By Ruth Whittington ([email protected])

With the NHS in the UK nearing its 60th birthday, there’s been considerable talk about whether the system should be put into retirement. At the recent European-based World Healthcare Congress in Berlin the Chief Executive Officer David Nicholson explained why he felt that there was plenty of life in the old girl yet.

Nicholson pointed out that the last 18 months have seen significant change in the NHS. One year ago, the NHS was in its third year of producing a deficit – averaging about £0.5 billion annually. In 2007 the organisation managed to turn this around so successfully that they created a surplus of £0.5 billion, and this year the surplus is projected to be 3 times that. Now, why, you may ask, is a surplus a good thing in a non-profit organisation? Simply because when you have money you have an element of control over what you do. Being constantly in debt leaves you on the back foot and leaves little room for manoeuvre. So it is with the NHS, Nicholson claims.

Thinking of the NHS as purely a system helps with the implementation of change, according to Nicholson. He described the changes that have happened in the NHS as a series of phases.

The first phase began in the post 1997 era with a focus on building capacity based on national targets. In this phase the NHS grew by almost a third, in staff buildings and all levels of healthcare provision.

Phase Two of the change was in providing reforms in healthcare delivery – setting up tariff systems and organisational models.

Phase Three, underway at the moment is the individualisation and personalisation of care – making patients partners in their own healthcare provision.

From the 1st of April (a somewhat unfortunate choice of date) patients will have free choice of their secondary healthcare. The NHS is hoping to introduce an element of choice and contestability into healthcare, and also to integrate primary and secondary care a little better with advanced IT systems. To that end, they are working closely with BT Health to develop electronic patient records.

A start of this phase is the ability for patients to interact with their own healthcare records via HealthSpace on the web. So it seems, with an exciting future ahead, the NHS is heading a second youth/swinging sixties/second wind.