NHS Long term plan
In January 2019, the NHS published its long term plan.
The 10-year plan followed a government commitment on the NHS' 70th birthday to increase its funding for the period 2019–24, taking real-term funding increases from 2.2% to 3.4% on average for NHS England. It sought to build on the Five year forward view for the NHS in England from 2014. Although the funding commitment for the period 2019/20–2023/24 was for the NHS England, rather than local government and other providers of public health and adult social care services, the plan also addressed priorities relevant to these sectors.
The plan aimed to deliver improved health in early childhood years, early diagnosis and prevention of major health problems, increased investment in mental health, and support for people to age well with greater autonomy and independence. The plan also included a focus on how to better employ data and digital technology in the NHS.
In the plan, the NHS stated the need to address workforce planning issues and ensure post-Brexit migration policy would work for the health and social care workforce.
Other key inclusions were:
- prevention commitments to tackle rates of smoking, obesity and alcohol addiction; reducing antimicrobial resistance; reducing air pollution; and addressing gambling addiction
- ambitions to improve the environmental sustainability of the NHS through measures including changing to lower carbon inhalers, adapting anaesthetic practices, and reducing single-use plastics in the supply chain
- learning disability and autism as a clinical priority for the first time in an NHS plan, with commitments on existing initiatives under the Transforming Care programme to improve services so that more people with a learning disability and/or autism could be cared for in the community.
Integration and a place-based, local health system approach were central to how the NHS would deliver these promises.
The plan highlighted the complementary role of local government in public health and preventative health services, adult social care and wider determinants of health, and the need for government funding in these areas to avoid impact on the NHS.
The plan mentioned that the proposed green paper on adult social care (first announced in March 2017) would include further proposals for integrating health and social care. The plan outlined that people with social care needs would receive more support from the NHS through community health teams and the expansion of personal health budgets.
STPs and ICSs
The NHS asked Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) to prepare and publish their own 5-year implementation plans.
Primary care networks
In primary care, the plan introduced the concept of ‘primary care networks’ to fund GP practices to work together as 'genuinely integrated teams of GPs, community health and social care staff’.
The response to the ambitions of the long term plan was generally positive, but the Nuffield Trust, King’s Fund and Health Foundation thinktanks highlighted workforce shortages, a potential no-deal Brexit, an underfunded public health sector and an unreformed social care system as obstacles to the plan’s implementation.
These challenges were echoed in the House of Commons. Responding to Secretary of State for Health and Social Care Matt Hancock’s announcement, Labour MP Jonathan Ashworth said: ‘There are many welcome ambitions from NHS England today, but... those ambitions will be hindered by... no plan to recruit the staff we need… no plan for social care and... deep cuts to public health services’.
The NHS Long term plan.
NHS England; 2019.
Staff shortages and prospect of no deal Brexit threaten to undermine ambitious NHS plan.
Nuffied Trust; 2019.
House of Commons.
NHS Long term plan. 7 January 2019: Vol 652 Col 62-84.
The King’s Fund.
The King’s Fund response to the NHS long term plan.
The King’s Fund; 2019.
NHS Long term plan launch: pragmatic and ambitious, but making it a reality will be tough.
Health Foundation; 2019.