Our goal is to make sure everyone gets safe, effective, and compassionate treatment and support, whilst making best use of the money and resources we have. We continue to work closely with everyone involved in health and care to make that happen.
To keep our services running smoothly, we’re always looking for new and better ways to deliver care. We regularly have discussions among NHS organisations, doctors, and other experts in areas like planning, finance, and community health. These talks help us figure out where we need to make improvements, especially when it comes to maintaining the quality and safety of our services in the future.
This doesn’t always mean changes that patients will notice; often, it’s about finding ways to improve how we work to ensure better outcomes for everyone.
We want to reassure everyone that while these discussions are necessary, any proposed changes will be made openly and with public involvement. We’re committed to including patients and our diverse communities in these conversations, ensuring that your voices are heard, your experiences are understood, and your needs are met. Our priority remains delivering safe, high-quality care.
What is ‘We Need to Talk’ and why are you bothering? Won’t you just do what you want anyway?
No, this isn’t the case at all. We can point to many examples down the years where your views and feedback have influenced a decision or outcome.
We won’t get to where we need to be without you. The story of the NHS is as much yours as it is ours.
It’s why we have to be frank and honest with you so you understand the challenges we face and what’s at stake: we can’t keep doing things the same way and expect different results. Without big changes, the care you and your family rely on is at risk. But how we change will be partly up to you.
The NHS didn’t get to this point overnight and we are not going to pretend there’s an easy fix. We know past efforts have been difficult and successes not great enough.
However, the destiny of our healthcare system is a shared destiny. Together we can acknowledge the difficulties we’re in, face down the challenges together and be brave enough to make the changes that are necessary to ensure the NHS is there for everyone – for us, for our children, and for our grandchildren – for many years to come.
During this four-week period of public engagement, we’ll be out and about in our communities, talking to you. And we’ll be asking you to engage with us on social media.
You can find out more and let us know your views by completing a short survey. Visit: www.ournhs.org.
If you or someone you know doesn’t have access to the internet, we can send further information and the survey out in the post. Call us on 01482 672156 (please leave a message), email us at hnyicb.engagement@nhs.net or write to us at:
Humber and North Yorkshire ICB
FREEPOST RTTL-HSBE-BLHL
Health House
Grange Park Lane
Willerby
HULL
HU10 6DT
I’m hearing a lot at the moment about the NHS being broken. Is it broken?
The government is using this phrase because it says that is what it heard when it spoke to people across the country during the election campaign. Whilst we wouldn’t quite put it like that, we know the NHS is in a great deal of difficulty – and you’ve probably noticed that too or will know someone who has.
To put it simply, we are an ageing population with increased health needs which means there are a lot of people who need the help of the NHS.
At the same time, there are limits on the amount of money we can spend, we don’t always have the workforce we need, and some of our buildings and IT are not really fit for purpose.
Taken together, this means we can’t always give you the care we would want to give you, as quickly as we would like. It’s incredibly frustrating for us and we know it is for you too.
If you’ve struggled to get an appointment with your GP, can’t see a dentist, spent hours waiting to be seen in an A&E, or months waiting for an operation, you will have first-hand experience of an NHS that’s in difficulty, struggling to deal with a population that’s generally in poorer health since the COVID pandemic and is now buckling under the weight of demand.
It’s affecting the morale, mental and physical wellbeing of our staff too. They are absolutely dedicated to the NHS and work incredibly hard to give you the care you deserve, and they sometimes go home frustrated they cannot help you more.
Without radical action, the quality of the services we deliver – and the lives you have – will become compromised. You have told us yourselves. In a snap poll carried out during October 2024 by NHS Humber and North Yorkshire Integrated Care Board (ICB), almost 63 per cent of the 428 people who responded said the NHS needed to change.
We need to make bold decisions to provide safe and appropriate services which we can confidently keep going with the staff and money we have available now and are predicted to have in the future.
Things may feel gloomy at the moment, but we are optimistic. Since the foundation of the NHS in 1948 it has constantly had to adapt and modernise, and we are confident we can make the necessary changes again to ensure the story of the NHS continues to be written for many decades to come.
We hear a lot about demand in the NHS – what do you mean?
