The 2,000 days project

While there are lots of inspiring examples of new care provision, current reform struggles to deliver the change needed, and integrated care is not happening on the scale required.

The NHS must re-energise its approach to handle rising demand, hospital debt, slow technological innovation and growing public expectations.

An Industry Coalition Group of clinicians, senior leaders in hospitals, primary care, the central bodies, charities and the private sector met earlier this year to take on the challenge. As a result a new approach has been developed, culminating in a published report - The 2,000 days project.

The first and last 1,000 days of life

The group looked at care in the first and last 1,000 days of life, and found with both periods there were failures to grant people’s wishes – fewer people give birth and die at home than want to.

It became clear that the alternative to hospitals has been pumping more resources into a primary care system that is overwhelmed. So, the group are proposing a new approach to community-based services, Principal Care.

People, staff, and creativity are key to changing care

• Person-centred care must be at the heart of every NHS decision and action.
• Person-centred care means taking every opportunity to maximise our ability to manage our own health. The NHS needs to focus on what we can do, not just try to fix what we can't.
• NHS leaders need to see joy and fulfilment in the workplace as key to delivering person-centred care and nurturing innovation.
• Care services must stop being health and safety police, and take a more balanced approach to risk, to empower staff and let people live the lives they want.
• Clinicians and managers need to be taught how to think digitally so they develop their own solutions using consumer technology. Online and face-to-face services should be integrated.
• Where possible there should be direct access, including digital access, to community services.
• The costs, benefits and practicalities of developing care at home need to be understood and debated.