News / Dorrell calls for new model

The NHS needs a fundamental change in the way services are delivered, former Commons health committee chairman Stephen Dorrell told the HFMA FT Finance conference in Brighton at the beginning of July.

He said the system had been designed to treat normally healthy people when they became ill and return them to health. While acute medicine remained important, the service now needed to shift its emphasis onto the majority of its users with long-term conditions. 'We need to run a care system where medicine is available rather than a medical system where care is too often not available,' he said.

He said that meeting rising demand from broadly flat real terms resources remained the service's 'most important challenge'. 'You don't deliver 4% [efficiency] by sending for the procurement director, it isn't about buying things more cleverly,' he said. 'The only way to deliver efficiency gains on anything remotely resembling this scale is to face the need to change the care model.'

He added that the quality of service had to be central to plans, in particular in services delivered outside hospital.

Mr Dorrell said that finance teams had a big support role to play. 'Finance in any organisation does its job best when people don't notice it,' he told the conference. 'You always know an organisation in crisis - it's the one where the finance director is forever in demand because something is going wrong and the pressures have not been thought through. The challenge for you is to ensure we have thought about the underlying economics of healthcare so that those who deliver the care are enabled to do their job to the best of their ability.'

He added: 'When we don't think ahead and understand the challenges we face, we end up with decisions driven by finance and not enabled by finance.'