During the COVID pandemic, a lot of non-urgent operations and procedures were pushed back so hospitals had the beds and staff to look after people with coronavirus. At the same time many unwell people put off seeking medical help because either they felt a sense of duty not to add to the demands on the NHS at a time of national emergency or were worried about catching the virus.
As life in the UK began to return to normal, healthcare settings started to experience a tsunami of demand, with many patients coming forward, perhaps more unwell than they might have been, had they received a diagnosis and treatment sooner.
The surge in people presenting with more serious health problems has manifested itself across the NHS, with hospitals, GP practices, mental health providers and other healthcare organisations now struggling to deal with a backlog of care and treatment.
There are currently more than 7.5 million people in England on a hospital waiting list for a procedure or treatment (almost 200,000 in Humber and North Yorkshire), while latest estimates put the mental health waiting list at 1.2 million people.
Demand for GP practice appointments is at unprecedented levels (practices in our region are delivering around 200,000 more appointments every month compared to five years ago) and we know access to NHS dentistry remains an issue for many of you, with some of our communities described as “dental deserts”.
Ambulances are not always reaching people in a timely manner, and there are days when accident and emergency departments in our region are overwhelmed – more than one in 10 patients now spends more than 12 hours in A&E, with the national four-hour waiting time target not met since July 2015.
Demand on our mental health services continues to rise, with children and young people perhaps most impacted by COVID. And a growing awareness of conditions like ADHD and autism is adding to the demand for assessment and diagnosis.
Can’t you just recruit more medical people like doctors, nurses and consultants?
There are around 100,000 job vacancies in the NHS and in parts of our area there’s a heavy reliance on agency staff who are often more expensive to employ.
In some specialities in some of our hospitals, vacancy rates are running at 30 per cent and despite our best efforts there are some highly specialised roles that we are struggling to fill.
Recruitment is a highly competitive field and we are not just competing for staff nationally, but we are facing similar competition when we look abroad to fill our vacancies.
Some specialist roles, like cancer doctors, are in demand across the world and other staff want to work in bigger towns and cities where they see more opportunities at work with the chance to take part in research and teaching, and in their personal lives with access to a wider range of leisure activities.
It’s a conundrum we need to solve urgently, because we know many of our specialist and more experienced staff are likely to be retiring in the next 10 to 20 years.
It’s not just in hospitals where there are difficulties recruiting. The number of GPs working in Humber and North Yorkshire has remained largely the same over the last year and we have shortages of other healthcare professionals like advanced nurse practitioners. We know there are shortages in some mental health specialisms too and the numbers of people working in social care aren’t enough to keep pace with an ageing population.
When we have workforce gaps, it means we’re not able to do all of the things we’d like to do and it becomes more of a struggle to bring waiting lists down or give people the appointments they need in a timely manner.
If the population is ageing and more people are sick and need help, can’t you just build more hospitals or make use of the hospital buildings you already have?
It’s a lovely idea, but we have to be realistic. Putting the question of workforce aside, the public finances are simply not there – nor likely to be in the foreseeable future.
Therefore, we have to work with what we have – and that in itself is a challenge.
Some of our buildings are really old, weren’t necessarily built as hospitals and are not really configured in a way that best meets the needs of a modern NHS. Some of our hospital buildings are deteriorating and need a lot of money to put right. Some need essential work like sorting the electrics or water supply, installing more lifts or fitting modern fire alarm systems. It’s not inconceivable that we may have to close some buildings completely if they continue to decline.
Meanwhile, in Primary Care, there are GP surgery buildings that pre-date the NHS and we know many practices don’t have the room they need to give all of the people the care they need, when they need it.
How does an ageing population affect the NHS?
As we get older we tend to need more help from the NHS to keep us well and look after us when things go wrong. It is great news that people are living longer – and in some ways that’s a testament to the advances within the NHS – but if people are in poorer physical or mental health as they get older, it leads to greater demand on health and care services.
Our population is ageing at a faster rate than anywhere else in the country (by 2043, there will be 75% more people aged 75 and over) and healthy life expectancy is actually decreasing in some parts of Humber and North Yorkshire.
As our population gets older we are also seeing more people living in poorer health (particularly people living in deprived coastal communities and some rural areas).
We know many of these people will need much higher levels of health and social care support in the coming years.
