Improving Patient Safety AND Reducing Clinical Costs

Reduced Microbial Bioburden = Improved Patient Safety

Reducing microbial bioburden on frequently-touched clinical surfaces is now recognised as fundamental to improving patient safety.
Healthcare-Associated Infections (HCAIs) are still prevalent in healthcare; Antimicrobial Resistance (AMR) is making the situation worse.

Strategic use of effective antimicrobial materials, as an adjunct to cleaning and hand hygiene, is proven effective – not only at reducing microbial bioburden on clinical touch surfaces – but also at reducing the infection risk to patients.

Reduced microbial bioburden on copper items in clinical settings (Salgado, 2013)
Recent research into antimicrobial efficacy under typical dry usage conditions shows a marked difference between copper alloys and other materials marketed as antimicrobial:
There is a wealth of robust evidence, spanning nearly 40 years, supporting the use of clinical touch-surface items made from copper alloys. This translational science article gives a useful overview with relevant citations:
Making clinical touch surfaces from copper & copper alloys gives rapid and continuous reduction of microbial bioburden, without change to cleaning regime or staff behaviour, this reduces the infection risk to patients and staff.
Helping To Tackle Antimicrobial Resistance
But that is not all – further research shows that copper has a role to play in helping to reduce the spread of AMR.

Horizontal Gene Transfer, a key element of AMR spread and development, takes place on standard clinical touch surfaces, but not on copper.

Installing touch-surfaces made from copper alloys – proven to lower HCAI rates – will also help to reduce antibiotic prescription levels.
Cost-Benefit Analysis: Astounding Results Indicated
Prevention of HCAIs is better, cheaper, and more ethical than simply trying to treat them.
Research by York Health Economics Consortium (YHEC) indicates very rapid initial payback plus significant long-term savings from installing copper touch surfaces.
Most commonly-used clinical disinfectants are compatible with copper materials, when used in accordance with manufacturer’s guidelines.
Routine cleaning to remove dirt and soil is necessary for good sanitation and to assure the effective antimicrobial performance of the copper alloy surface.  Cleaning agents typically used for traditional touch surfaces are permissible; the appropriate cleaning agent depends on the type of soiling and the measure of sanitisation required. Normal oxidation or wear of copper-alloy surfaces will not impair the antimicrobial effectiveness of the product.
A French study on use of copper over more than three years in five long-term care facilities concluded that, even with standard cleaning, copper alloy touch surfaces were an effective solution to reduce bacterial spread:
Feedback From Early Adopters
Feedback from the several sites around the world that have installed copper touch surfaces is positive.

At Grinnell Regional Medical Center in the US, post-installation assessment shows that the copper surfaces maintain ‘terminal clean’ levels of microbial bioburden even in ‘closed’ hospital rooms:

Recognition in design guidelines and healthcare ratings systems around the world

The benefits of strategic use of antimicrobial copper touch surfaces have been recognised in healthcare design guidelines and quality assessment systems around the world.   These include:

  • Health Protection Scotland, 2017
  • ECRI Institute: Top 10 Technology Watch List for the Hospital C-Suite, 2014
  • CNESH: Canadian Network for Environmental Scanning in Health, 2014
  • AHRQ: US Agency for Healthcare Research and Quality, 2013
  • CMJ: Polish National Centre for Quality Assessment in Healthcare, 2016
  • EPIC3: NHS England NICE-accredited guidelines, 2014
  • Finnish Building Information Foundation Indoor Hygiene, 2017
  • International WELL Building Standard™, 2016
  • IGBC: Indian Green Building Council – Healthcare Facilities Rating System Guidelines, Pilot Version, 2016


Healthcare providers are under pressure to improve efficiency, resilience to seasonal challenges (such as ‘flu and norovirus) and to reduce their antibiotic prescription levels.

A robust body of evidence shows that strategic use of Antimicrobial Copper – a simple intervention – offers significant and long-term benefits for patients and healthcare providers alike.

