Modernising Nursing Careers: Setting the Direction

2 Health care is changing

Health services in the UK are undergoing unprecedented reform backed by massive extra investment. This reform programme is transforming the way health care is provided.

The reform programmes across the UK are:

• putting the needs and preferences of patients, users and the public, rather than those of professionals, at the forefront of decisions about patterns of services
• focusing on integrated care based on individualised pathways across local health economies and social care
• enabling much more choice for individuals
• improving the care of people with long term conditions
• laying greater emphasis on prevention, health promotion and supporting self-care
• moving more care outside of acute hospitals into the community and people's homes
• providing incentives for working in new ways.

Massive investment in reform
The NHS budget in England has doubled since 1997 and will have trebled by 2008 when it reaches £93.6 billion.
In Northern Ireland there has been a 35% increase in health and social care spending over the last three years, with £3.8 billion being spent in the current year.
In Scotland the health care budget has increased by 76% since 1999 to £8.9 billion.
The health and social services budget in Wales has doubled to £5.1 billion since 1999.

Throughout the UK these reforms are underpinned by consultations that show what people are looking for from health services. They want:

• choice about services
• more care available outside hospital and closer to home
• to take personal responsibility for their own wellbeing and to be supported in caring for themselves
• better care for those with long term conditions.

What patients say about care that is effective and meets their needs:
"I am only small, but now I feel tall. Now I can hold my head up high"
( Now I feel tall, DH 2005)

While significant improvements have already been made there still remains much to be done if we are to continue to have a world class health care system in a rapidly changing environment.

Some key achievements
Waiting lists are at their lowest since records began.
In Northern Ireland virtually no patient is waiting longer than 12 months for any treatment.
Throughout the UK 19 out of 20 people at A&E are dealt with within four hours.
Mortality from heart disease across the UK has fallen by 20% and for some cancers by 10%.