Speech to NHS Providers

Good afternoon.

I’m very glad to have the chance to talk to you today. Because we are at a perilous moment in the course of this pandemic.

I am very worried about the growth in the number of cases, especially in the North West and North East of England, and parts of Wales, Scotland, Northern Ireland, and parts of Yorkshire.

You have all had the most extraordinary 9 months, and in my view you have risen to the challenge.

But in parts of the country, the situation is again becoming very serious.

Hospitalisations in the North West are doubling approximately every fortnight.

And have risen by 57% in just the just last week alone.

Unfortunately, we are seeing hospitalisations of the over 60s rising sharply, and the number of deaths from coronavirus also rising.

And we know from bitter experience that the more coronavirus spreads, the harder it is to do all the other vital work of the NHS.

Yesterday, we heard from the Academy of Royal Colleges.

Helen Stokes-Lampard said: “If we don’t act fast we risk the NHS being overwhelmed and risk all the good work done to restore services.”

And then this morning, we heard from the Royal College of Emergency Medicine.

When Katherine Henderson said: “If we do not come together and take effective precautions, COVID will continue its explosion across the country, the consequences of which could be the implosion of the NHS this winter.”

The message to the public must be that we all have a part to play, to control this virus.

Our strategy is simple: suppress the virus, supporting the economy, education and the NHS, until a vaccine can make us safe.

My message to you, and to everyone who works in the NHS, is that we can, and we will, get through this.

Sadly, there will be more difficult times ahead.

But we will get through it together.

And one of the good things that has happened this year, and there have been some good things, is that the whole public, has shown just how much it appreciates the NHS.

There’s only one organisation that can inspire people to applaud from their doorsteps and balconies, come rain or shine.

That can inspire colourful support in windows across the land.

There’s only one organisation that can inspire a heroic centenarian to walk laps of his garden and inspire millions of people to sponsor him.

The NHS. The best gift a nation ever gave itself.

And this year, when all nations faced peril and adversity, the NHS was there for us, as it always is, and always must be.

The spontaneous outpouring of admiration that we have seen from all corners of this country, I think that is testament to how much people cherish this amazing institution.

We all pulled together to protect the NHS.

But crucially, it’s the NHS that protects us all.

Not just the doctors and nurses, and I want to say this very directly, but the cleaners, porters, mental health teams, ambulances, and all the diverse and varied parts of this incredible system.

During the greatest public health crisis in a generation, you have been the linchpin of our national effort.

And we must work together for the population who we serve, through this pandemic and beyond.

Today I want to say a few words about how.

People

First of all, of course, the NHS is only as good as its people.

And if the last few months have shown us anything it is that the NHS is blessed with exceptional people.

And we are doing everything in our power to support them, and boost their number.

During the crisis, we put out a call for former health and care professionals to return to the front line – and 47,000 volunteered to play their part.

I think this is an incredible testament. To them, and to every single one of our 1.4 million strong team – and the over 2 million in social care – I want to say, on behalf of the nation, thank you. Thank you for your service.

Our returnees were supported by people from all walks of life who stepped up.

Furloughed cabin crew redeployed into call handling roles.

Clinically trained firefighters provided surge capacity for our ambulance services.

Volunteers delivered hot food to the vulnerable, and to NHS staff.

This was a phenomenal effort from so many, new recruits and established colleagues.

And we all learned just how flexibly we can work when needs must. This sort of flexibility helped the NHS really deliver, and it is something we should hold onto for the future.

And, of course, we are looking to expand the workforce for the long term, through our plans to recruit 50,000 more nurses, and more clinical staff.

This work is bearing fruit.

This year we have seen doctors numbers at their highest ever.

And over the last year, we’ve seen the number of nurses increase by over 14,000.

And we owe it to them, and all our NHS colleagues, to take forward some of the positive changes that we’ve seen during this pandemic.

From my point of view I’ve seen that the white heat of the crisis showed us a lot about our health service.

And for me, what was most illuminating was to see how some of the things that I know frustrate you all.

Like some of the bureaucracy and the hierarchy that too often gets in the way of caring for patients.

How a lot of this melted away.

Of course, it is important that we have the guide rails so we can measure performance and hold ourselves to the highest standards.

But in a health and social care system like ours, that has evolved over the course of over 70 years.

It is easy for layers of overlapping and disproportionate bureaucracy to build up over time.

I hear from providers what this can mean on the ground – multiple requests for information that don’t add value.

Multiple layers of instruction when we need to devolve trust.

Not enough support for the frontline staff who are doing a really stressful job.

So, we must learn from this illumination.

We must look at every rule and process afresh, and ask whether it makes sense after what we’ve learnt from the pandemic.

And we must increase our support to the frontline.

A few months ago, I launched our Red Tape Challenge within the NHS and social care, inviting views from colleagues on how we could bust bureaucracy.

How we could free up our colleagues’ time to focus on what matters – giving care.