Strategic use of clinical touch-surface items made from Antimicrobial Copper has been proven to be an effective supplement to infection control – with dramatic results shown by laboratory testing and clinical trials – without the need to change behaviour of healthcare workers, cleaning staff or patients.

Reducing infections will improve patient safety – this is one of the five strategic objectives in the WHO Global Action Plan for tackling Antimicrobial Resistance.

Achieving clinical cost-savings and freeing-up beds is a fundamental part of improving healthcare efficiency. The YHEC research provides a strong business case for Antimicrobial Copper.

Strategic use of copper materials for touch-surfaces is a simple measure for healthcare providers to improve their overall performance, their finances and their reputation; with wider social and economic benefits.

The wide range of copper alloys available means that products made from them do not even have to look like copper or brass. Some of the alloys are practically indistinguishable from stainless steel, yet have proven antimicrobial efficacy.

We hope this is helpful and thought-provoking.
If you have any questions, please do not hesitate to contact us.

Why YOU need an appropriate antimicrobial test standard for indoor touch surfaces

Concerned by HCAIs (infections acquired from healthcare) and Antimicrobial Resistance?

Here’s something you should know…

Use of effective antimicrobial surfaces, as a simple supplement to good hand hygiene and cleaning regimes, has been proven to reduce not only microbial bioburden on frequently-touched surfaces but also patient infection rates.

In healthcare, fewer infections mean better healthcare efficiency (clinical cost-savings and freed-up beds) and improved patient outcomes.

Thus far, no major surprises… but what about this?
Not all antimicrobials are equal and there is no universally-adopted standard test protocol to measure their effectiveness ‘in the field.’

How, then, can we identify and specify appropriate antimicrobial surfaces to use in construction or refurbishment projects?

Healthcare scientists and clinicians urge careful stewardship of antimicrobial agents; this includes antimicrobial surfaces as well as antibiotic drugs.

Some commonly-used antimicrobial surfaces – which work under the standard “warm and wet” test protocols* – have negligible efficacy under typical indoor conditions.**

Using such surfaces could actually aggravate the problem of antimicrobial resistance, which the WHO described in April 2015 as “the single greatest challenge in infectious disease today.”

There are appropriate tests currently available in the UK which are ready to be used.***

Until we agree an appropriate test standard for antimicrobial efficacy – relevant to touch surfaces under typical indoor conditions – needless suffering will continue and we will deny ourselves a simple yet effective measure that improves healthcare and helps combat antimicrobial resistance.

Regulators such as the US EPA and the OECD are aware of this. The OECD Working Group under the Inter-Organisation Programme for the Sound Management of Chemicals (IOMC), which represents the interests of a number of countries and regions, has proposed a tiered system approach with Tier One test methods providing proof of principle and Tier Two methods more closely representing in-use environmental conditions.

For a more comprehensive explanation, with details of efficacy tests performed on Antimicrobial Copper,  visit:


So, the next time a salesman or colleague talks to you about an antimicrobial surface, ask:-
a) can it offer public health benefit claims?
b) does it work rapidly, under typical indoor usage conditions?
c) how does it work – does it actually destroy microbes?
d) how durable is the antimicrobial protection?
e) is use of this product likely to contribute to AMR?
f) for evidence – not claims, but results with test protocols
and, last but not least:

g) talk to colleagues & clients about the need for an appropriate test standard for antimicrobial efficacy under typical indoor conditions!


Comments or questions? –  please contact us.



* JIS Z 2801 or ISO 22196 (measure microbial reduction at 24 hours exposure, under elevated temperature and saturated humidity conditions).

