Darzi Report – What does the NHS review mean for you?

Lord Darzi has published an independent investigation of the NHS, which concluded that the health service is in a “critical condition”. With the Government saying that the NHS needs to be reformed to overcome challenges like long waiting times, we look at what this means for the public.

Why has the Government asked for this review? 

In July, the Secretary of State for Health and Social Care announced that the Government had asked Lord Ara Darzi, a surgeon and former health minister, to review NHS performance.  

Though this work was about NHS data and performance rather than public views, we sat on the review’s expert reference group and provided evidence on people’s experiences of trying to access NHS appointments. 

The Department of Health and Social Care has now published the independent review's outcomes, which reflect what patients have been telling us about the challenges they face. 

What does the review say about the state of the NHS? 

The review concluded that the NHS is in "serious trouble": 

• People are struggling to see their GP. 
• The NHS is failing to meet its formal waiting targets across all services, with long waiting lists for mental health, community support, hospital appointments, and cancer care. 
• Treatment waiting times contribute to people being unable to work, often permanently. 
• A&E is in an "awful state". 
• Too much of the NHS budget is being spent on hospitals. 
• Patient rights are not being exercised due to low awareness of people's choices regarding their care. 

Unfortunately, these grim findings will be all too familiar to patients who experience these daily frustrations. 

As part of our involvement, we shared these stories with the review team, from difficulties accessing GP and dentistry appointments to confusion when referred from one service to another and poor experiences of A&E. 

We also highlighted what people have told us about waiting for hospital care, which was referenced in the Darzi review, and evidence that these experiences impact some groups of people more than others.

These groups include people who need communications from NHS teams in a specific format or have a worse experience of waiting for support. 

The result is people losing confidence that the NHS will be there for them when needed. 

The report did not examine people’s experiences of social care services. However, the review recognised social care’s challenges, with a rise in social care needs placing "an increasingly large burden on families and on the NHS".

What does this mean for you? 

The report does not make specific recommendations to improve patient care immediately.

However, it has set out some suggested next steps to repair the NHS and inform the Government as it develops its ten-year health plan, which will be published in Spring 2025.  

Positively, one of these suggested priorities is engaging with and re-empowering patients. 

This provides a real opportunity to reshape the NHS so that it works not only for patients but also with them.

We told the review that the NHS should focus on four areas:

1. Getting more NHS professionals to remember that people are experts in their care and must be involved in decisions that impact their health.
2. Making improvements to ensure that the NHS listens to patients, learns from and acts on their feedback, and guarantees meaningful and actionable rights. 
3. Getting the basics right. Small things can often make the biggest difference to patients, such as NHS teams keeping people updated about their treatment and communicating with people in ways that work for them according to their needs and preferences.
4. Using patient experience as a key way of understanding if NHS services are performing well.

For now, in addition to listening to patients, the Government’s immediate focus will be on digitising the NHS, moving from hospital support to care in people’s local communities, and shifting from a focus on sickness to a focus on preventing ill health. 

What next?

The review finishes by saying that although the NHS faces huge issues, things can be turned around.

The NHS's founding principles remain: it is there for people, free at the point of use, and based on need, not ability to pay. 

The Government said in response to the review that it will take time to improve the NHS and that they will consult patients on a ten-year plan to help make care better. 

The Government also confirmed that any social care changes will be looked at separately as part of the work to introduce a National Care Service. 

As the NHS develops its ten-year plan, we will continue to call for the improvements you have told us you want to see. 

We will also encourage the NHS to adopt our proposals to give patients more power, such as by introducing the NHS Patient Promise. 

Read more about the Patient Promise and our other proposals