The NHS needs to get better at proactive, anticipatory care, Dr Martin McShane, director for long-term conditions at NHS England (pictured), told the Royal Pharmaceutical Society conference on September 15.

Healthcare professionals should work collaboratively and make best use of IT if they are to meet the challenges facing the NHS, said Dr McShane. "We have to work together to deliver a system that works and is sustainable. Quality improvement comes from the front."

The four big drivers in NHS care were practice, policy, measurement and incentives. "But measurement systems and our incentives are geared in the wrong way. We can’t manage population health because we can’t link data between healthcare sectors." Taking care homes, with three times as many people as in acute hospital beds, as an example, national data was not available on residents admitted to hospital. "We need a system that rewards proactive anticipatory care. This is a vital issue to address."

A 4 per cent growth in acute care spending had led to disinvestment in primary care although general practice workload had almost doubled in 15 years. But if, for example, primary care and community and mental health services worked together the system could be more joined up and efficient.

"We need to move from a purely condition based focus to one that looks at mobilising the assets that patients and carers bring to the agenda. And if we’re to address the problems of the future one of the things we’re going to have to do is to first of all embrace that this is a digital era. There’s so much more we can do to help people to help themselves. It’s here – embrace it or be swept aside by it."

The future would involve smaller general hospitals, more concentrated specialism and removing the barriers between different elements of care. Care should be centred around the patient. "Pharmacists have a huge role here. We need to organise ourselves to work collaboratively. We need to work with the patient to understand them and the outcomes that are important to them. We need to get the right incentives in place to align our common purpose."