24 hours agoShareSaveAlison HoltSocial affairs editorShareSaveBBC”That was really quick – straight in, straight out,” says Phil Brown as he leaves a smart glass building in a shopping centre in Barnsley.He has just had an ultrasound scan at an NHS centre which sits between familiar High Street names. It is easy-to-reach healthcare – as convenient as popping out to the shops.This is part of the government’s vision for the future of the NHS, soon to be set out in a 10-year plan. In England, ministers have already promised three big changes: shifting more services from hospitals into the community, focusing on preventing ill-health and making more use of new technology.BBC Panorama spent months in South Yorkshire meeting people already changing how they work, to see what it will take to fix a health service which is buckling under increasing demand.The NHS also has to cut waiting times, money is tight and the organisation which currently runs it, NHS England, is being scrapped to reduce bureaucracy.There is another deep-rooted problem – a care system, supporting older and disabled people in the community, that is understaffed, underfunded and in crisis.Government critics say you cannot reform the NHS unless you reform social care, because it helps get people out of hospital more quickly and prevents some being admitted in the first place.An independent commission will begin looking at social care reform next month. There will be an interim report, but the final report is not due until 2028.Challenged on whether you can reform the NHS without changing social care, Health and Social Care Secretary, Wes Streeting tells Panorama that he doesn’t need to wait for a review and plans to divert more NHS money into social care.”I want to spend more of our resources through social care, because it delivers better outcomes for patients and better value for taxpayers,” he says.Streeting would not be drawn on how much money would be involved, but said details about spending on social care would be in the 10-year NHS plan.Most care is paid for by councils, or by the people who need it. It can end up costing some families tens of thousands of pounds. Only those with the very highest needs get help from the NHS.Future of the NHSAt Barnsley Hospital it used to take about six weeks to get a non-urgent scan, but at the town’s NHS centre next to the shops most people are seen in two weeks.The centre’s new scanners and X-ray machines have increased the number of patients staff can see and freed up the hospital so it can concentrate on emergencies and inpatients.Phil had skin cancer removed four weeks ago from his chin and the consultant wanted to check a couple of pea-sized lumps in his stomach. The scan results will be sent to his GP.”It’s about peace of mind. You’re not waiting for appointments,” he says.Liz Elfleet, medical imaging manager at Barnsley Hospital NHS Foundation Trust who helped set up the unit, describes this as the future of the NHS.”We’ve seen around a 50% reduction in patients not attending for appointments,” and the number of women accepting an invitation to have a routine breast screening appointment has risen “from 43% to just under 80% over the three years,” she says.The centre, which offers a range of health checks and scans, was opened in 2022 under the last Conservative government. The current Labour government says many more services will now move out of hospital into the community.In Barnsley, that is already happening. Part of another shopping centre is being converted into a second, large health hub. The project will be funded by the local council, regional mayor and a government grant.The leader of Labour-run Barnsley Council, Sir Steve Houghton, says the scanning centre has shown NHS facilities can boost town centres, and they estimate people spend about £17 on average in local businesses when they visit.Preventing ill-healthThe second big shift the NHS is being asked to make is to focus more on preventing ill-health. In Sheffield, a GP practice has already begun to do this, to help them manage a workload which they say had become overwhelming.Five years ago, Steel City General Practice analysed the data for 10,000 of their patients who needed the most help. “So we then said, let’s actually proactively bring them in. They haven’t contacted us – we’ve contacted them,” says Dr Krishna Kasaraneni.GP appointments usually take about 10 minutes, but the Steel City practice gave these patients longer appointments to try to pick up problems earlier. They also took a risk and didn’t chase a national target to see all patients within two weeks.Dr Kasaraneni says it has paid off. “The numbers of strokes have dropped over that five-year period. Coronary heart disease numbers have dropped,” he says. It has helped the doctors manage their workload better.The improved health of the patients has freed up some appointments, and on average people don’t wait longer to see someone, but the growing older population means they are stil …
