The plan sets out how the NHS will use the extra £20.5bn a year by 2023-24 to drive improvements in the service over the next 10 years.
- investment in “world class, cutting edge treatments,” including genomic tests for every child with cancer and artificial intelligence to potentially improve stroke diagnosis
- a renewed focus on prevention to stop an estimated 85 000 premature deaths each year, including new dedicated alcohol and tobacco treatment services in hospitals, and an expansion of the diabetes prevention programme
- a new guarantee that investment in primary, community, and mental health care will grow faster than the overall NHS budget2; the plan says this will include £4.5bn to fund integrated care across England
- the “biggest ever” investment in mental health services, rising to at least £2.3bn a year by 2023-24,3 will include an expansion of community based services, including in schools, to help 345 000 more children and teenagers
- a package of upgrades to improve neonatal services, including more specialists and expert nurses in units
- extra investment in early detection in areas such as cancer and respiratory care
- “every patient will have the right to online ‘digital’ GP consultations, and redesigned hospital support will be able to avoid up to a third of outpatient appointments – saving patients 30 million trips to hospital, and saving the NHS over £1 billion a year in new expenditure averted. GP practices – typically covering 30-50,000 people – will be funded to work together to deal with pressures in primary care and extend the range of convenient local services, creating genuinely integrated teams of GPs, community health and social care staff.”
- The document warns that the H&SCA is damaging the NHS and stopping it from making vital improvements to the care patients receive.
Health Service Journal :
- The whole of England is to be covered by integrated care systems in just over two years, with ICS “central to the delivery of the long-term plan”.
- The 30 worst financially performing NHS trusts will be subject to a new “accelerated turnaround process” as part of plans to bring the provider sector into the black by 2020-21.
- The NHS is asking the government to rip up key parts of the Lansley Act on competition, with the regulator consulting with “clinicians and NHS leaders” to present government with a “provisional list” of requests for changes to legislation.
- GPs will sign new “network contracts”as part of NHS England plans to extend the scope of primary and community services.
- Formal regulation of senior NHS managers could be introduced to improve their standing and help fill the most difficult jobs, with the NHS to consider “the potential benefits and operation” of a professional registration scheme.
- The NHS and government will look at funding key public health services from the NHS budget, including considering ”whether there is a stronger role for the NHS in commissioning sexual health services, health visitors, and school nurses, and what best future commissioning arrangements might therefore be”.
- More doctors will be encouraged to train as generalists rather than specialisingin a specific area of medicine in an effort to shift away from the dominance of “highly specialised” medicine and to ensure medics are better able to provide care to patients who have more than one long-term condition.
- No commitment made on when the service will get back to meeting its core statutory access targets, although the document pledges to speed up access for the sickest patients.
- Patients will have “a new right” to switch from their existing GP to a “digital first” provider and all patients in England will have access to a “digital first primary care offer”, such as online or video consultations, by 2022-23.
- The target for all secondary care providers to move to digital records has been pushed back to 2024.
- Specific waiting time targets for emergency mental health serviceswill be introduced from 2020, while a new national waiting time for children and young people’s services and access standards for community mental health will also be introduced.
- A new “same day” model for emergency departments and a further cash boost for primary and community services are to be set out in the NHS long-term plan, being launched today.
KONP website:
Rationing plan for 17 NHS treatments no longer to be commissioned by CCGs. Trusts are also urged to ‘grow their external (non-NHS) income’ and ‘work towards securing the benchmarked potential for commercial income growth’. They must set up systems to raise money by charging patients for treatment (‘overseas visitor cost recovery’) – a policy recently denounced by several medical Royal Colleges because of its impact on individual and public health.
The 44 discredited Sustainability and Transformation Plans, re-branded as Integrated Care Systems, will hold the regional budgets to control NHS Trusts. ‘Planning assumptions’ in each STP area are to be agreed by 14 January. Neither the STPs, nor the ICSs, nor the Long Term Plan has been mandated by an Act of Parliament, let alone by patients or healthworkers.
The private sector could gain control of individual ICSs through long term contracts to manage the entire health system within one region.
John Lister:
A depressing re-run of previous plans and gimmicks: the only novel proposals are for more central control and less accountability, for trusts to run more like and with private businesses seeking profits, and to raise money by undermining the principles and values of the NHS.
There is no reason to believe this plan, with even less local accountability and no serious plans for public consultation, will prove any more acceptable to the public or successful in implementation than the secretive STPs in 2016 or other previous failed efforts.
Campaigners have yet to see anything to recommend the new plans, or any indication NHS England is willing to come to grips with the crisis fuelled by chronic austerity limits on funding – or demand an end to chaos and fragmentation of the Health & Social Care Act.”
Kailesh Chand (GP; BMA)
Continuation of the NHS 2000 modernisation plan of the Tony Blair government. The end game is one where ‘NHS’ will simply be a ‘kitemark’ attached to institutions and activities of a system of private providers.
The whole of England is to be covered by integrated care systems (ICSs) in just over two years, with ICSs ‘central to delivery of the long-term plan’ which is essentially a market model of health care that can be taken over by the likes of Virgin and United Health.
ICSs and their focus on population health are seen as central to the plan: ‘triple integration’ – of primary and specialist care, physical and mental health services and social care. The private sector will be licking its lips at the prospect.
£20.5 billion funding will barely make up for eight years of austerity that have crippled the NHS and social care and undermined public health. The gap between policy rhetoric and supply has never been starker.
There is nothing in the plan’s outlined aspirations – keeping people out of hospital, caring for the vulnerable in the community, earlier diagnosis of treatable disease – that any right minded person wouldn’t want to do or make happen. The question is how are we going to meet the challenge? Where will the money and the personnel come from?
Analysis by the King’s Fund, the Health Foundation and the Nuffield Trust suggests the health service could be short of more than 350,000 staff if it continues to lose employees and cannot attract enough from abroad.
