The NHS Long Term Plan has now been published following several days of snippets being fed to the media on the benefits which the Plan will seek to introduce.
The NHS Long Term Plan has now been published following several days of snippets being fed to the media on the benefits which the Plan will seek to introduce. It sets out three main ambitions for future care provision:
Then it goes on to look at how these ambitions will be delivered with sustainability and transformation partnerships (STPs) and integrated care systems (ICSs), by looking at five main challenges:
1. Doing things differently: the NHS will give people more control over their own health and the care they receive, encourage more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘integrated care systems’, to plan and deliver services which meet the needs of their communities.
2. Preventing illness and tackling health inequalities: the NHS will increase its contribution to tackling some of the most significant causes of ill health, including new action to help people stop smoking, overcome drinking problems and avoid Type 2 diabetes, with a particular focus on the communities and groups of people most affected by these problems.
3. Backing our workforce: Increased NHS workforce, training and recruiting more professionals – including thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. The NHS will be a better place to work, so more staff stay in the NHS and feel able to make better use of their skills and experience for patients.
4. Making better use of data and digital technology: More convenient access to services and health information for patients, with the new NHS App as a digital ‘front door’, better access to digital tools and patient records for staff, and improvements to the planning and delivery of services based on the analysis of patient and population data.
5. Getting the most out of taxpayers’ investment in the NHS: Working with doctors and other health professionals to identify ways to reduce duplication in how clinical services are delivered, make better use of the NHS’s combined buying power to get commonly-used products for cheaper, and reduce spend on administration.
In terms of ICSs, the Plan envisages these will cover the country by 2021, which for the first time, sets a clear development timetable. Our experience is that no system is the same and that many have the main components in place, they just need to be set in a clear governance framework. This then enables the development and implementation of system plans in place and neighbourhood.
The digital revolution agenda, strongly advocated by Matt Hancock, also features prominently in the Plan. It is clearly integral to better care and protection, and enables the greater involvement of individuals in decisions about them. Understanding how to leverage and procure better digital technology across regions, which can work with other systems nationally, is a major discussion point with clients to ensure the NHS pound is effectively spent. It is also important to look at existing systems and consider how from primary care/neighbourhood they can enable integrated care.
The expectations above are not unexpected and follow on from the shorter term framework of the Government’s Mandate to NHS England published each year, which sets its objectives and budget. As to how the Long Term Plan will be met within STPs and ICSs, then each is expected to develop and implement its own strategies for the next five years. Many of our clients have anticipated this approach and are looking at effectively developing their own local Mandate to reflect local needs. This will allow multiple organisations to develop an overall plan and consider the needs which other locally developed documents, such as Joint Strategic Needs Assessment (JSNAs), have identified so they can meet their statutory and Long Term Plan objectives.
The Plan also considers the need for legislative reform as a mechanism to support more rapid progress, rather than being necessary because the current statutory framework prevents the delivery of the Plan. Specifically, it is noted that the framework encourages autonomous rather than collective working and has rules and processes for procurement, pricing and mergers that are skewed towards fostering competition rather than enabling integration. As a result the proposals put forward for change to legislation, which were invited by the Government, and which we have discussed with many clients during supporting their STP and ICS development work are (page 113 of the long term plan):
The view is that in undertaking the above reform then the Government will meet the views espoused by Aneurin Bevan in 1946 when he said:
“That is always the process of legislation in this country. It starts off by voluntary effort, it starts off by empirical experiment, it starts by improvisation. It then establishes itself by merit, and ultimately at some stage or other the State steps in and makes what was started by voluntary action and experiment a universal service.”
Browne Jacobson LLP has been supporting STPs and ICSs across the country for a number of years and we have worked with a number of organisations to enable the NHS to better understand how to operate within the statutory framework and meet the new expectations of national bodies and Government.
With our clients we have been at the forefront of developing innovative new ways of working to meet STP plan expectations and we are always happy to share our knowledge with both existing and new clients.
Contact Gerard Hanratty to discuss how we can help you with your STP plan and integrated working.
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