The Government has unveiled its plan for the next 10 years, including pledges around a new operating model, expansion of the NHS App and AI, a push for greater use of genomics and new neighbourhood contracts.
Health leaders have generally welcomed it’s ‘bold ambitions’, as NHS Confederation’s chief executive Matthew Taylor has called them. But there is caution over the finances of the plan and how exactly it will differ from other NHS policy initiatives.
The Health Foundation’s chief executive Dr Jennifer Dixon said it welcomed ‘many of the changes’, including more integrated services, boosting primary and community care, harnessing innovation and technology and reducing health inequalities.
But she added: ‘These are not new ideas and questions remain about how they will be implemented and whether they will be backed by sufficient resources.’
She said that it was ‘unclear whether past lessons have been learned to enable the latest versions to succeed’ and added that the plans to abolish a ‘swathe of NHS bodies and change the roles of many others’ risks the NHS getting lost in organisational change.
The Nuffield Trust chief executive, Thea Stein, added that the plan ‘assumes that technological advancement and preventing ill health will save money. Care closer to home doesn’t mean care on the cheap and technology has a long history of costing health services more, not less’.
‘What’s more, where previous plans have been backed by significant extra funds, the hope and prayer here is that the NHS can achieve this extraordinary transformation without much new money,’ she said.
The King’s Fund chief executive, Sarah Woolnough, said that there was also ‘nowhere near enough detail about how it will be implemented’, in the 150 pages.
‘Without this detail it is hard to judge how the ambitions written on the page will make a difference to the reality of the care we receive over the next few years,’ she said.
‘From what we can see in the plan, there will be regional pilots for some proposals, which means some areas of the country will see improvements to NHS services before others.’
‘Big bets’ on technology
On the changes to technology, which include an expansion of the NHS App, a greater use of AI, wearables, robotics and geonomics, the Health Foundation said the Government was placing ‘big bets on new innovation’.
‘Used effectively, the NHS App has the potential to empower patients and support them to better manage their health, make processes more convenient and improve efficiency,’ said Dr Dixon.
‘But it is just one part of more complex changes in services and behaviours needed to bring the NHS into the 21st century – changes that fundamentally depend on the hard work and dedication of NHS staff, working with patients and the public.’
Ms Stein from the Nuffield Trust agreed that ‘however good the NHS app gets, it will be down to NHS staff to deliver this plan’.
The King’s Fund also stated that there was an ‘urgent need to get the basics right first’, such as basic IT and outdated equipment.
Going further for patients
The plan has ‘gone further’ at putting patients at the core of the health service, according to Ms Stein from the Nuffield Trust.
‘Many plans have talked about putting patients at the heart of care, but this plan goes further, both in its tone and through tools like expanding the NHS app,’ she said.
She added that better technology alone ‘won’t fix systemic inequalities or the structures that have caused patients to feel powerless’, but that the plan is also reviewing the way GP practices are funded which is a ‘huge step forward’ and could ‘have a real impact on patient care’ if backed by the money promised.
Mr Taylor from NHS Confederation said that a key part of making the plan successful would be in ‘resetting the relationship between the NHS and the public so that local communities are placed at the heart of these reforms and people are supported to be active agents in their own health and wellbeing’.
Workforce needs detail
The plan also mentioned a number of measures around workforce, including giving £5m to 10 ICSs to support 1,000 young people and those from deprived backgrounds into pre-employment training, entry level roles or training posts, and to reduce dependency on international communities.
NHS Providers’ chief executive Daniel Elkeles said while a workforce of the right number and mix of skills was ‘fundamental’ to the success of the plan, that ‘we need to see the detail of how this is going to happen through the NHS Workforce Plan’. This plan is due later this year.
NHS Confederation’s Mr Taylor added that bringing care closer to home through neighbourhood health teams ‘recognises the complex and interconnected challenges many patients face’. But he said delivering on this would require ‘sustained investment in digital and estates, support for the NHS’s workforce, and a commitment to decentralise national control by empowering local leaders to do what is best for their communities’.
‘Extra capital funding will be vital if the NHS is going to be able to develop new community health centres,’ he added.
Partnerships are crucial
Local Government Association chair, Cllr Louise Gittins, said to realise the vision of the plan, ‘we all need to work differently together and with our communities’.
‘For the 10 year plan to succeed, it is absolutely paramount that all of the NHS, and its partners, engage fully and openly with councils across the country, and work collaboratively with us to deliver for our communities,’ she said.
Amerjit Chohan, chief executive of national healthcare volunteering charity Helpforce added that it ‘warmly welcomed’ the recognition of the role of volunteering in the rebuilding of the NHS.
‘Around 100,000 dedicated volunteers already make an immense contribution to the NHS through a myriad of roles ranging from community first responders and ward assistants to mealtime helpers and end of life companions. Together, they provide over 6.4 million hours of time every year,’ he said.
‘NHS volunteers used to be seen as a ‘nice to have’ but, as today’s announcement shows, health leaders and policymakers now recognise volunteering as a vital element of modern healthcare delivery, including helping to shift care from hospital to community settings.’
Mayor of Greater Manchester, Andy Burnham, also said in an integrated partnership update that he ‘welcomed’ the plan and that it would ‘build on’ a decade of partnership working in Manchester and emphasised that it was the UK’s ‘prevention demonstrator’.
‘Bringing health services closer to home through neighbourhood centres and teams is the approach that is already the driving force of our Live Well mission to transform how we deliver public services – putting practical support back into every neighbourhood, working with communities to tackle health and social inequalities, and breaking through the barriers to getting and holding down good jobs,’ he said.
Future direction is ‘clear’
In response to the publication of the plan, Kent and Medway ICB chief executive, Paul Bentley, said the ‘direction is clear’ for the health service going forward.
‘I am pleased the NHS in Kent and Medway has already been moving towards the shifts – acute to community, cure to prevention and analogue to digital – and in some areas is ahead of the curve, which is very positive,’ he said.
South East London ICB added that it would begin reviewing and aligning its medium term strategic plans in the summer and autumn to ‘ensure we are well placed to deliver on all aspects of the Plan in a coordinated, locally meaningful way’.
Andrew Bland, chief executive of NHS South East London ICB, added: ‘We are building a joined-up health and care system that’s shaped around people’s lives, not around organisations. This is about doing things differently, using technology and community-based prevention to deliver better outcomes, and working together across sectors to improve everyday experiences of care.’
The 10 year plan was revealed by the Government last week, following details of the plan that had already been unveiled, including a partnership between the Government and food retailers to tackle obesity, plans to increase patient access to information, review GP funding allocations as a way to tackle health inequalities, and enable patients to access clinical trials through the app.
