The All Party Parliamentary Group on Primary Care and Public Health has been looking at what progress has been made in implementing NHS England’s Five Year Forward View and concludes a huge opportunity is being missed.

The Five Year Forward View (FYFV) called for the NHS to undergo major change, in particular engaging with patients and the public to a far greater degree and increasing its focus on prevention and wellbeing.

However, MPs are gravely concerned about the lack of progress towards these goals since the report was published in October 2014. In particular, they note that no leadership, policy or co-ordination strategies have been developed to enable the FYFV’s goals in respect of engagement, prevention and wellbeing to be met, at either national or local level.

Such drivers of change urgently need to be put in place and MPs recommend a minister and national director are appointed to create and implement a national strategy for self-care, providing leadership and co-ordination to ensure the prevention and wellbeing aims of the FYFV are met within the five-year time frame.

Empowered

People want to be empowered and to take responsibility for their own health but require support to help them self-care. The APPG recommends the Making Every Contact Count initiative is urgently implemented nationwide and in a structured and consistent way. This and a number of other local self-care initiatives have demonstrated clear outcomes in terms of reductions in GP and A&E visits with concomitant improvements in health education and empowerment.

It is worrying that current public funding systems are actively working against the development of health promotion and self-care initiatives, MPs say. Most NHS funding goes into secondary care, but more spending on primary care and public health could go a long way to easing the burden on secondary care.

In particular, there is an urgent need for the NHS tariff system to switch the basis of its funding away from levels of activity and more towards outcomes and prevention, particularly in A&E. The cuts in local authorities’ public health budgets, imposed so soon after they have once again taken on these responsibilities, are also of concern. Local authority funding meant for health promotion in the community should be ring-fenced to ensure it is protected, the report says.

Inconsistent, complex and confusing

The information available to people about where to seek medical help is a significant issue. Too often it is inconsistent, complex and confusing, and this is driving them to GPs and A&E for conditions that could be treated at home or with the advice of a pharmacist.

In 2014, A&E departments dealt with 3.7m visits for self-treatable conditions, such as flu and muscle sprains, while three-quarters of people directed to A&E by the NHS 111 helpline did not need to be there. Only 1 per cent of callers were advised to consult a pharmacist. People must receive consistent information, expressed clearly and plainly, about what options they have and which services are the most appropriate for them, say MPs.

Finally, poor levels of health literacy are harming the health of many people, especially the vulnerable, and are contributing to the pressures on the NHS, the MPs conclude. Special efforts need to be made to help and empower these groups, while across the nation, health literacy and health education need to become a life-long learning process starting at pre-school.

Only 1 per cent of callers were advised to consult a pharmacist