NHS Long Term Plan

What it says

24 January 2019

As the NHS experiences its biggest staffing and financial crisis, NHS England chief executive Simon Stevens has published a new strategy for the modernisation and future of the NHS. The NHS Long Term Plan includes a redistribution of resources to the poorest communities to tackle health inequalities, and calls for scrapping competitive tendering, brought in by the 2012 Health and Social Care Act. It also commits to fund community and primary care so that it grows faster than hospital budgets. The plan aims to save up to half a million lives.

The NHS will open a digital ‘front door’ so that people can consult their GP online to save time and money, and encourage people to take potential problems to the doctor earlier. The idea is to improve the flow of patients through A&E. There will also be genetic testing to find people at risk of dangerously high cholesterol levels that could lead to heart disease and stroke, and prevention programmes for obesity and smoking.

NHS England says it is also considering the relaxation of key treatment waiting time targets, including hospitals’ duty to deal with 95% of A&E patients within four hours. A workforce strategy is expected later in the year to deal with the 100,000 NHS staff vacancies, although the full impact of Brexit on NHS staffing levels is still an unknown.

The NHS England plan sets out how to use the £20.5bn a year funding increase. The plan says:

• First, we now have a secure and improved funding path for the NHS, averaging 3.4% a year over the next five years, compared with 2% over the past five years
• Second, because there is wide consensus about the changes now needed. This has been confirmed by patients’ groups, professional bodies and frontline NHS leaders who since July have all helped shape this plan – through over 200 separate events, over 2,500 separate responses, through insights offered by 85,000 members of the public and from organisations representing over 3.5 million people
• Third, because work that kicked-off after the NHS Five Year Forward View is now beginning to bear fruit, providing practical experience of how to bring about the changes set out in this plan.

The NHS Long Term Plan will also:

• Open a digital ‘front door’ to the health service, allowing patients to be able to access health care at the touch of a button
• Provide genetic testing for a quarter of people with dangerously high inherited cholesterol, reaching around 30,000 people
• Give mental health help to 345,000 more children and young people through the expansion of community-based services, including in schools
• Use cutting edge scans and technology, including the potential use of artificial intelligence, to help provide the best stroke care in Europe with over 100,000 more people each year accessing new, better services
• Invest in earlier detection and better treatment of respiratory conditions to prevent 80,000 hospital admissions and smart inhalers will be piloted so patients can easily monitor their condition, regardless of where they are
• Ensure every hospital with a major A&E department has ‘same day emergency care’ in place so that patients can be treated and discharged with the right package of support, without needing an overnight stay.

NHS England chief executive Simon Stevens said: “The NHS has been marking its 70th anniversary, and the national debate has rightly centred on three big truths. There’s been pride in our health service’s enduring success, and in the shared social commitment it represents. There’s been concern – about funding, staffing, increasing inequalities and pressures from a growing and ageing population. And there’s also been legitimate optimism – about the possibilities for continuing medical advance and better outcomes of care.”

Many health-related organisations have added their voice in reaction to the announcement, including the Royal College of Surgeons of Edinburgh (RCSEd). RCSEd President Professor Mike Griffin, stated: “In the medium term, there needs to be an open and honest conversation on the true level of resources health and social care needs to ensure it meets demand and how workforce planning can be improved to deliver the staff needed to deliver the best possible patient care.”

While the Royal College of Surgeons of England, President Professor Derek Alderson, said there was much to welcome and that it was right that the NHS and government had ambitious vision for the future of healthcare in the UK: “However, health service leaders need to guard against the potential risk of focusing on primary and community care at the expense of hospital care. Demand for hospital treatment, including surgery, continues to rise and many patients still turn to A&E rather than make use of new community services which they can be unfamiliar with.”

The voice of patients from Patients Association chief executive Rachel Power highlighted a failure in the plan to safeguard the future of the health and social care system. She said: “NHS England has done what was asked of it in terms of developing a coherent plan. The government now needs to do its part, and get serious about addressing the substantial strategic problems that still pose major threats to the health and care system.”

Further information is available here:

NHS Long Term Plan 

NHS Five Year Forward View 

Response from the Royal College of Surgeons of England

Response from the Royal College of Surgeons of Edinburgh

Response from the Patients Association

NHS England press statement

 

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