NHS Long Term Plan published

January 7, 2019

The NHS Long Term Plan has been published today, committing to saving more lives by tackling major conditions and investing in cutting edge treatments.

The measures outlined in the plan aim to prevent 150,000 heart attacks, strokes and dementia cases while more than three million people will benefit from new and improved stroke, respiratory and cardiac services over the next decade, according to NHS England.

People will benefit from services including improved neonatal care, life-changing stroke therapy and integrated support to help older people stay out of hospital, live longer and have more independent lives.

The NHS Long Term Plan also promises that investment in primary, community and mental health care will grow faster than the overall NHS budget. This will fund a £4.5bn service model across England, where health bodies come together to provide better, joined up care in partnership with local government.

The commitment to tackle major physical conditions comes alongside investment in mental health services rising to at least £2.3bn a year by 2023/24. Over the next 10 years, around two million more people who live with anxiety, depression or other issues will receive help, including new dads as well as mums, and 24-hour access to crisis care via NHS 111.

According to NHS England, 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.

'In looking ahead to the Health Service’s 80th birthday, this NHS Long Term Plan acts on all three of these realities. It keeps all that’s good about our health service and its place in our national life. It tackles head-on the pressures our staff face. And it sets a practical, costed, phased route map for the NHS’s priorities for care quality and outcomes improvement for the decade ahead.'

Around 23,000 premature deaths and 50,000 hospital admissions will also be prevented over the next decade by putting over 100,000 patients with heart problems through a healthy living and exercise programme every year.

A renewed focus on prevention to help people live healthier lives will stop thousands of people developing life threatening or limiting conditions, including the expansion of the Diabetes Prevention Programme, and care will increasingly be delivered in people’s homes or in the community, freeing up space in hospitals for those who need it most.

Ian Dalton, Chief Executive of NHS Improvement, said, 'We need to...make the best use of the new investment to fundamentally reset how the NHS is run so that our growing and ageing population can get the right care at the right time and in the right place.

'This means breaking down organisational barriers to take a more holistic approach to how care is delivered and paid for, embracing new and existing forms of technology, recruiting and retaining the right number of staff, and shifting the focus away from hospitals to prevention and care in the community.'

Paul Farmer, Chief Executive of Mind, said, 'We are really pleased to see that mental health is such a key focus in the NHS Long Term Plan and we welcome the £2.3bn set aside for mental health services. This is the kind of sustained investment we need to see to put mental health on an equal footing with physical health and, if delivered, this plan will make a difference to the lives of thousands of people with mental health problems.

'Everyone now needs to work together to develop the workforce needed and to deliver these plans and to ensure the money reaches the front line. Local decision makers need to develop their own plans and the proof of delivery will be in the experiences of people trying to access the services they need.'

Niall Dickson, Chief Executive of the NHS Confederation, said, 'This plan heralds an end of austerity for the NHS and as such marks the dawn of a new era – one in which we will need to transform the way services are delivered to patients and the public.

'We very much welcome the increased funding for the NHS and the vision to strengthen and improve services. But the plan cannot escape the harsh reality that the NHS will still face tough decisions on what it can and cannot do. Our plea is that politicians be honest about the trade offs that will be required and that we are realistic about what can be achieved given the ever increasing demands of an ageing population.

'The next few years will be about balancing the need to keep the NHS going, overcoming the large deficits in many hospitals and other NHS organisations, delivering some improvements, and preparing for new ways of delivering care that will make the NHS sustainable. This is not about miracles - money will be tight and staffing will remain a headache for years to come. Getting a long term strategy for the NHS workforce is crucial.

'The ambitions in the plan will also in part be determined by factors beyond the NHS' control. The Government must find a solution to the social care crisis that has seen thousands of people no longer receiving the care and support they need. It must also follow through on its commitment to improve the health of the nation through better prevention by overturning the significant cuts we have seen to public health budgets. Failure to address these issues will continue to place significant extra pressure on front line NHS services.

'We now need to see the detail of the plan. Plans are fine but the challenge is how they are implemented and we will be watching closely to see whether this plan meets three key tests of it set by our members who are leading front-line services: is it deliverable and affordable; does it enable care to shift out of hospitals and closer to people’s homes; and does it give local leaders the freedom they need to shape and develop the health services required in their area?'

Responding to the NHS Long Term Plan, Glen Garrod, President of the Association of Directors of Adult Social Services, said, 'The new financial settlement for the NHS is the largest single increase for any public service in recent times outside of the spending review. ADASS welcomes the publication of the long term plan as an opportunity to assess how the additional money will be used to improve the overall health and wellbeing of local communities and not just to relieve current pressures on hospitals.

'ADASS is pleased to see that priority will be given to primary care, mental health and community services. Alongside social care and housing, these services are vital to enable people to live as independently as possible in their own homes and communities through the right mixture of joined-up services thus reducing the need for admission to hospital for mental or physical health reasons and or long term care. We reiterate our commitment to work collaboratively with the NHS at local, regional, and national levels to achieve these goals. The proposed expansion of personal health budgets is also very welcome, there is much that can be learnt from the experience of social care in implementing personal budgets in extending choice and control.

'It is encouraging that the new plan recognises the importance of prevention. However it is hard to see how this can be delivered with continuing cuts to public health budgets, where spending per person has fell by nearly a quarter since 2015/16. The contribution that local government generally makes, for example in leisure and housing, to prevention needs to be recognised in this context.

'The new plan sets out how the NHS will respond to demographic change, increasing complexity and acuity of needs, rising costs and workforce constraints. These same challenges are driving the pressures on social care. As the previous NHS Five Year Forward View recognised, an effective NHS depends on adequately funded social care – the two services are inter-dependent. Now that there is a long term plan in place for the NHS, it is deeply disappointing that the promised Green Paper setting out proposals for sustainable long term funding for social care has still not been published.

'The Green Paper and the NHS Long Term Plan should have been developed in parallel. A major opportunity has been missed. The absence of clarity and certainty about future social care funding represents a major risk to the ambitions of this NHS Plan.'

The full NHS Long Term Plan has been published on the dedicated website.

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