Staying on the leading edge: Health transformation – still some way to go

The annual spring gathering of health and social care leaders and partners at NICON always produces an insightful, constructive two days of discussion.

Over two years have passed since the Department for Health published its 10 year approach to transforming health and social care in Northern Ireland and since the launch of ‘Health and Wellbeing 2026 – Delivering Together’,  we continue to experience political uncertainty and considerable pressure on services.  So we pause to ask is our health service on its way to being truly transformed in eight years’ time? And has the lack of political scrutiny helped or hindered?

In the absence of a Minister, the Department for Health Permanent Secretary Richard Pengelly opened the annual NICON conference and highlighted progress to date but stressed that without reform, problems in health and social care system will “get worse year on year”.

As Permanent Secretary he has had the power, and importantly, the confidence to take some key decisions forward including public consultations on reshaping stroke and breast assessment services as well as reviews into urgent and emergency care, oncology, neurology, paediatrics, as well as initiatives such as the rolling out of Multi-Disciplinary teams at GP surgeries.

Evidence of any progress however is overwhelmed by some key challenges and evidence of a system in a state of constant crisis. Waiting lists, staff pressure, a looming nursing strike, increasing health inequalities and an ageing population.

Pengelly reassured the audience of over 600 people that the transformation agenda continues but there is further need to prioritise and be more efficient.  Can health trusts sacrifice the performance of their individual trusts for the benefit of the system as a whole? 

While there will never be enough money for health, a large injection of cash is what Pengelly stresses is needed to address some key problems including the issue of waiting lists, as well as noting the longer term answer of reshaping services to improve capacity and provide more diagnoses and treatments. That’s not to mention the role of Health in Community Planning or galvanising other agencies to deliver health outcomes.

The essence of the road map for reform in moving more care into the community and creating specialist treatment centres is well-evidenced and widely supported by experts and the political parties at the time but it does not mean that transforming health as it moves towards the next stage of implementation is going to be quick or easy, even if our  local politicians make progress in the current talks.