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NHS England publishes 10-year Long Term Plan

A new Long Term Plan for the NHS has been published.

The 10-year plan has been developed in partnership with frontline health and care staff, and with patients and their families. It is designed to address the challenges currently facing the health service, including lack of funding, low staffing, and increasing inequalities and pressures caused by a growing and ageing population. Included within the plan are spending commitments related to the additional £20.5 billion budget settlement for the NHS, announced by the Prime Minister in the summer of 2018.

A key element of the plan is a move to a new service model in which patients get more options, better support, and properly ‘joined-up care’ at the right time and in the right care setting. The aim is to improve both the quality of care and the health outcomes for major diseases such as cancer, heart disease, stroke, respiratory disease and dementia.

There is a particular focus on primary care. Over the next five years every patient will have the right to online ‘digital’ GP consultations. New technologies will be rolled out to enable hospital-based services to increasingly be provided in primary care. GP practices will be funded to work together and extend the range of convenient local services. Integrated teams of GPs, community health and social care staff will be formed to provide fast support to people in their own homes as an alternative to hospitalisation and to increase NHS support for people living in care homes.

The reforms will be supported by a new guarantee that, over the next five years, investment in primary medical and community services will grow faster than the overall NHS budget. This is expected to create a ringfenced fund worth at least an extra £4.5 billion a year by 2023/24.

More action on the prevention of poor health will help people stay well and also reduce demand on the NHS. To help tackle health inequalities NHS England says that it will base its five-year funding allocations for local areas on more accurate assessments of health inequalities and unmet needs. All major national programmes and every local area across England will be required to set out specific measurable goals and mechanisms by which they will contribute to narrowing health inequalities over the next five and ten years.

Regarding major health conditions, the NHS long-term plan concentrates on increasing the number of planned operations and cutting long waits. As with primary care, it also makes a commitment that mental health services will grow faster than the overall NHS budget.

Other parts of the plan include actions to tackle current workforce pressures and provide better support for staff.

Specific workforce actions include expanding the number of nursing and other undergraduate places, developing new routes into nursing and other disciplines, including apprenticeships, and an expansion of international recruitment. More information will be included in a comprehensive NHS workforce implementation plan to be published later this year.

For social care, mention is made of support for local approaches to blending health and social care budgets. However, the plan states that the government will set out further proposals for social care and health integration in the forthcoming Green Paper.

Regarding implementation, Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) across the country will now be expected to work together with local councils to develop their own strategies based on the plan. Local five-year plans must be developed in each area by autumn 2019.

Commenting on the publication of the NHS plan, the Social Care Institute for Excellence Chair, Paul Burstow, who is an advisor on the forthcoming Green Paper on Social Care, said:

‘The NHS Long Term Plan has a welcome focus on providing personalised care across the health and care system. For people living with long-term conditions, at any age, having greater control to shape the care, treatment and support you need is key to improved outcomes and quality. NHS England admit that, whilst there have been some great pockets of practice, approaches to personalised care have been far too fragmented in the past.’

He concluded:

‘SCIE is pleased to be contributing in a number of ways to making personalisation happen. We look forward to the Green Paper on Social Care and the continued integrated approach that puts personalised care and support at the top of the agenda to put putting people at the heart of the system.’

The plan is available for download at www.longtermplan.nhs.uk.