** Michels, H.T., Noyce, J.O. and Keevil, C.W. (2009), Effects of temperature and humidity on the efficacy of methicillin-resistant Staphylococcus aureus challenged antimicrobial materials containing silver and copper. Letters in Applied Microbiology, 49: 191–195. doi: 10.1111/j.1472-765X.2009.02637.x

*** OECD is aware of the limitations of standard tests, which OECD class as Tier 1 tests.
The available tests referred to in this post constitute Tier 2 tests as per para 2 on page 8 of OECD  “GUIDANCE DOCUMENT FOR QUANTITATIVE METHOD FOR EVALUATING ANTIBACTERIAL ACTIVITY OF POROUS AND NON-POROUS ANTIBACTERIAL TREATED MATERIALS”  ENV/JM/MONO(2014)18 dated 11th July 2014
“2. The method provides only a basic foundation for conducting tests on antimicrobial treated articles, and a second tier method must be developed to ensure an accurate assessment of antimicrobial activity. A guidance document is currently under development for tier 2 testing, i.e. laboratory-based tests to substantiate claims made for the article with test conditions that simulate intended use, durability and compatibility of the article – provided that the protocol describes the claim being supported in an adequate manner. Further, Tier 2 testing protocols will also accommodate use of shorter contact times (e.g. 2h) and inoculum dried on treated surfaces.”

Recent Publications & Papers

Interest in (and research into) the real-world efficacy and kill mechanisms of metallic copper surfaces against microbes (bacteria, viruses, yeasts and fungi) is accumulating.

Here are some recent papers for you:

Michels HT, Keevil CW, Salgado CD, Schmidt MG. 2015. From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections HERD, October 2015 vol. 9 no. 1 64-79,

This paper, published in HERD, helps summarise and explain the mechanisms, efficacy and benefits of copper & copper-alloy touch surfaces (collectively called “Antimicrobial Copper”).
It is open-access, so you can download the full pdf without cost.

Warnes SL, Little ZR, Keevil CW. 2015. Human coronavirus 229E remains infectious on common touch surface materials. mBio 6(6):e01697-15. doi:10.1128/mBio.01697-15.

Animal coronaviruses that ‘host jump’ to humans, such as SARS and MERS, result in severe infections with high mortality. The Southampton researchers found that a closely-related human coronavirus – 229E – can remain infectious on common surface materials for several days, but is rapidly destroyed on copper.

Hans M, Mathews S, Mücklich F, Solioz M. 2015. Physicochemical properties of copper important for its antibacterial activity and development of a unified model. Biointerphases 11, 018902 (2016); doi: 10.1116/1.4935853

Abstract: Contact killing is a novel term describing the killing of bacteria when they come in contact with metallic copper or copper-containing alloys. In recent years, the mechanism of contact killing has received much attention and many mechanistic details are available.
The authors here review some of these mechanistic aspects with a focus on the critical physicochemical properties of copper which make it antibacterial. Known mechanisms of contact killing are set in context to ionic, corrosive, and physical properties of copper.
The analysis reveals that the oxidation behavior of copper, paired with the solubility properties of copper oxides, are the key factors which make metallic copper antibacterial. The concept advanced here explains the unique position of copper as an antibacterial metal. Based on our model, novel design criteria for metallic antibacterial materials may be derived.

Meyer, T.J. 2015. Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria. International Journal of Biological, Biomolecular, Agricultural, Food and Biotechnological Engineering. Vol:9, No:3.

Abstract: For centuries humans have used the antimicrobial properties of copper to their advantage. Yet, after all these years the underlying mechanisms of copper mediated cell death in various microbes remain unclear. We had explored the hypothesis that copper mediated increased levels of lipid peroxidation in the membrane fatty acids is responsible for increased killing in Escherichia coli.
In this study we show that in both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) bacteria there is a strong correlation between copper mediated cell death and increased levels of lipid peroxidation.
Interestingly, the non-spore forming gram positive bacteria as well as gram negative bacteria show similar patterns of cell death, increased levels of lipid peroxidation, as well as genomic DNA degradation, however there is some difference in loss in membrane integrity upon exposure to copper alloy surface.

