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7 January 2019

Mixed reception for NHS England long-term plan

More money is always welcome, but concerns over funding and staffing levels persist.

By Rohan Banerjee

NHS England has unveiled its new long-term plan, which includes increased funding over the next ten years to help to improve the early detection of diseases and create a more preventive healthcare system which the government claims could save half a million lives.

The 136-page document explains how the NHS will spend the extra £20.5bn of budget the Prime Minister pledged last summer to mark the organisation’s 70th anniversary. This will bring the NHS’s total budget in England to £135bn by 2023-24, representing an annual increase in spending of just under 3.5 per cent each year until then.

But Chris Hopson, chief executive of NHS Providers, the trade body for hospitals, mental health and ambulance services, has suggested that “a decade of austerity” has left the NHS with “a lot of catching up” to do. “The funding settlement – while welcome – does little more than cover rising costs and demand,” Hopson said.

The most significant increases in funding will go to GPs, mental health services and community care, which account for less than a quarter of current NHS spending. It is hoped that this will relieve the current pressure on hospitals.

A new focus on community-based, rather than hospital-based, primary care also includes “24-7 rapid response teams” made up of doctors, nurses and physiotherapists. However Dr Jennifer Dixon, chief executive of the think tank The Health Foundation, pointed out that the NHS’s existing staffing issues – official figures show that one in every 11 posts is vacant –  will not be solved solely by reorganisation. While Dixon praised “a pragmatic plan with an ambitious vision to improve NHS care,” she said that “making it a reality will be extremely tough. The NHS is already short of 100,000 doctors, nurses and other staff.”

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“While there are initiatives in the [long-term] plan to build the workforce,” Dixon said, “they need to be matched with action from central government to secure training budgets and a supportive migration policy to allow international recruitment that is vital to staffing the NHS.”

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The long-term plan also states that new technologies and digitisation of existing services will make the healthcare system better equipped to streamline and personalise treatments, and to reach earlier diagnoses of conditions. NHS England added that it wanted to make “better use of data” and outlined plans for online GP bookings and consultations, DNA testing for people with rare genetic conditions, as well as for investment in surgical robots.    

Sarah Wilkinson, chief executive of NHS Digital, hopes that new technologies can become “pervasive” across health and social care, which will be crucial to empowering “individuals to take a much more proactive and responsible approach to monitoring their own health and wellbeing.” She said: “We know how challenging it can be for organisations, particularly those under constant pressure to deliver critical services, to adopt new technology and digital systems. We are completely committed to supporting NHS organisations on all aspects of this journey from technical education, to integrating new technology into services and care pathways to the design of highly usable and accessible patient-facing solutions.”