Long term plan must allow the NHS to return to sustainable success

09 October 2018

The chief executive of NHS Providers, Chris Hopson, has said the forthcoming long term plan must be a ‘reset’ moment for NHS performance and finances.

Speaking at NHS Providers’ annual conference and exhibition, he hailed the ‘incredible achievements’ of NHS trusts over the last six years in treating more patients and service users than ever before while raising standards of care, at the same time as the longest financial squeeze in the history of the health service.

In that time, he said, the number of calls handled by ambulance trusts has risen by more than 30%, 180,000 more people are being treated within four hours in A & E, and mental health and learning disability trusts have led the world in introducing a new regime of outcome standards designed to improve treatment. Community trusts are often leading the way in rapidly improving care for patients by bringing together different parts of the health and care systems.

But he also pointed to the ‘incredibly frustrating paradox’ of a health service dealing with rapidly rising demand and realising record levels of savings while frontline staff work harder than ever, yet missing key performance and financial targets, resulting in a ‘permanent cycle of debilitating public failure’.

It is vital that we don’t lose the opportunity to create the performance and financial reset the NHS frontline so desperately needs.

Chris Hopson    

The long term plan, he said, must allow the provider sector to return to sustainable success, “to enable frontline staff and trust leaders to feel, once again, that their efforts are being properly reflected in a positive public narrative about how well the NHS is doing.”

He acknowledged that much of the current work on the long term plan is concentrated on the new commitments that politicians and NHS national leaders will want to make, but he warned it was “vital that we don’t lose the opportunity to create the performance and financial reset the NHS frontline so desperately needs.”

While recognising the responsibility of trust leaders to confront and deal with the challenges they face in ensuring the best possible care for patients and service users, he said they need “the right national framework and support so they can deliver an achievable and realistically prioritised operational task and transform their local systems.”


He went on to spell out what that meant for the long term plan, which must: 

“we need realism on the size, scope and nature of the demand challenge our NHS faces. And we need that realism reflected in all our plans, priorities and performance oversight.”

“hasn’t the time come to treat the workforce shortages providers now face as the crisis they have now become?”

“no unfunded commitments, no over ambitious assumptions, no aspirational wish lists.”

“end the current confusion and uncertainty on the journey from individual institutions to integrated local health and care systems.”

“it is local leaders to decide what is deliverable and what is not; what is safe and what is not….either we trust them or we don’t.”

We need realism on the size, scope and nature of the demand challenge our NHS faces. And we need that realism reflected in all our plans, priorities and performance oversight.

Chris Hopson    


Chris Hopson urged the government to avoid a Brexit that damages the NHS. He also said it must “ensure the NHS has the capital, public health and training budgets it needs when the next spending review completes its work. And, above all, it absolutely must develop a robust long-term solution to social care.”

He concluded that if the long term plan met the challenges he set out, it would allow frontline trust leaders to deliver what they do best – providing outstanding care to the patients they serve.

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