leading surgeon and former Labour minister, Lord Ara Darzi,

addition, the report specifically highlighted that promises by successive governments to move care out of hospitals had been hampered by the lack of investment in community nursing. Over

nine weeks, Lord Darzi examined over 600 pieces of analysis from the Department of Health and Social Care, NHS England and external organisations during his investigation. An expert

reference group made up of more than 70 organisations, including the Royal College of Nursing and the Royal College of Midwives, also contributed to the review. Lord Darzi identified “three

major shocks” that he said had led the health service into the crisis that it was in today. The first was austerity, with the report noting that the 2010s were “the most austere decade since

the NHS was founded”. The second was the fact that the NHS has been starved of capital, with low investment in buildings, scanners and other digital technology. As part of this, the review

argued that the NHS remained “in the foothills of digital transformation”. Lord Darzi said the last decade was a “missed opportunity to prepare the NHS for the future” and to embrace digital

technologies that could support prevention. The third shock, the only one of which Lord Darzi argued was not a political choice, was the Covid-19 pandemic. The report found that the

combination of austerity and capital starvation “saw the NHS enter the pandemic with higher bed occupancy rates and fewer doctors, nurses, beds and capital assets than most other high-income

health systems”. On workforce, Lord Darzi found that “too many staff are disengaged” because of burnout from the pandemic. He noted “distressingly high levels of sickness absence” in the

NHS, with as much as one working month a year missed for each nurse and each midwife working in the NHS. RELATED ARTICLES Despite the damning analysis, Lord Darzi insisted that the NHS’s

vital signs “remain strong” and he praised staff for their “shared passion and determination to make the NHS better for our patients”. While he noted that his task was to provide a

diagnosis, rather than a cure, he set out several themes that should be taken forward by the new Labour government. These were: * Re-engage staff and re-empower patients * Lock in the shift

of care closer to home by hardwiring financial flows * Simplify and innovate care delivery for a neighbourhood NHS * Drive productivity in hospitals * Tilt towards technology * Contribute to

the nation’s prosperity * Reform to make the structure deliver The Darzi review was commissioned by the new government, which said the findings will be used to inform a 10-year plan to

reform the NHS. Sir Keir pledged today that these reforms would be “the biggest re-imagining of our NHS since its birth”. In his speech, delivered at the King’s Fund, he said: “If we get

this right, people can look back and say this was the generation that took the NHS from the worst crisis in its history, got it back on its feet and made it fit for the future.” The 10-year

plan will see the NHS undergo three “big shifts” in how it delivers care, noted Sir Keir, addressing some of the key points in the Darzi report. These include moving “from an analogue to a

digital NHS”, shifting care “from hospitals to community” and “moving from sickness to prevention”. Sir Keir promised that, instead of the top-down approach of the past, the 10-year plan was

“going to have the fingerprints of NHS staff and patients all over it”. He said: “Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society.

“It won’t be easy or quick – but I know we can do it.” Responding to the speech, the general secretary and chief executive of the RCN, Nicola Ranger, said: “The best reform in the NHS looks

beyond its own doors and at investment as well as the delivery and standard of each service. “Only that holistic approach will achieve the aims being set out today by the prime minister.”

Professor Ranger argued that nurses would “stand up to their patients and continue to challenge care standards”. “They can provide high quality care and believe ministers, with their advice,

can make that happen,” she said. “Today the government has begun its journey to turn around health and care after years of neglect,” she sadded. “This must start with significant investment

in the nursing workforce to make any reforms or shifts viable.” Royal College of Midwives chief executive Gill Walton said: “The Darzi Report identifies many of the big issues within the

NHS, but once again maternity care does not get the high profile it deserves. “Capacity remains a major concern among our members,” she said. “The midwifery community wants to provide the

best quality, safest care to women and families but they can’t do that if they are having to fight for crumbs from the table.” “The new health secretary, Wes Streeting MP, said that of all

of the issues that keep him awake at night, maternity safety is top of the list, so we remain optimistic and hopeful that our new government understand these pressing issues and will put the

safety of mothers and babies, and of midwifery staff at the top of his list.” She added: “All we’re asking is that every maternity service has the right staff in the right place at the

right time.” Unison general secretary Christina McAnea said: “Reform is needed, but that won’t come without a cost. Just as with social care, the NHS can’t get back to tip-top health without

a well-resourced team of staff. “Both health and care sectors are many thousands of workers short,” she said. “The NHS might have more staff but it still doesn’t have enough.” She added:

“Nothing short of a complete reset will do. At the heart of this renewal must be an understanding that the best asset the NHS has is its staff.” Ed Hughes, chief executive of the Council of

Deans of Health, said: “Whilst the Darzi review focusses on the identifying the problems within the NHS, the solutions to its problems will be found through a coordinated response from many

sectors, including the education sector, to develop the new 10-year-plan, which we hope will bring clarity on the size and shape of the future workforce. “Reforming the NHS is a

cross-government mission and we look forward to playing our part in that alongside government and the NHS, so that together we can bring about the changes needed for a thriving NHS.” RELATED

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