The NHS Long Term Plan - Briefing

Stethoscope and medical records
Friday, 11 January, 2019

This Briefing Note was produced on 7 January by NAVCA, the network of organisations which, like RedbridgeCVS, help support and develop voluntary sector groups. We reproduce it with their permission.

Today marks the publication of the much anticipated NHS Long Term Plan. The Plan, intended as a blueprint for the future of health and social care in the UK, was significantly postponed due to ongoing Brexit chaos.

The Long Term Plan has been drawn up with the expertise and experience of NHS frontline health and care staff, patient groups, VCSE organisations and others as well as a consultation which received around 2,500 submissions from individuals and groups representing the opinions and interests of 3.5 million people.

The document finally launched today outlines an ambitious set of priorities focussed around delivering world-class care and making the NHS sustainable alongside a funding pledge from the Prime Minister of £20bn per year above inflation until 2023 - accounting for the equivalent of an annual “real terms” rise of 3.5%, which is almost double the NHS’ funding allocation since 2010.

With particular reference to our sector, the plan outlines a renewed focus on the prevention agenda, setting targets to avoid 150,000 heart attacks, strokes and dementia cases and stop an estimated 85,000 premature deaths each year. There is an increased focus on joined-up care delivery and collaboration between the NHS and external partners, (including communities and the VCSE), to take forward key priorities at local level. 

Perhaps even more significantly, the Plan also acknowledges the vital role that volunteers play across all areas of the NHS from “from first responders and care companions to trust governors and transport volunteers”, and pledges to invest £2.3 million into support for volunteering programmes across the country.

Key Priorities

A selection of the key priorities outlined in the plan include the following:  

Tackling major physical conditions

  • Improving cancer survival rates and increasing early detection of cancer from one in two cancers to three in four.
  • Provide genetic testing for a quarter of people with dangerously high inherited cholesterol, reaching around 30,000 people.
  • Implementing improved services which will see more than three million people benefit from new and improved stroke, respiratory and cardiac services over the next decade.

Mental Health

  • Investing £2.3 billion a year by 2023/34 to expand mental health care; to include 24 hour access to crisis care via NHS 111, increased support for around two million more people who suffer from anxiety, depression.
  • Provide mental health support to 345,000 more children and young people through the expansion of community based services, including in schools.
  • Delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24.

Maternity

  • Improving safety and halving both stillbirths and maternity-related deaths by 2025.
  • Increasing support for new parents, taking into account that one in five new mothers struggles with mental health in the first year of her baby's life.

Integrated Support

  • Increasing funding for primary and community care by at least £4.5bn.
  • Giving greater choice to older people by expanding the use of personal budgets to allow people to decide what care they want, and greater support in the community to keep older people out of hospital, living longer and more independent lives.
  • 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.
  • Developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home.

Digital Technology

  • Making it easier for patients to access health care via online GP booking, digital GP consultations for all those who want them and digital prescriptions management
  • 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

Volunteers

  • The plan recognises the vital role of volunteers in the delivery of care across the NHS as well as in helping older people “stay physically active and connected to their communities and younger people to develop skills and experience for work and education”. The plan will encourage NHS greater access for younger volunteers through programmes such as #iWill (as outlined in the Civil Society Strategy) an increased focus on programmes in deprived areas, for those with mental health issues, learning disabilities and autism
  • The Plan outlines a funding pledge of at least £2.3 million to scale successful volunteering programmes across the country and double the number of NHS volunteers over the next three years.

Reception/Criticism

Whilst the plan has been relatively well received, it has sparked criticism for being “undeliverable” in light of the ongoing NHS staffing crisis and major issues with hospital waiting times in some areas that remain unacceptably high and unresolved. Alongside this, there doesn’t appear to be any provision for the potential impact of Brexit in funding and staffing.  The impact of a withdrawal of the free movement of EU workers would clearly have a hugely detrimental impact on staffing within the NHS, and thus the ability to deliver the plan. (Before the EU referendum, 10% of NHS doctors were from EU member states).

It’s also noticeable that the Long Term Plan and long awaited Social Care Green Paper have not been released at the same time (developing the two in parallel would have provided a significant opportunity to clarify funding and delivery of social care. As it stands the two are somewhat disjointed with the separate release of today’s plan).

Next Steps

At local level the NHS will be working with non-health partners (local authorities, VCSE organisations, community groups) to develop strategies to cover the next 5 years.  The development of these strategies will be led by Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) and will set out how localities intend to deliver the ambitions outlined in the NHS Long Term Plan to improve health and wellbeing in local communities.  These local five year strategies will be due for publication in Autumn 2019.

Further Information

A full version of the NHS Long Term Plan can be found online here: http://bit.ly/2CUeVGP along with a summary of some of the key priorities: http://bit.ly/2Tws4ez

You can also listen to a podcast on the plan, its content and delivery here: (BBC Radio 4 Today Programme’s Beyond Today Podcast): https://bbc.in/2LTliNe

London Borough of RedbridgeNHS Redbridge Clinical Commissioing GroupLondon CouncilsMayor of LondonEuropean Social FundSkills Funding Agency  Big Lottery