Firms to receive NHS cash to reward staff for
losing weight in 'radical model' for health care
NHS England unveils five-year plan to shake up services and cut
costs
Charlie Cooper
Health Correspondent
Thursday 23 October 2014
The NHS will encourage companies to reward their staff for losing weight, as part of a major report
billed as a blueprint for the future of the health service in England.
Setting out his vision for the next five years, NHS England chief executive Simon Stevens said that the
health service would have to break out of its “narrow confines” and promote healthy lifestyles.
Entirely new models of care, which could include GP surgeries clubbing together into federations to
replace many services currently carried out in hospitals, will be set up across the country.
The report also says the NHS can eradicate most of its projected £30bn deficit by 2020, but will need
the Government to increase spending on the health service by at least £1.5bn per year above inflation
to avoid going into the red.
Cutting rates of obesity, smoking and drinking will be critical to saving the NHS from the costs of
treating millions of patients with preventable conditions including diabetes, heart disease and some
cancers, NHS leaders said.
Simon Stevens, NHS England chief executive (Getty)
Employers are viewed as key to promoting better health in the population and Mr Stevens said that he
wanted to see measures to encourage participation in Weight Watchers-type schemes.
Incentives could be in the form of shopping vouchers, cash or prizes. The scheme would have NHS
backing but the vouchers would be issued by employers to staff who commit to losing weight.
Ordinary people should be incentivised to volunteer to care for elderly members of their community
through £200-a-year council tax rebates, the report adds.
The report, Five Year Forward View, which has been produced by NHS England along with other
national NHS bodies including Public Health England and the Care Quality Commission, throws down
the gauntlet to the next government on the long-term future and funding of the NHS in England.

Focusing on prevention and looking after patients with long-term conditions outside of hospital is
expected to save the NHS money, with efficiency savings of up to three per cent possible by 2020, the
report says.
However, even if the NHS achieves this ambitious target it will still have a deficit of £8bn if the NHS
budget is only protected and not increased.
“The NHS itself needs to change and change significantly,” Mr Stevens said. “We have no choice but to
do this. If we do it, a better NHS is possible. If we don’t then the consequences for patients will be
severe.”
David Bennett, chief executive of Monitor, which regulates the NHS Foundation Trust sector, said that
if spending on the NHS was not increased, the health service would need to find other ways to
“survive”. “We can’t finish up with a deficit. If we didn’t get any extra funding we would have to do
what we could to survive as we have over recent years,” he said.
He did not rule out the NHS having to charge for hospital stays or GP appointments if government
spending did not increase.
The ‘Five-Year Forward View’ aims to reduce pressure on A&E
departments (Teri Pengilley)
David Cameron has committed to “protect NHS spending and continue to invest more” but has made
no concrete commitments on how much extra funding the health service would receive in the next
Parliament.
Health Secretary Jeremy Hunt welcomed the report, adding that the NHS could only continue to
improve with “important reforms”.
However, Labour’s Shadow Health Secretary Andy Burnham said the report “laid bare the
inadequacy” of the Conservatives’ NHS spending plan.
“David Cameron’s decisions will leave patients facing even longer waits and raise the spectre that a reelected Tory Government would have to introduce rationing, cuts and charges,” he said.
Labour has committed to increasing NHS spending by £2.5bn per year above inflation, but much of
the money to pay for the increase may not be available till half way through the next Parliament.
Health Secretary Jeremy Hunt has welcomed the report (Getty)
Mr Stevens said there was a “consensus” about what needed to be done to improve patient care and
NHS efficiency. Better, more organised care for the millions of patients with long-term conditions,
who collectively account for 70 per cent of NHS spending, is central to the plan.
The NHS will “make it possible” for groups of GP practices to form federations, which could employ
hospital specialists to keep people out of hospital. These GP groups could also have the power to
directly admit people to hospital – a radical shake-up of the traditional divide between hospital and
GP care.
Forward view: Key reforms
The NHS’s Five Year Forward View sets out a wide-ranging vision for the future of the health
service, with reforms in almost all key areas of care:
GPs Will get a “new deal”, including more money, and at least 4,900 more trainees. Practices will be
allowed to merge and form bigger local health organisations, joining with community nurses and
mental health professionals and even employing hospital specialists, offering more care and
treatments at the GP surgery.
Hospitals Care and surgery for many serious conditions – such as stroke, heart disease and some
cancers – to be concentrated at specialist centres. However, small local hospitals will remain, and in
some places could be taken over by new, GP-local care organisations led groups. Large hospitals in big
cities could take on responsibility for leading community care and GP services in their area.
Urgent care Focus on reducing pressure on A&E and bringing care closer to home. Greater evening
and weekend access to GPs, ambulance crews will be empowered to make more decisions, networks of
linked hospitals will allow more serious cases to bypass small A&Es and go straight to specialist
emergency centres nearby
Care homes The NHS will provide more “in-reach” care to elderly and infirm people living in homes.
More rehabilitation and health services will available, but often in partnership with local authorities
currently responsible for social care.
Public health Workplaces will give employees incentives to improve their health through weight loss
and there will be greater powers for local authorities and elected mayors to set public health policy,
aiming to cut obesity, smoking, drinking. The NHS will become more “activist” and set example with
healthier food options in hospitals and encouraging healthy lifestyles for NHS staff.
Midwives Will have the opportunity to club together and to set up their own NHS-funded midwifery
services, and there will be more opportunities for women to give birth at home.
Carers 1.4m unpaid carers in England will receive more support, including £200 council tax rebate
for those who care for the elderly in their local community or volunteer at their hospital. People living
with dementia and other patients with long-term conditions will be offered personal budgets, so that
resources can be spent in a way that suits them.
Digital technology NHS-accredited “health apps” will allow patients to manage their own health
and care. Appointments with GPs and ordering repeat prescriptions will be routinely available online.
Greater use of patient data will provide “electronic glue” between NHS services nationally and locally.
Patient records will be electronic and patients will have access to them.
Mental health Waiting times targets for people needing psychological treatments will come in next
year, and will be improved from 75 per cent seen within six weeks to 95 per cent by 2020. The mental
health needs of patients with physical health conditions, such as cancer, to be assessed and met.
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