These papers are also recommended:

Taylor M, Chaplin S. 2013. The Economic Assessment of an Environmental Intervention: Discrete Deployment of Copper for Infection Control in ICUs. Antimicrobial Resistance and Infection Control 2013, 2(Suppl1):P368

This paper is the York Health Economics Consortium research into the cost-effectiveness and payback of copper touch surfaces. Read more, with a worked example for a UK 20 bed ICU, in this pdf document YHEC Business Case

More information on YHEC website


Warnes SL, Keevil CW. 2011. Mechanism of copper surface toxicity in Vancomycin-resistant enterococci following wet or dry surface contact. Applied and Environmental Microbiology, Sept. 2011. pp. 6049–6059.

Abstract: Contaminated touch surfaces have been implicated in the spread of hospital-acquired infections, and the use of biocidal surfaces could help to reduce this cross-contamination.
In a previous study we reported the death of aqueous inocula of pathogenic Enterococcus faecalis or Enterococcus faecium isolates, simulating fomite surface contamination, in 1 h on copper alloys, compared to survival for months on stainless steel.
In our current study we observed an even faster kill of over a 6-log reduction of viable enterococci in less than 10 min on copper alloys with a “dry” inoculum equivalent to touch contamination. We investigated the effect of copper(I) and copper(II) chelation and the quenching of reactive oxygen species on cell viability assessed by culture and their effects on genomic DNA, membrane potential, and respiration in situ on metal surfaces.
We propose that copper surface toxicity for enterococci involves the direct or indirect action of released copper ionic species and the generation of superoxide, resulting in arrested respiration and DNA breakdown as the first stages of cell death. The generation of hydroxyl radicals by the Fenton reaction does not appear to be the dominant instrument of DNA damage. The bacterial membrane potential is unaffected in the early stages of wet and dry surface contact, suggesting that the membrane is not compromised until after cell death.
These results also highlight the importance of correct surface cleaning protocols to perpetuate copper ion release and prevent the chelation of ions by contaminants, which could reduce the efficacy of the surface.

Warnes, S.L. et al. 2012.  Horizontal transfer of antibiotic resistance genes on abiotic touch surfaces: implications for public health.  MBio 2012 Nov; 3(6):e00489-12. DOI:10.1128/mBio.00489-12.

“This study demonstrated that HGT readily occurs on dry touch surfaces such as stainless steel, providing a potentially important route for multidrug resistance emergence and dissemination in public buildings and transportation systems if surfaces are not regularly and efficiently cleaned…. The use of copper alloys in clinical and community settings could help reduce infection spread and also reduce the incidence of horizontal transmission genes conferring drug resistance, virulence, and pathogenesis and expression efficiency.”

Further references:

The above is a small selection of papers from over 40 years of research into the intrinsic antimicrobial properties of copper and copper alloys.

Contact us for further scientific references or advice.

Research partners wanted!

Plastic materials with in-use antimicrobial efficacy


We are currently looking for evidence and researchers regarding durability and antimicrobial efficacy  under dry usage conditions of plastic materials in healthcare and hygiene-critical settings.

These plastic materials need to be:

  • antimicrobially effective under typical indoor / dry conditions*
  • durable
  • resistant to disinfectants used in “deep clean” or outbreak situations in hospitals
  • suitable for injection-moulding processes
  • low cost / comparable to standard plastics

*These two papers indicate why this is necessary


Please contact us ASAP if you can help with this.

Look forward to hearing from you soon and please ask if you have any questions.

Plastic peril – the cost of convenience?

Our oceans are contaminated with plastic.. So why do we use so much of it in healthcare?

Greenpeace volunteers collect plastic rubbish from Manila Bay, Philippines. 2006

Plastics must now be the most common materials in our hospitals – especially touch surfaces in clinical settings.  Why, when microbiologists tell us just how readily microbes attach to plastic surfaces?

Furthermore, we have known for years that most plastic materials are sensitive to damage from disinfection products, rendering them even better-suited to microbial attachment and biofilm formation.