And our team has been interviewing people from across the system.

And we have received hundreds of submissions directly from staff, with over 1,000 suggestions of where things could be improved.

The responses themselves have been illuminating.

As one frontline member of staff told us: “All of a sudden we could do everything we needed to do quickly and efficiently because of COVID.”

And that: “We have coped fine without endless meetings and forms.”

Hallelujah.

I can hear lots of you relating back to seeing the same experience.

We also heard from providers that they welcome the ability to act with more flexibility – for example, greater freedom around redeploying staff and contracting.

And I heard, too, of the multiple reports that have proposed reduced bureaucracy in the past, but haven’t been acted on.

Many times I was told that this question has been asked and then nothing has been done about it.

So we will act on the suggestions we’ve heard.

We will act on the recommendations of the reports that have already charted the way, but been left to one side over the past decade.

I want to keep this momentum going, working with you with the goal of making it easier for you to do your jobs.

So that we build a better health service, ultimately for our patients and for our colleagues on the front line to deliver care.

Now, I know how difficult these past few months have been for so many.

And the survey published by NHS Providers this week showed that many colleagues are feeling tired and burnt out.

Believe me, I get it. I want to do everything I can.

The People Plan has already set out our commitment to investing in health and wellbeing in the future.

Through increased flexible working.

Through creating an inclusive and diverse workplace. That’s a culture change that we know we need to see.

And through boosting opportunities for education and training.

And today I can announce a new research project to understand and address the impact of this pandemic on our NHS staff.

Researchers will work across England to identify those most in risk, and most in need of tailored support.

And we will place a particular focus on colleagues from black, Asian and minority ethnic backgrounds, who we know, tragically, have been particularly affected by this virus.

There is more to do.

And I pledge, every day, that I will do whatever it takes to protect the people who do so much every day to protect us.

Systems

The next thing I want to turn to, is how we make sure the systems work as well as possible. Even if people are healthy and happy, they can’t perform at their best if the system isn’t set up to support them.

No one designing the NHS would set it up in the way it is set up now.

A system where primary care, community care, pharmacies, mental health trusts, and many, many, other parts, exist – at least in law – as atomised and isolated institutions.

No. A collaborative approach is essential for us to have better, less fragmented decision-making.

To treat complex conditions better.

And to provide the best care for everyone who needs it, in the setting that is best for them.

And to provide preventative care to keep people healthy in the first place.

Now, I don’t believe in reorganisations designed in Whitehall offices, based on management consultants’ spreadsheets.

I am allergic to all that. It is my job to improve the system we’ve got so it works better for everyone. It is the hard yards of incremental reform.

In fact, it’s every single person’s job to improve their part of the system, so that it works better for everyone.

All 1.4 million of us ought to be working together to improve the system that we’ve got.

I know there is a strong and growing consensus behind the systems-led approach.

Streamlining work by bringing together commissioners, providers and local authorities, to plan services for the populations we serve.

And we will move to the system by default. We will remove barriers that prevent collaboration, and follow the approach set out in the Long-Term Plan.

We will improve, rework, join up and tie systems together so we can all focus on the people that matter: the populations we serve.

When battling coronavirus, we have been able to solve problems together at a systems level that previously would have been impossible to crack.

We will deliver ICSs in all geographies by April, and take them further still.

We will strengthen how systems operate, across all parts of the NHS, and tie in tightly with local authority colleagues who share our mission to the populations we serve.

So bringing to bear the whole wealth and diversity of experience that exists in a local area.

All with the shared goal of helping people to live healthier lives for longer.

Recovery

We must make these improvements, even while we battle coronavirus, because they will help us to battle coronavirus.

And we must learn from how we have battled coronavirus.

And we’ve got to recognise the Herculean efforts, both to keep services going, and to get us ready for winter.

And I want to touch on what I think is a seldom-discussed success during this pandemic, which was just how much urgent non-COVID work we were able to keep going at the peak.

As well as treating COVID , cancer treatments continued at 82% of usual levels between March and July.

Our A stayed open.

Primary care and outpatients switched to telemedicine faster than I could ever possibly have imagined.

It has been a phenomenal team effort and I would like to thank and pay tribute to everyone who has been involved.

Not just to those who maintained and delivered the services, but everyone who created the infrastructure – including that digital infrastructure – that made it possible.

We will keep doing everything we can to keep non-COVID treatments and diagnostics going over the next few months.

And the more coronavirus is under control, the more we can continue the recovery and keep essential services open.

As we prepare for the tough months ahead, I have no doubt that we will see the same dedication and care that we have seen all the way through 2020 – the NHS’s most challenged year.

Conclusion

And I pledge you this:

This year has proved beyond measure the importance of our nation’s most cherished institution.

At our best moments in our lives, and at some of our worst.

The NHS is always there for all of us.

And at a time when it is being tested like never before, for this pandemic and into the future, it will be always at your side.