On 12 September 2024, Lord Darzi published an important report exploring the current performance of the NHS across England and the challenges facing the healthcare system.

The independent review highlighted a series of key issues facing the NHS, such as many waiting time targets not being met, a failure to shift care away from hospitals and into the community, a lack of capital investment, and structure problems.

Lord Darzi makes numerous recommendations to get the NHS back to peak performance. These include re-engaging staff, getting more people back into work, reforming the structure of the NHS, utilising technology to drive productivity, and facilitating care closer to home by hardwiring financial flows.

Below, AT Today has covered some reactions from leading health and social care organisations, including the BHTA, RCOT, SCIE, The King’s Fund, LGA, and NHS Confederation.

David Stockdale, Chief Executive of the British Healthcare Trades Association (BHTA), said: “Lord Darzi’s report offers a refreshing perspective as the Government faces the realities of the NHS’s current challenges. The health service, its employees, and suppliers have been undervalued and underused for too long, which this report fully acknowledges.

“I’m particularly pleased to see the stated shift in focus from hospitals to community care. The BHTA stands ready and willing to support the NHS in accelerating this transition, as our members provide both the innovations and local expertise needed to usher in a new era of healthcare in the UK.”

Director of Practice and Innovation at the Royal College of Occupational Therapists (RCOT), Karin Orman, commented: “While the findings of Lord Darzi’s report are shocking, they’re not surprising for those of us who have worked in the NHS over the past decade. The NHS is in desperate need of major reform, with budgets and staff reallocated to where they can make the most difference.

“We believe that one of the key things that will help save the NHS is moving the majority of occupational therapists – and other allied health professionals – from hospitals into community settings, such as GP surgeries, schools, housing teams, social services, care homes and places of work.

“Widening access to occupational therapy where people live, work and go to school will help prevent people reaching crisis point and ultimately reduce pressure on health services. It will mean people will have the support they need to live in their own homes and continue with the occupations that they want and have to do.

“By focussing on prevention and early intervention, people living with multiple health conditions or complex needs will be better able to manage their symptoms and reduce the need for hospital and specialist services.

“But we need the resourcing and funding to make this happen. Getting the occupational therapy workforce right will actually help reduce the pressures on GPs, nurses, and all other areas of the NHS, as well as helping people live well for longer.”

Kathryn Smith, Chief Executive of the Social Care Institute for Excellence (SCIE), commented: “Although focused on the problems facing the NHS, the Darzi Review strengthens the case for acting on social care reform sooner rather than later.

“The Review lays bare the critical and long-standing issues facing both the NHS and the social care system, from service fragmentation and underfunding to inefficiencies and an ageing population. To resolve the NHS’s long waiting times and improve healthcare outcomes, we need to consider patient pathways across health and social care systems as a whole.

“Lord Darzi’s analysis recognises that health and social care cannot function effectively in silos; they are inter-dependent. Enabling people of all ages, not just older people, to live independently, manage long-term conditions and relieve the pressure on fnite NHS and emergency services are goals of both systems. Without a coordinated approach, people will continue to face under-met and unmet care needs, and family carers will remain overstretched.

“Waiting for government action and investment on social care may prove to be a false economy. Social care must be treated as an equal partner to the NHS, and we must leverage opportunities now for upstream prevention, new models of community care and digital innovation. The NHS 10-year Plan has an important role to play in reimagining both our future national health system and social care.

“This is a vital moment for the future of care in the UK—one we cannot afford to miss. We look forward to working closely with government, health and care partners as future plans for the NHS and a National Care System take shape.”

Sarah Woolnough, Chief Executive of The King’s Fund, reacted: “This review is an authoritative and sobering articulation of what patients have been telling us for some time – services are stretched to breaking point and people are losing faith that support will be there when they need it.

“The review is more than just a gloomy assessment of how long it will take to recover services, it is a mandate for government to take bold, decisive action.

“The biggest improvements to health and care in this country will come from prioritising services outside of hospital. That means greater investment in the primary and community services that support people before they end up needing hospital treatment. It means political focus on public health strategies that keep people healthy and prevent illness in the first place. And it means finally getting to grips with the much-needed reform of adult social care.

“Lord Darzi’s review also underscores the need to move beyond past lazy criticism regarding the value of NHS managers and instead recognise that implementing major improvement to the health service requires investment in high-quality leaders.

“Ministers now face tough trade-offs between tackling immediate NHS pressures or prioritising reform of the root causes of the crisis. Today’s review makes clear that incremental improvement will not do – radical change is needed.

“The task is not simply to prop the NHS back up; it is to create a new approach to health and care in this country.”

Cllr Louise Gittins, Chair of the Local Government Association (LGA), said: “We support the findings of this rapid investigation of the state of the NHS, including that it notes funding in the wider health system did not keep up with increasing demand.

“Health is about more than healthcare, and local councils are vital in addressing the wider determinants of health, through their role in housing, green spaces, youth services, and the local economy. They plan, commission, and provide essential services like social care, public health, and children’s services, all of which are key to improving population health and preventing ill health.

“To effectively reduce pressure on healthcare systems, improve health outcomes and tackle inequalities it is vital to involve local government in shaping the upcoming 10-year plan for health. Reforming social care and investing in local government services are essential for a healthier population and a sustainable NHS, and therefore local government must be integral in developing the solutions.”

NHS Confederation Chief Executive Matthew Taylor, who was asked by Lord Darzi to lead one of review’s engagement sessions, said: “This report paints a bleak picture of the state of an NHS which, despite working harder than ever before, has been struggling in the face of rising demand, a decade of underinvestment and the impact of the pandemic. NHS leaders will recognise Lord Darzi’s diagnosis of the NHS’ problems and will work with the government to help address them.

“The review has rightly identified many of the root causes, not least how we invest much less in our buildings, technology and equipment than many comparable countries. And how the ill-fated NHS reforms of the early 2010s were an unnecessary distraction and stripped out vital management capacity that has harmed efforts to make services more productive. We would add the parlous state of social care to that list, which successive governments have failed to address.

“The government has taken the first necessary step in diagnosing the problem, and the task now is to move to identifying the prescription. Ministers will need to work on two fronts. First, to help the NHS avoid a winter crisis given the financial crisis that is engulfing the service. NHS leaders are already having to make tough choices about what services and staff they can afford at a time when they actually want to be preparing to ramp up capacity to meet the usual spike in demand over winter. Emergency funding will be needed in the Autumn Budget, not least to boost staff and capacity in social care. We also cannot repeat the mistakes of the past by raiding already overstretched capital budgets to plug holes in day-to-day spending.

“In parallel, the government needs to prepare for the long term through its planned 10-year strategy. We know this is far from easy given the perilous state of the public finances. But the fact remains that unless we restore the NHS to the long-term average funding increases it needs, accompanied with changes to the way that local services are delivered, then we will never bring down waiting lists to the levels required as well as preventing more illness from occurring in the first place.”