In contrast, some simple everyday metals, fully recyclable (and with a high recycled content when new) are not only durable and attractive, but proven to be very effective against microbes – bacteria, viruses, yeasts and fungi… even under typical indoor usage conditions.

So, these metals can work continuously – between touches and between cleans – to destroy pathogens rapidly and thereby reduce the infection risk to patients and staff.

The strategic use of copper and copper-alloys, as a simple adjunct to cleaning and hand hygiene, is now recognised in design guidelines and healthcare quality assessment schemes around the world as a simple and cost-effective measure to improve patient safety and healthcare provider finances.

Materials matter – for healthcare and for our planet.

Poland leads the way in Europe

Poland’s National Centre for Quality Assessment in Healthcare (NCQA)* has revised its accreditation standards for healthcare facilities, to include Europe’s first official recommendation that antimicrobial copper touch surfaces are incorporated as an infection prevention and control measure.


Established in 1998, Poland’s Hospital Accreditation Programme encourages healthcare facilities to improve not only the quality and efficacy of services, but also patient safety standards. It provides a structured process of external assessment, carried out by the NCQA and based on measurable criteria and accepted standards. NCQA is a Polish Ministry of Health body authorised to conduct a hospital accreditation programme in Poland. In order to obtain accreditation, hospitals are required to demonstrate appropriate procedures are in place and followed.

Chapter IX ‘Infection Control’ in the NCQA accreditation standards provides guidelines concerning the prevention of pathogen transmission by touch.

The Minister of Health explained: ‘Healthcare-associated infections may be a source of substantial iatrogenic harm [undesirable or unwanted effect caused by therapeutic intervention]. It is therefore essential to limit both their number and severity.’

The new chapter states: ‘Reduction of microbial transmission should be achieved, inter alia, using frequently-touched surfaces made from metals with antimicrobial properties, such as copper, brass and bronze, as per the US Environmental Protection Agency’s registration.’

Healthcare facilities applying for NCQA accreditation may be granted between three and five points for installing antimicrobial copper surfaces, depending on the percentage of touch surfaces used.

Copper is a powerful antimicrobial with rapid, broad-spectrum efficacy against bacteria and viruses, and has been shown to kill the pathogens that cause infections, including Influenza A, E.coli and norovirus. It shares this benefit with a range of copper alloys—such as brasses and bronzes—forming a family of materials collectively called ‘antimicrobial copper’.

Touch surfaces made from solid antimicrobial copper are used in hospitals and care homes around the world to reduce the spread of infections, supporting key infection control measures such as good hand hygiene and regular surface cleaning and disinfection. This official recommendation acknowledges the significant peer-reviewed scientific evidence base for copper’s role in reducing microbial contamination and boosting patient safety.

For more information, visit


* Locally known as Centrum Monitorowania Jakości w Ochronie Zdrowia (CMJ).

Project Opportunity: our ref 2015E12A

One of our UK NHS Trust clients is keen to fit copper door handles, push plates and light switches during their refurbishment programme over the next 5 years, across two hospital sites.
They want to standardise components across both sites. They will accept natural copper / copper-alloy colours, as part of a visual statement, so there are no alloy constraints.

The first step is a preliminary “meet the buyer” meeting on 19th Jan 2016 between 12-3pm, for the Trust team to see products and budget prices.

This invitation is open to manufacturers of Cu+ approved copper door handles, push plates and light switches.
Product robustness appropriate for harsh environments such as hospitals is essential, and grade 4 category certification to EN 1906 required for door handles.
Interested companies must have presence and support in the UK, and be able to attend a “meet the buyer” meeting held at the Trust premises on 19th January 2016.
If you and your products meet these requirements, please contact us and express your interest by 5pm on 4th Jan 2016.

To make this fair, we would suggest your price information should be provided in a sealed envelope to the Trust buyer.
Please note the limited space / numbers constraints at the event.
The Trust will be looking to see product samples and pricing, to enable a swift decision.
Product cost will naturally be a major consideration, and please note the requirement for hospital items to withstand rough handling / abuse.

