Why the relationship between Marie Curie and the NHS is so important

by Paul Harniess Head of Commissioning Paul-Harniess

Every time a new patient is referred to a Marie Curie Nurse or one of our nine hospices, it happens because the NHS has signed a contract with the charity.

As part of a contract, we significantly subsidise the cost of running our nursing service and our nine hospices. This is why every donation counts. The NHS covers the remainder. Direct care and support that we provide to people – with the exception of Marie Curie Helper – is commissioned by the NHS, or more specifically an individual responsible for commissioning local services.

High standards of care

An NHS commissioner’s aim is to meet the needs of local people with the highest possible standards of care in a way that represents value for money. We need these local decision makers to commission our services so that we can provide care and support to local people, either in their own home, or in one of our nine hospices. Marie Curie has worked with the NHS on a commissioning basis since the early 1970s. However, in recent years, the pressure on commissioners, and on Marie Curie, has increased beyond recognition. Demographic trends – such as an ageing population and more people dying with multiple long-term conditions – will make funding the current health and social care system unsustainable. If the NHS system continues in its current form, a funding gap of £20-£30 billion is forecast by 2020.

Commissioning challenges

The burden of responsibility for making sure that this potentially huge funding gap is minimised rests principally with commissioners. It’s a tough job, and as it gets tougher, demands on us also increase. In response to this pressure, Marie Curie has become much more focused on how it can help commissioners meet the challenges that they face. That means understanding what their needs are and doing everything we can to listen to what commissioners want and deliver it. In recent years, the charity has increased the flexibility of the nursing services it offers, moving from pre-booked nine-hour shifts to provide multi-visit, rapid response and other flexible service variations. This can mean helping patients get out of hospital promptly and keeping them out of hospital; ensuring that patients can stay independent at home for as long as possible and only need to go to hospital when absolutely necessary; and making sure that, if they do go into hospital, they can be supported at home again as soon as possible. Everyone involved in planning and delivering health and social care is trying to address the long-term challenge of meeting the population’s needs within the money that’s available. There is a strong consensus that more care can be safely and cost effectively provided in patients’ homes, as Marie Curie Nurses do, without needing to rely on expensive hospital care, particularly if people do not want or need to be there.