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Details of new long-term plan for NHS in England set to be revealed today

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Investment in primary, community and mental health care will grow faster than the rest of the overall NHS budget, NHS England has pledged as part of its new plan for the health service.

This will fund a £4.5bn new service model for the 21st century across England, where health bodies “come together to provide better, joined up care in partnership” with local councils, said the body.

It said the NHS long term plan would save almost half a million more lives with “practical action” on major conditions and investment in “world class, cutting edge” treatments.

The new 10-year plan for the health service is set to be published at 12pm today, after being delayed since the end of last year. The blueprint will set out how the £20.5bn annual budget increase promised by prime minister Theresa May will be spent.

Ahead of its publication, some of the main aims and innovations to be included in the plan have been revealed in a statement by the government arms’-length body NHS England.

Maternity care, children’s services, cancer care, mental health and heart disease all look set to benefit, and there will be funding boosts for community care, digital technology and prevention.

“It sets a practical, costed, phased route map for the NHS’s priorities for care quality and outcomes improvement for the decade ahead”

Simon Stevens

For example, the plan will see technology, such as digital GP consultations, coupled with early detection and a renewed focus on prevention stop an estimated 85,000 premature deaths each year, said NHS England.

Measures in the plan would also help prevent 150,000 heart attacks, strokes and dementia cases, while millions would benefit from better stroke, respiratory and cardiac services over the next decade.

Patients would benefit from services ranging from improved neonatal care to life-changing stroke therapy and integrated support to keep older people out of hospital, living longer and more independent lives, it added.

The commitment to tackle major physical conditions comes alongside the “biggest ever” investment in mental health services rising to at least £2.3bn a year by 2023-24, according to NHS England.

For example, around two million more people who experienced anxiety, depression or other problems would receive help over the next decade, including new fathers, plus 24-hour access to crisis care via NHS 111.

 

The long-term plan will also open a digital “front door” to the NHS, allowing patients to access healthcare “at the touch of a button” – reflecting health and social care secretary Matt Hancock’s interest in technology.

“Cutting edge” scans and technology, including the potential use of artificial intelligence, will also be used to help provide the “best stroke care” in Europe.

In addition, the plan will provide genetic testing for a quarter of people with dangerously high inherited cholesterol, reaching around 30,000 people, and give mental health help to 345,000 more children and young people through the expansion of community-based services, including in schools.

It will facilitate investment in earlier detection and better treatment of respiratory conditions to prevent 80,000 admissions and smart inhalers will be piloted to help patients easily monitor asthma.

Meanwhile, the plan will see every hospital with a major accident and emergency department have “same day emergency care” in place, so 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,” he said.

Ian Dalton

Ian Dalton

Ian Dalton

“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,” said Mr Stevens.

“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,” he added.

Also speaking on the plan, Ian Dalton, chief executive of the regulator NHS Improvement, said there was a need to “make the best use of the new investment to fundamentally reset how the NHS is run”.

He said: “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.

“The long-term plan sets out an exciting roadmap for how we will do this together for the benefit of patients,” he added.

Meanwhile, the much-anticipated plan has been billed over the weekend as a “historic step” by the prime minister. An announcement by Number 10 on Sunday also identified priorities for the plan such as improved access for mental health services and a major expansion of personal health budgets.

In addition, the statement cited aims to improve in maternity, older people, outcomes for major conditions, digital access to services, and cutting waste including back office savings of £700m.

However, the plan was expected to include a substantial chapter on workforce, but the government has now indicated that this part of the of plan will come at a later date to the main document.

The Royal College of Nursing and others have warned that NHS England and the government “must urgently” address chronic shortages of nurses and other staff to make the new plan a success.

Over the last few weeks, NHS England and the Department of Health and Social Care have been drip-feeding some of the policies and initiatives that are to be included in the long-term plan.

For example, it was revealed on Saturday that problem drinkers and smokers who end up in hospital will be helped by dedicated new services, as part of the plan.

Forming part of new health service prevention measures, people who are alcohol dependent will be helped by new “alcohol care teams”, said NHS England.

In addition, more than half a million patients who smoke will be “helped to stop” in a new drive that will see all smokers admitted to hospital encouraged to quit.

Meanwhile, over the festive period, the government announced that a maternity shake-up will form part of the long-term plan.

“The plan cannot escape the harsh reality that the NHS will still face tough decisions on what it can and cannot do”

Niall Dickson

Ministers promised a major redesign of neonatal services, led by an expansion in staff numbers including more specialist nurses. And child health records – the “red book” – will be digitised and digital maternity records for 100,000 women will be piloted by the end of 2019.

In addition, NHS England said that national funding for children’s hospices is to rise by as much as £25m a year. However, the total annual increase would be dependent on local commissioning bodies agreeing to match the rise in funding on offer from NHS England.

Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “This plan heralds an end of austerity for the NHS.

“The plan looks set to promise a host of improvements, including in areas such as maternity care, children’s services, cancer care, mental health and heart disease. It will also signal significantly more investment in community care, much greater use of digital technology and more emphasis on prevention,” he noted.

“We very much welcome the increased funding for the NHS and the vision to strengthen and improve services,” he said. “But the plan cannot escape the harsh reality that the NHS will still face tough decisions on what it can and cannot do.”

Mr Dickson said: “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 big challenge ahead is now to make it happen. The NHS is already short of 100,000 doctors, nurses and other staff”

Jennifer Dixon

He added: “We now need to see the detail of the plan. Plans are fine but the challenge is how they are implemented.”

Dr Jennifer Dixon, chief executive of the Health Foundation, said the plan looked “pragmatic” and “ambitious”, but making it a reality will be “extremely tough given growing pressures on services, widespread staff shortages and continued cuts to other parts of the health and care system”.

“The plan outlines a positive shift in the model of NHS care, towards an increasing focus on preventing people becoming ill in the first place, reducing avoidable demand, and narrowing unjust gaps in health between the best and worst off,” she said. “This is particularly welcome given life expectancy improvements are stalling and health inequalities widening.

“The big challenge ahead is now to make it happen. The NHS is already short of 100,000 doctors, nurses and other staff,” said Dr Dixon.

“The extra £20.5bn by 2023-24 promised by the government is a substantial investment. But without a step change in productivity, or in managing demand for care, trade-offs are inevitable. These need to be spelled out clearly so the public know what they can expect from the NHS,” she said.

Nigel Edwards

Nigel Edwards

Nigel Edwards

Nuffield Trust chief executive Nigel Edwards said: “The goals of this plan look right – carrying on with joining up care and improving services for older people, while pushing vital issues like heart attack survival and children’s health up the agenda.

“These are the most important issues for patients, and the level of ambition is good. What worries me is how difficult it will be to roll out such wide ranging changes. There are several big pitfalls ahead,” he noted.

“The extra funding will actually be below the historic average and what experts thought was needed,” he said. “It’s enough to move forwards, but with little room for manoeuvre.”

Mr Edwards also warned that a “no deal” Brexit could “eat up” up money and stop the plan’s “progress dead in its tracks”.

In addition, he warned that the NHS would have “even less to spare” if social care and public health continue to be starved of funding, but he added: “The biggest obstacle of all is the lack of key staff.”

“Every year thousands of children will still fail to receive the help they need”

Anne Longfield

Anne Longfield, the Children’s Commissioner for England, said: “I welcome the commitment to make child and adolescent mental health services a priority and the promise of extra resources so that more children can receive support and treatment as quickly as possible.

“However, every year thousands of children will still fail to receive the help they need,” she said. “The government must be more ambitious and its aim should be for a CAMHS system that helps every child suffering from a mental illness, not just some.

“That will require bolder policies like an NHS-funded counsellor in every school to identify and tackle problems early, and closer parity between what is spent on adult and child mental health services,” she said.

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Readers' comments (1)

  • All well and good but not a word about people with learning disabilities. There is a shortage of learning disabilities nurses to cater for the increasing number of children being born with syndromes that include learning disabilities. Foetal Alcohol syndrome is just one of them as babies born with this condition do have learning disabilities.
    Why are people with learning disabilities always at the bottom of these plans?

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