No fee is imposed by ACT Surfaces Ltd to attend this event, nor will we be seeking to earn a commission on your product sales for this project.

Please email Andrew – quoting our ref 2015E12A – if you are able and willing to attend on Tues 19th Jan 2016, 12-3pm, in South East England, advising alloys and product details (please email any images & literature that we don’t already have stored in our GoogleDrive folder).

A concise ppt or pdf file of products and finishes in your range would be welcomed.
The inital focus is on door handles and light switches, however the Cu+ product listings on will be  used to illustrate further items that may become of interest to the Trust.

We will inform the client of interested suppliers at lunchtime on Tuesday 5th January 2016.

If necessary, due to space constraints, the Trust will shortlist invited companies on the basis of submitted and publicly-available information.

If you have any questions or concerns, please ask.

We wish you a happy Christmas and successful 2016.
ACT Surfaces Ltd

——– Forwarded Email ——–

Subject: Copper fittings
Date: Mon, 21 Dec 2015 13:57:10 +0000


Following our conversation today, could you please arrange to visit us on the afternoon of 19th January 2016?

As discussed, it would be useful to bring suitable manufacturers of copper fittings with you, who will be able to bring sample items along with estimated costs.

As I explained, we have multiple refurbishment and new build projects proposed in our Estates Strategy, which we are planning to action over the next five years. We are specifically looking to review the merits of copper based door handles, door push plates and light switches with a view to installing these products as standard fittings within our upcoming projects.

I will organise a meeting room with space for up to 5 interested manufacturers to display their products, from 12.00 noon to 15.00 hrs.

I will also invite suitably interested colleagues to visit with the manufacturers and yourself, to discuss the benefits of copper fittings and examine the products on display.

This staff consultation event will contribute to our decision making around the type of alloy and colour of copper fittings to install.

I look forward to meeting with you in the New Year.


Bang on the button…

Elevator buttons as unrecognized sources of bacterial colonization in hospitals

A study published in 2014 by the University of Toronto, analysed lift buttons and toilet washroom surfaces at 3 large urban teaching hospitals located in Toronto, Ontario.

The researchers found (perhaps because lift buttons are frequently used and only periodically cleaned):  “Elevator buttons had higher colonization rates than toilet surfaces in the same buildings.”

Read that paper here:

This news article (Daily Mail, 2015) highlights research by the Centre for Superbug Solutions at the University of Queensland comparing bacterial contamination of typical office items.

Interestingly, swabs taken from the outside elevator button showed less bacterial loading than the buttons inside the elevator: “Some of the germiest surfaces were a mobile phone screen, a computer keyboard and a kitchen bench, while door handles, desks and chairs were much cleaner,” Dr Elliott said.

Read more:

In a different study, it was found that a single contaminated doorknob or elevator button can spread virus rapidly through entire office buildings, hotels or hospitals.

Using bacteriophage MS-2 as a surrogate for Norovirus, Charles Gerba and his researchers found that contamination of just one single doorknob or table top results in the spread of viruses throughout office buildings, hotels, and health care facilities.

Within 2 to 4 hours, the virus could be detected on 40 to 60 percent of workers and visitors in the facilities and commonly touched objects.

American Society for Microbiology. “How quickly viruses can contaminate buildings — from just a single doorknob.” ScienceDaily. ScienceDaily, 8 September 2014. <>.

These findings led to a further study, published in final edited form May 2016, investigating spread from a single person’s hands versus a single door push-plate, and efficacy of intervention measures to combat viral spread.

A bundle of good hand sanitation practice, cleaning and educational display material was found to be effective at reducing contamination on personal and communal fomites  (See for details).

Make a material change – go copper!

