The NHS Long Term Plan was published in January 2019. It is a new 10 year plan for the NHS to improve the quality of patient care and health outcomes. There’s been concern – about funding, staffing, increasing inequalities and pressures from a growing and ageing population. NHS Long Term Plan takes all three of these realities as its starting point to redesign patient care to future-proof the NHS for the decade ahead.
The NHS Long Term Plan aims to make sure the NHS is fit for the future, providing high quality care and better health outcomes for patients and their families, through every stage of life.
It details how this would be achieved through three main themes:
1. Giving everyone the best start in life;
- reducing stillbirths and mother and child deaths during birth by 50%
- ensuring most women can benefit from continuity of care through and beyond their pregnancy, targeted towards those who will benefit most
- providing extra support for expectant mothers at risk of premature birth
- expanding support for perinatal mental health conditions
- taking further action on childhood obesity
- increasing funding for children and young people’s mental health
- bringing down waiting times for autism assessments
- providing the right care for children with a learning disability
- delivering the best treatments available for children with cancer.
2. Delivering world-class care for major health problems to help people live well;
- Providing education and exercise programmes to tens of thousands more patients with heart problems, preventing up to 14,000 premature deaths
- Faster and better diagnosis, treatment and care for the most common killers, including cancer, heart disease, stroke and lung disease, achieving survival rates that are among the best in the world.
- Supporting families and individuals with mental health problems, making it easier to access talking therapies and transforming how the NHS responds to people experiencing a mental health crisis (by spending at least £2.3bn more a year on mental health care)
3. And helping people age well by
- increasing funding for primary and community care by at least £4.5bn
- bringing together different professionals to coordinate care better
- helping more people to live independently at home for longer
- developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home.
- upgrading NHS staff support to people living in care homes.
- improving the recognition of carers and support they receive
- making further progress on care for people with dementia
- giving more people more say about the care they receive and where they receive it, particularly towards the end of their lives.
The NHS Long Term Plan also describes the actions that will need to be taken at local, regional and national level to make the ambitious vision a reality.
1. Doing things differently: by giving people more control over their own health and the care they receive, encourage more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities (see chapter on Accountable Care Organisation)
2. Preventing illness and tackling health inequalities: NHS will increase its contribution to tackling some of the most significant causes of ill health, including new action to help people stop smoking, overcome drinking problems and avoid Type 2 diabetes, with a particular focus on the communities and groups of people most affected by these problems.
3. Backing the workforce: continue to increase the NHS workforce, training and recruiting more professionals – including thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. We will also make the NHS a better place to work, so more staff stay in the NHS and feel able to make better use of their skills and experience for patients.
4. Making better use of data and digital technology: provide more convenient access to services and health information for patients, with the new NHS App as a digital ‘front door’, better access to digital tools and patient records for staff, and improvements to the planning and delivery of services based on the analysis of patient and population data.
5. Getting the most out of taxpayers’ investment in the NHS: continue working with doctors and other health professionals to identify ways to reduce duplication in how clinical services are delivered, make better use of the NHS’ combined buying power to get commonly used products for cheaper, and reduce spend on administration.
What happens next?
The local NHS organisations will work with each other, local councils and other partners to develop and implement their own strategies for the next five years. These strategies will set out how they intend to take the ambitions that the NHS Long Term Plan details, and work together to turn them into local action to improve services and the health and wellbeing of the communities they serve – building on the work they have already been doing.
The local NHS organisations are expected to publish local plans for 2019-20 by April 2019 and publish local five year plan by autumn 2019.
Ref: https://www.longtermplan.nhs.uk/
BMA response to NHS long term plan
“While the Government has highlighted plans to expand capacity and grow the workforce, very little has been offered in the way of detail. Given that there are 100,000 staff vacancies within the NHS, the long-term sustainability of the NHS requires a robust workforce plan that addresses the reality of the staffing crisis across primary, secondary and community care. This will require additional resources for training, funding for which has not been mentioned in the long-term plan.
“There is also a pressing need to address immediate and short-term pressures given that doctors and NHS staff are routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout. As well as the toll on wellbeing, this has a detrimental impact on recruitment and retention and, unless this is addressed, we risk a workforce plan without the doctors in the future to deliver it.
“The BMA supports increased investment in general practice and community care. This is imperative for effective future planning given the ageing population and the fact that doctors are treating patients with more complex needs, though we await further detail on how this will be delivered.
“With patients experiencing unacceptable waits in A&E, and with waiting lists for surgery and appointments growing, we also need immediate, practical solutions and the necessary investment for hospitals to deliver both in the long and short-term.
“A renewed focus on prevention is welcome but the reality of the situation is that we are seeing a significant increase in obesity and related diseases along with worsening health inequalities exacerbated by years of cuts to public health budgets. The Government must go further than what is outlined in the long-term plan and commit to population-wide measures, such as a minimum unit price for alcohol, restricting sugar levels in food, and greater restrictions on junk food marketing, if we are to achieve necessary improvements to the health of the public.
“Narrowing inequalities cannot occur without adequate provision of social care which is not covered in the long-term plan. The BMA eagerly awaits the publication of the green paper on social care this year which must fully align with the long-term plan for the NHS.
“Ultimately, there is a need for honesty about how far the £20.5 billion over five years will stretch. This is well below the 4% uplift that independent experts have calculated is required and below historic spending levels since inception of the NHS. World class care requires world class funding and the investment in the long-term plan will still leave the UK falling behind comparative nations like France and Germany.
“If we are to truly transform the care we give to patients, and create a sustainable, world-class health service, this long-term plan must deliver beyond grand ambition and address the realities faced by doctors, NHS staff and patients today.” deWhenU