The development of the NHS long-term plan offers a reset moment for the NHS, and a chance to develop a credible, plan for improving care for patients and the public, that is owned by the sector.
At a time when the NHS is undergoing a period of rapid transformation, and services are facing ever-increasing pressures at the front line, the case for meaningful engagement with those who are using and delivering services has never been clearer.
"The prospect of a new NHS Assembly to help challenge and support the delivery of the long-term plan is therefore an idea whose time has come."
The prospect of a new NHS Assembly to help challenge and support the delivery of the long-term plan is therefore an idea whose time has come. It presents a timely opportunity for NHS leaders within the national bodies to re-establish clear lines of engagement and co-production with the frontline as a fundamental pillar of robust policy development.
Four core features of the NHS Assembly
Below, we set out four key elements for the NHS Assembly to meet its potential as an influential forum for discussing the priorities for the NHS going forward.
A clear purpose and vision…
The NHS Assembly is likely to be comprised of diverse groups across the health and care sector including representatives of commissioning, providers, patients and the independent and voluntary sectors. The role and remit of the assembly needs to be well-defined at the outset, to ensure a clear focus on how the long-term plan can provide the NHS with sustainable solutions to the pressures it faces.
…Underpinned by a realistic task for the sector, agreed with those involved in delivering the plan
We know that the NHS is under increasing financial and operational pressures. The provider sector ended 2017/18 with a deficit of nearly £1bn, an overall 8% staff vacancy rate, and ongoing under-performance against key constitutional targets like the 4-hour A&E target. Similar pressures and challenges are also being felt across primary and social care.
"Any ask of the NHS should be agreed with those involved in the development of the plan and supported by a clear and realistic plan for how the service will deliver it."
It's clear that the NHS needs significant financial investment, and the public will expect something in return for the additional funding provided by government, but any long-term plan needs to take into account the sector's starting point, and be realistic about what trusts can achieve with the funding available. The plan has a greater chance of succeeding if it is underpinned by meaningful input from the frontline right from the outset, to ensure its represents an achievable and sustainable task for the health sector. Any ask of the NHS should be agreed with those involved in the development of the plan and supported by a clear and realistic plan for how the service will deliver it.
Aligned with the ten-year plan
The NHS Assembly will not be convened in time to help inform the development of the long-term plan, so its members will need to be brought up to speed on the intentions and background to the proposals set out in the plan, so that these priorities can be carried through in the work of the assembly.
Inclusive and representative
NHS trusts, clinicians, commissioners and other NHS staff on the frontline will be responsible for the front-line delivery of the NHS long-term plan, and it is patients, the public and carers who will see the impact of any policy proposals set out in the plan. So it's essential to make sure that the voices of those involved are heard. This includes membership organisations, royal colleges, and, importantly, patient representative groups.
"While the NHS Assembly is a welcome new development, it cannot provide the depth and breadth of engagement needed to design an achievable long-term plan for the NHS alone. There is a need for engagement with the bodies representing different parts of the NHS to continue alongside the work of the assembly."
While the NHS Assembly is a welcome new development, it cannot provide the depth and breadth of engagement needed to design an achievable long-term plan for the NHS alone. There is a need for regular, detailed and bespoke engagement with the bodies representing different parts of the NHS and the workforce within them, and those representing patients, carers and families, to continue alongside the work of the assembly.
As the membership body for trusts within the sector, we look forward to working with the national bodies to help ensure the success of the new assembly, and to play our part in ensuring the voice of the frontline continues to be heard as we seek to meet our ambitions for the NHS over the next decade.