NHS planning guidance is rightly ambitious, but presents big challenges
31 January 2020
- NHS England and NHS Improvement have published the NHS operational planning and contracting guidance 2020/21.
- It stated that hospitals must reduce bed occupancy to below 92%, improve A&E performance against benchmarks, and reduce waiting lists.
- Half of centrally held financial support available to providers will be tied to the performance of their wider system, in new rules which will apply to the “financial recovery fund”.
- The NHS failed to spend over 70% of the £200m NHS apprenticeship levy.
- The target for 50,000 more nurses set by the government will be supported through a significant expansion of ethical international recruitment, driven by a new programme which will be established early in 2020.
- NHSX are in talks with health systems and providers to determine whether there is a “minimum and optimal” level of technology spending, based on how digitally advanced a trust is, and trusts will be expected to “begin introducing” video consultations in major outpatient services.
- Commissioners must carry out regular visits to patients with learning disabilities or autism who are sent to out of area hospitals, with children visited every six weeks and adults every eight weeks.
- It confirms the people plan will be published in March/April 2020.
Responding to the NHS operational planning and contracting guidance 2020/21, the chief executive of NHS Providers, Chris Hopson said:
“The planning guidance issued today provides more important detail about how the NHS will deliver the long term plan and make the required transition to integrated care, system working and a broader range of priorities than the old set of narrow acute hospital waiting time targets, important though these are.
“It’s right that the NHS is ambitious for patients. But we also need to recognise the context. This winter we have seen performance fall to the lowest levels recorded while the waiting list for routine surgery grows. There are over 105,000 vacancies in trusts alone, and each year we are seeing demand and the need for more complex care grow. And whilst we welcome the extra NHS funding the government has committed, this comes after the longest and deepest financial squeeze in NHS history and does not reflect a return to the long term trend: it’s no bonanza. In this context, improving waiting list performance, recovering financial deficits, starting to deliver the new priorities in the long term plan and the people plan, and taking the next steps in transforming the NHS is, collectively, a very big ask.
In this context, improving waiting list performance, recovering financial deficits, starting to deliver the new priorities in the long term plan and the people plan, and taking the next steps in transforming the NHS is, collectively, a very big ask.Chief Executive
“We particularly welcome the emphasis on prevention and wellbeing and health inequalities within this guidance and the recognition that mental health, community and ambulance services all have a vital role to play in providing great care to patients, alongside acute hospitals.
“While this guidance will enable trusts to plan for 2020/21,we still need to see the detail of the final people plan, the long term plan implementation plan, the results of the clinical review of standards, and the new NHS England and Improvement operating model and oversight framework. We also need a full multi year capital settlement and multi year education, training and public health revenue budgets. These will all follow over the next few months. Taken together, we will then have the complete new strategic framework the NHS frontline needs to underpin the long term plan.
While this guidance will enable trusts to plan for 2020/21,we still need to see the detail of the final people plan, the long term plan implementation plan, the results of the clinical review of standards, and the new NHS England and Improvement operating model and oversight framework.Chief Executive
“Workforce challenges remain a top priority for trusts. We welcome the ambition to increase nursing numbers but the NHS will also need to be properly supported to deliver the other key commitments in the people plan – making the NHS a great place to work, investing in leadership and training and enabling the NHS workforce to take full advantage of technology.
“Trusts will welcome changes to the financial system intended to support the provider sector to reduce its overall deficit. But we need to recognise that these are stretching targets. It is becoming clear the 20/21 starting point will be worse than envisaged even a few months ago, and that there are still a small number of trusts who are concerned they are being asked to deliver the impossible. We must avoid pressurising providers to sign up to unrealistic targets, or we risk revisiting the problems we had with the previous financial framework.”