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Eight things you need to know about the NHS long term plan


By Rachel Carter
8 January 2019

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The NHS long term plan, which details how the health service will redesign and deliver patient care over the next decade, was published yesterday.

The plan was commissioned by Prime Minister Theresa May in the summer, when she announced additional funding for the NHS to mark its 70th birthday.

Here are eight things healthcare leaders should know about the plan:

1.Primary and community care services get a bigger chunk of the NHS budget

Primary and community care services will get a £4.5bn funding boost by 2023-24 as part of the long term plan. The plan states that: ‘this is the first time in the history of the NHS that real terms funding for primary and community health services is guaranteed to grow faster than the rising NHS budget overall’.

2. All GP practices have to join a primary care network

The long term plan confirms the government’s commitment to primary care networks and all individual GP practices in a local area will have to enter into a network contract. The networks are based on GP registered lists and typically cover 30-50,000 patients.

They will include ‘expanded neighbourhood teams’, comprising professionals ranging from pharmacists, GPs and district nurses, to dementia workers and allied health professionals such as physiotherapists.

3. Mental health services are also getting a funding boost

The plan creates a ring-fenced local investment fund for mental health services, which will be worth at least £2.3bn a year by 2023-24. This is expected to help services expand and improve access to community and crisis services for both adults, children and young people.

4.  Integrated Care Systems to cover all of England by 2021

Integrated Care Systems (ICSs), which bring together health and social care organisations, will be ‘central to the delivery of the long term plan’ and should be working across the country by April 2021, the NHS has said. Each local system will be supported to implement a timetabled development plan, with intensive support available for struggling areas.

5. Urgent and emergency care service reform continues

The long term plan pledges to reduce the pressure on A&E services by continuing to implement a raft of reforms. This includes fully rolling out the urgent treatment centre model, which has streamlined minor injury units and walk-in centres into a standardised offer for out-of-hospital urgent care, by the autumn of 2020.

The same day emergency care model, which uses new diagnostic and treatment practices to avoid admission to wards, will also be set up in every acute hospital with a type 1 A&E department by 2019-20.

6. Workforce planning will be less disjointed

The plan recognises the strain on the NHS workforce and reaffirms a commitment to recruiting more doctors and nurses. It says that NHS Improvement is now better aligned with Health Education England, which will lead to less disjointed workforce planning, and sets out a number of specific workforce actions designed to have a ‘positive impact now’.

A full workforce implementation plan will be published later in 2019, the document says, after the extra funding available for training, education and continuing professional development through the Health Education England budget has been set by the government.

7. A new commitment to improving prevention and tackling health inequalities

The plan sets out new actions that the NHS will take to improve prevention of avoidable illnesses, with one example being to offer NHS-funded tobacco treatment services to all smokers admitted to hospital by 2023-24, based on a model used in Canada and Manchester.

It also pledges ‘stronger action’ on tackling health inequality, which includes making up to £30m available to improve specialist NHS mental health services for homeless people.

8.A ‘digital first’ option for most patients by the end of the decade

The plan lists a series of ‘practical priorities’ to take forward digital NHS transformation, with the long-term view that a ‘digital first’ option will be available to most patients in ten years’ time.

This includes, over the next three years, ensuring that staff working in the community have access to mobile digital services, including patient records and care plans.

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