Professor Anton Emmanuel, Commentary editor-in-chief, shares his thoughts on articles published in this June edition.
The 10-Year Health Plan has been a long-anticipated imagining of what the NHS ought to be aspiring for as it approaches its 90th year. It is intended to cover the entirety of health (if not social) care. Efficient use of resource is prioritised and the utilisation of outpatient services is at the heart of that consideration. Working with the Patients Association, the RCP has produced a report to envisage what future outpatient clinic services should aspire for. At the heart of this is the challenge of integrating primary and secondary care as envisaged by some regions and integrated care systems. The summary of the report shared in this edition of Commentary highlights the familiar prevailing challenges– how to permit patient choice, how to use expert resources efficiently and how to bridge data gaps.
On a related theme, there is a parallel article about the future vision of the ambulance services. Anna Parry of the Association of Ambulance Chief Executives discusses with Dr John Dean, our clinical vice president, about the integration of ambulance and hospital services in order to optimise community-based care. Central to this is the recognition of the complexity and expertise of staff in the ambulance sector, organised as 14 organisations across the United Kingdom. Building on that knowledge of professional skills moves into creating accountability frameworks and efficient patient pathways – and the challenges of this are covered in this excellent dialogue.
Another future-facing article in this edition addresses future training of physicians. The piece draws on the next generation survey of doctors, which demonstrated the loss of morale engendered by resident doctors feeling that service delivery was prioritised over training or personal wellbeing. The unsustainability of a model which fails to nurture talent has been highlighted in the RCP response to the NHSE’s review of medical training. The complementary priorities of addressing health inequalities and optimising workforce retention need to be at the core of any viable and meaningful reform.
Professor Anton Emmanuel
Medical director of publishing and Editor-in-chief, Commentary