Abundant data from laboratory testing and in-situ clinical studies around the world shows that touch-surface items made from copper and copper alloys have a consistently lower microbial burden than standard items, without change to cleaning regimes or human behaviour. See

Copper / copper-alloy materials are very effective, especially under typical indoor conditions, at killing pathogens quickly and completely.
Use of copper materials for touch surfaces is recommended as an adjunct to hand hygiene and cleaning, to provide a greater degree of protection, between touches and between cleans.
The US EPA has registered over 500 copper alloys as able to make public health benefit claims relating to touch surfaces.
No other metal, not even silver, can make that claim.


Comparing Copper versus Stainless Steel, repeated contamination over 24h between cleans
Continuous Reduction test results for MRSA on copper alloy C11000 and stainless steel S30400. Each inoculation added 650,000 CFUs.  More details at:
Bacteria (gram +ve or gram -ve), viruses, yeasts and fungi (including spores) are proven to die rapidly on copper / copper-alloy materials, with destruction of DNA (including plasmids) evident within seconds of contact on these metals. 

See this translational science article for a good overview and source of scientific references

No other material, such as silver-containing coatings, comes close to copper’s antimicrobial efficacy: particularly under typical indoor conditions:


*image: Elevator button made from CuNi 90/10 (CW352H) copper alloy, which has good corrosion resistance and similar fabrication properties to stainless steel, yet offers lifetime efficacy against microbes.

Simon Stevens’ call for bold action to make NHS fit for future

NHS England Chief Executive Simon Stevens today called for bold action on prevention, the redesign of care and efficiency to help the NHS through the most challenging period in its history.

In his first speech since the general election – and sharing a platform with the Prime Minister – Mr Stevens said:
“We’ve just come out of a general election debate that has once again confirmed a fundamental consensus between citizens of this country – on the unique importance of the NHS to the life of our nation, and as the embodiment of the promises we make to each other, across the generations.”

Referring to the NHS Five Year Forward View, he says: “Last Autumn the Health Service came together to chart a shared direction for our country’s NHS. “Patients groups, caring professionals, national leaders – uniting behind the NHS’ own ‘manifesto’ for the next five years. It’s a plan for better health, more personalised care, and a financially sustainable Health Service, which we’re now getting going on.”

Pointing to the realities of current service pressures, he argues that the Health Service is entering probably the most challenging period in its 67 year history. Alongside action this year to stabilise NHS finances, Stevens argues for a new partnership between the public, the government and the health service, involving concrete and sometimes controversial action on three broad fronts – prevention, care redesign, and efficiency linked to new investment.
On prevention, while life expectancy is at its highest ever, smoking still explains half of the inequality in life expectancy between rich and poor, binge drinking costs at least £5 billion a year, and junk food, sugary fizzy drinks and couch potato lifestyles are normalising obesity. So we need wide ranging action – as families, as the health service, as government, as industry, using the full range of tools at our disposal.

On care, Stevens argues the mission-critical task over the next five years is fundamental redesign of how services are provided, blurring the old boundaries between GP and hospital care, physical and mental health services, health and social care. One of the best ways of getting this personalisation and integration will be to give patients and their families more clout over the support they receive. He points to the first wave of 29 ‘Vanguard’ areas across England, covering five million patients, launched six weeks ago.

On efficiency, Stevens notes that the Economist Intelligence Unit has shown that we already have a lean and efficient health service compared with just about every other industrialised country. But we still have big quality and efficiency differences – between different parts of the country, between different hospitals, and between different local clinical commissioning groups.

On funding, Stevens says: “Just like every health service around the world with a growing population and an aging population, we’re going to need more funding, year by year, not just in 2020.
“We’ve said at least £8 billion a year in real terms by the end of the decade. But precisely how much, and with what phasing, will partly depend on how radical and how successful we are on prevention, on care redesign, and on our broader efficiency programme. And we’ll need careful and disciplined phasing of our ambition to expand services – be it improved cancer care, mental health, primary care, seven day services – all of which we want to do.”

Read full speech here: