As you are probably aware, the NHS Long Term Plan was published yesterday (click here for a two page summary) – following a number of issues being previewed in the media over the past week. Much of the content of the plan is as expected but I thought it might be helpful to highlight some key messages and let you know about how Healthwatch Sheffield will be involved in the next steps.
What are the key clinical priorities?
- mental health
- multi morbidity
- healthy ageing (especially dementia)
- children’s health
- cardiovascular and respiratory diseases
- learning disability and autism.
Both primary care and mental health care are due to get higher proportion of extra funding. The model used, however, has not locked in an assumption that the increased investment in community and primary care will necessarily reduce the need for hospital beds but has provided funding for hospitals as if trends over the last three years continue.
What’s in the plan?
- NHS England is committing to end the split between primary care and community services. New ‘network contracts’ will enable more multidisciplinary services covering neighbouring GP practices to provide joined-up out of hospital care.
- Each area will be tasked with developing a plan to narrow health inequality gaps.
- There are ambitious targets to save thousands of lives – including: stillbirths and maternal deaths to be halved, saving 55 000 lives by early diagnosis of cancers and preventing 150 000 heart attacks, strokes and cases of dementia.
- There will be a big focus on people living well in their own homes and trying to resolve emergency admissions to hospitals without the need for overnight stays – including Same Day Emergency Care (SDEC).
- A greater focus on prevention and empowering patients will lead to an expansion in both the use of personal health budgets and social prescribing.
- The role of local authorities is recognised both as a commissioner and provider of key health and social care services, but also their functions in relation to the wider determinants of health.
- When it comes to targets, NHS England are planning to introduce a target for mental health to encourage parity with physical health. NHS England will also focus on reducing 18-week referral to treatment target and will reintroduce fines where people are left waiting longer than 12 months.
- There is a commitment for children’s and adolescent mental health services to support 345,000 children and young people a year by 2023/24 – up from the 70,000 target set out in the Five Year Forward View. The rules about the transition period are changing – the age for transition is extended to 25 with a general position that age is not an official hard and fast cut off point. It has to be about what is right for young people. This reflects what we have consistently asked for in this area.
- There is a focus on better use of technology, NHS England will create a right for people to access GP services digitally.
How will it be implemented?
- The first year of the plan 2019-20 will be a transition year. The plan sets out clear priorities but some areas – such as staffing and targets – still need to be developed further during this time.
- Local NHS organisations will be working with their local councils to develop and implement their own plans for the next five years. These strategies will set out how they intend to take the ambitions from the NHS Long Term Plan and turn them into action to improve services and the health and wellbeing of their local communities, with a specific requirement to reduce health inequalities
- Following this a detailed national implementation plan will be published in the Autumn.
- A workforce plan will be developed later this year.
Will there be organisational change?
- By April 2021 Integrated Care Systems (ICS) will cover the whole country (Sheffield is part of the South Yorkshire & Bassetlaw ICS), and commissioning arrangements will “typically involve a single CCG for each ICS area”.
- CCGs are described as “leaner, more strategic organisations that support providers to partner with local government and other community organisations.”
- The accountability and performance framework for ICSs will include a new ‘integration index’ which draw on the views of patients, carers and the public to measure how partners are providing joined up, personalised and anticipatory care.
- The plan supports collaboration to advance integration – such as CCGs and local authorities “blending health and social care budgets” and letting trusts and CCGs exercise functions, and make decisions, jointly.
- NHS England states it doesn’t need legislative changes to do this but have included a section which states what they would like if legislation were required – for example, proposing the creation of joint committees making decisions across wide areas.
The Long Term Plan is going to be high on the agenda locally and nationally – at a local level, Healthwatch Sheffield wants to ensure that people’s views are used to help shape implementation of the plan as part of a programme being coordinated by Healthwatch England. Over the coming weeks and months we will be working to ensure that as many people as possible will have an opportunity to have their say on what the Long Term Plan means.
We will let you know about opportunities to get involved, but do feel free to get in touch in the mean time to register your interest.
33 Rockingham Lane
Sheffield S1 4FW
0114 253 6689