NHS long term plan must be ambitious but realistic
10 September 2018
The forthcoming NHS long term plan can improve patient care and cement public trust in the NHS, but it must free the health service from a debilitating cycle of missed performance and financial targets, according to a new briefing from NHS Providers.
Five tests for the NHS long term plan sets out conditions for an ambitious and sustainable NHS, while recognising the many challenges the service faces.
The briefing shows that, over the last four years, trusts have treated more patients than ever before; realised much higher levels of efficiency saving than the economy as a whole and maintained the quality of care despite major workforce shortages. But, despite this hard work at the frontline, we have also seen a sustained failure to meet key performance targets, significant financial deficits for providers, and problems recruiting and retaining staff.
Over the last four years, trusts have treated more patients than ever before; realised much higher levels of efficiency saving than the economy as a whole and maintained the quality of care despite major workforce shortages.
The briefing therefore says that the plan must be firmly grounded in the reality of where the NHS, and its partners in social care, currently are: a 2017/18 provider sector deficit of nearly £1 billion, sustained underperformance against constitutional targets, an ageing infrastructure misaligned with care needs, and an overall 8% staff vacancy rate. The briefing also warns that the past four years show that setting trusts an unrealistic task locks them into a debilitating cycle of failure, damaging staff morale and the reputation of the NHS.
The new plan will only work if the government plays its part by dealing decisively with the funding crisis in social care, and by investing in public health to ease preventable pressures on the health service.
The briefing also argues that the new plan will only work if the government plays its part by dealing decisively with the funding crisis in social care, and by investing in public health to ease preventable pressures on the health service. Government also needs to make the right decisions on capital spending to modernise and renew buildings and technology, and funding for staff training. Beyond that, it underlines the importance of the government securing a good Brexit deal that protects the NHS. It also emphasises the need for the NHS to transform and invest in more integrated models of care, recognising that the current overall model of care is no longer sustainable.
The five tests set out why the long term plan should:
- be centred around patients, service users, carers and families
- be realistic and deliverable
- be underpinned by a credible and sustainable workforce strategy
- lay the groundwork for a sustainable high-performing service
- support local good governance, autonomy and accountability
The chief executive of NHS Providers, Chris Hopson, said:
“The new NHS long term plan presents a great opportunity to adapt and improve the NHS to meet society’s growing and changing healthcare needs.
“We should not underestimate the challenges ahead in restoring performance, recovering finances, and integrating services to provide efficient, seamless care closer to home.
“It is also vital that we plan now to secure the workforce we will need in the years to come.
“The plan must confront the reality of growing demand for treatment as a result of our older, growing, population and the increasing number of people living with long term conditions. We must have a plan that honestly sets out how we will work together as a health and care system to cope with this demand.
“No one is more ambitious for the NHS than frontline trusts and their staff who deliver care day in day out.
“Over the last four years, they have worked incredibly hard to treat more patients than ever before within target times and improve standards of care, despite widespread workforce shortages. They have also managed to reduce a ballooning £2 billion deficit, successfully pioneered new approaches to care and pushed ahead with local system working, integrating health and care to make it more seamless, convenient and efficient.
“But the plan must also reset what is asked of providers so that the vast majority of trusts, performing well, can return to being successful in delivering the care that patients and the public rightly expect.
“Assumptions about what can be achieved, and how quickly, must be realistic. That means listening carefully to frontline trusts, and winning their commitment to a plan that can be delivered, rather than setting them up to fail.
“If we are guided by the five tests set out here, we can put the NHS back on the path to success.”