The NHS Long Term Plan: A bright future or an unsustainable one?

How do you future-proof the NHS for the decade ahead? Not an easy question. However, it is one NHS England Chief Executive Simon Stevens sought to address as he launched the NHS Long Term Plan last week. The plan focuses on offering practical solutions to a wide range of key issues from how services will be delivered, to tackling health inequalities and ensuring staff have appropriate backing. But with the ongoing staffing crisis affecting the NHS and the fast-approaching cloud of Brexit uncertainty, will it be sustainable?  

The prime minister announced an additional £20.5bn for the NHS over the next ten years. Using this fund, the plan looks to relieve some of the pressure on NHS staff by shifting the focus to earlier in the healthcare journey, to more preventative and community-focused strategies of improving population health. This approach is certainly welcomed. It is hoped that through the commitments set out in the plan to improve prevention, we will start to see increased collaboration between local governments, community services and the NHS.   Also welcomed is the focus on digitally-enabled care. The plan even sets out a vision for the NHS in ten years’ time:  

‘The NHS will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it. Primary care and outpatient services will have changed to a model of tiered escalation depending on need. Senior clinicians will be supported by digital tools, freeing trainees’ time to learn. When ill, people will be increasingly cared for in their own home, with the option for their physiology to be effortlessly monitored by wearable devices. People will be helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools.’  

It is great to see a realistic and practical approach to digital in the NHS, building on the vision of Matt Hancock, Health and Social Care Secretary, to develop ‘the most advanced health and care system in the world’.

The Long Term Plan outlines ten top level steps to drive digital transformation including using decision support and artificial intelligence (AI) to help clinicians apply best practice, and using intuitive tools to capture data in order to empower clinicians and reduce administrative burden.

On a more tangible level, the plan explains that WiFi is being installed across the NHS and rollout of the NHS app has begun, which will provide people with online access to NHS 111, their GP record and the ability to book appointments from their phone.   Elsewhere, the plan outlines commitments to drastically improve cancer survival, provide much improved services for mental health and halving maternity-related deaths.  

Overall, the NHS Long Term Plan has gained a positive response from many key stakeholders, including Macmillan Cancer Support, Mind and British Heart Foundation. However, there are concerns over long term sustainability. Success of the plan relies on adequate NHS staffing, however recent research by the King’s Fund[1] has highlighted an estimated staff shortage of 250,000 or more by 2030. And, while initiatives have been proposed to solve this issue, attracting essential overseas workers may become even more complex depending on what instance of Brexit is delivered. Waking up to a no-deal reality on 29^th March may well leave people asking the question ‘where will the money and the workers to deliver these NHS commitments come from?’  

Despite this uncertainty, the NHS Long Term Plan does provide a pragmatic and practical approach to improving health and care services of the next ten years. Future-proofing the NHS is not an easy task, however we hope that this plan will benefit the health of all for the years to come.  

Sources:

[1] Health Foundation, King’s Fund, Nuffield Trust. The health and care workforce in England: make or break? 2018. https://www.health.org.uk/publications/the-health-care-workforce-in-england