It is predicted that to meet the current and growing demand for hospital services in the future we would need to build something like a new Hull or York Hospital every two years. This isn’t feasible or affordable, and it has been shown hospital is not the best place for our elderly loved ones anyway.
The NHS and us as individuals need to do things differently.
The NHS doesn’t have the money, the workforce or the buildings and IT that will be needed in the years ahead, so we have to look at other ways of doing things that maximise the budgets, staff and infrastructure that we do have.
At the same time, as individuals we should be empowered to play our part, by taking more responsibility for our own health and making better lifestyle choices so we don’t need the NHS as much.
What impact does people’s lifestyles have on the NHS?
Smoking and obesity are two of the biggest causes of preventable ill health. Unfortunately, obesity rates in Humber and North Yorkshire are rising, smoking remains prevalent in some areas, and overall physical activity levels are low. Too many people are dying prematurely.
With the right support around us, we can all make better choices that lead to a healthier and happier life.
In the years ahead we want to focus a lot more on preventative care and early intervention, encouraging healthy lifestyles and self-care, to help individuals maintain good health for longer so they are less reliant on the NHS.
Inequalities between different groups of patients will only worsen if we don’t take action which isn’t fair for many vulnerable people. We know, for example, that the gap in healthy life expectancy between our most and least deprived areas is around 13.5 years for males and 11.5 years for females – our task is to reduce that gap.
The Darzi report was quite an eye-opener – can you explain what the current thinking is in the NHS about what change might look like?
As we look ahead to the future of the NHS, we believe:
- You should have easy access to general health and care services – like primary care, mental health support, outpatient care, social care and end of life care – in a coordinated way, as close to home as possible.
- For planned treatments, you should receive the best quality care promptly. In some cases, this might mean traveling to specialist centres/centres of excellence that offer expert care to ensure better outcomes.
- We should be doing more to identify health and care needs in our population as early as possible and deliver targeted services that are best suited to meet those needs. We want to prevent illness and catch problems early so you stay healthier for longer, wherever you live.
- You should be more involved in decisions about your care, with more done to help you manage your health conditions as much as you can.
- You should have access to same-day urgent care in the most appropriate setting, such as primary or community care, while emergency care will be available at specific hospital sites for the best outcomes.
- Specialist health and mental health services, which people need less frequently, will be provided efficiently at larger scale centres, possibly in a single location, to ensure high-quality care and better outcomes when it’s most needed.
- We ought to be making more use of technology to make it easier for you to access care, streamline appointments, and support online health services.
- We should aspire to create a workforce that is proud to work for the NHS, and which you can be proud of too.
Before we further develop our thoughts into more tangible proposals, we want to know what matters most to you. The story of the NHS is not just our story to tell. It’s your story too.
What is the timeline for any changes?
We know we need to act quickly, but any big proposals will take time to work up because delivering healthcare is complicated and making changes in one service or place often impacts on other services and/or other places. When there are concrete proposals to share, we will want to discuss those in much more detail with you.
How does the ICB engagement activity (We Need to Talk) fit in with the national programme of engagement that has just been launched?
The UK government announced this week it is asking everyone—patients, NHS staff, and healthcare experts—to share their ideas and experiences to help improve the NHS.
The feedback collected will help shape the government’s new national10-Year Health Plan, which will be shared in spring 2025. This plan will focus on three main changes: bringing more care into local communities instead of hospitals, using more digital tools instead of paper records, and focusing on preventing illnesses rather than just treating them.
This sits alongside the work we started in Humber and North Yorkshire on October 14th. To keep the services that are important to all of us living in the cities, towns and villages in our region running smoothly, we need to find new and better ways to deliver care. We are out and about speaking to individuals and communities the length and breadth of Humber and North Yorkshire to understand their experiences of the NHS, their hopes for its future and what is most important to them.
We are reaching out in person, via social media and through the media to try and hear from as many people in our region as possible, especially people who have never responded to an NHS survey before.
Our questions are different to the national questions so people can take part in both if they wish to. And we will be feeding our findings into the national team too so everyone who takes part in our regional survey can be confident their views will be shared with policymakers working on this national campaign.
It’s a massive task but we have had a fantastic response so far and what we learn will inform how services are shaped in Humber and North Yorkshire to ensure we write the next chapter of our NHS together.