NHS plan due on Monday but workforce chapter to come later

The document, which was originally scheduled for release during December, is now expected on Monday and has been billed over the weekend as a “historic step” by the prime minister.

“The launch of the NHS long-term plan marks an historic step to secure its future”

Theresa May

The 10-year blueprint will set out how the £20.5bn annual budget increase promised by prime minister Theresa May will be spent.

An announcement by Number 10 today identified priorities for the plan as improved access for mental health services and a major expansion of personal health budgets.

In addition, it will prioritise improvements in maternity, older people, outcomes for major conditions, digital access to services, and cutting waste including back office savings of £700m.

It was also expected by many to include a substantial chapter on workforce planning, but the government has now indicated that this part of the of plan will come at a later date to the main document.

However, the Royal College of Nursing warned today that NHS England and the government “must urgently” address chronic shortages of nurses and other staff to make the new plan a success.

For example, in June when she first announced the development of the document, Ms May said more opportunities for flexible working and career development would be among key measures to feature in the plan, which she said would “reset the deal between the NHS and its staff”.

Over the last few weeks, NHS England and the Department of Health and Social Care have been drip-feeding some of the policies and initiatives that are to be included in the long-term plan.

For example, it was revealed yesterday that problem drinkers and smokers who end up in hospital will be helped by dedicated new services, as part of the plan.

Forming part of new health service prevention measures, people who are alcohol dependent will be helped by new “alcohol care teams”, said NHS England on Saturday.

In addition, more than half a million patients who smoke will be “helped to stop” in a new drive that will see all smokers admitted to hospital encouraged to quit.

“NHS staff are waiting for a further plan to address the extra staff needed to keep care at the highest quality”

Donna Kinnair

Meanwhile, over the festive period, the government announced that a maternity shake-up will form part of the long-term plan.

Ministers promised a major redesign of neonatal services, led by an expansion in staff numbers including more specialist nurses.

In addition, child health records – the “red book” – will be digitised and digital maternity records for 100,000 women will be piloted by the end of 2019.

In addition, NHS England said that national funding for children’s hospices is to rise by as much as £25m a year.

However, the total annual increase would be dependent on local commissioning bodies agreeing to match the rise in funding on offer from NHS England.

Other policies set to be in the plan have previously been revealed as well, including supporting earlier diagnosis of cancer, new mental health crisis services, and providing early intervention for people with a learning disability or autism.

The prime minister has paved the way for the launch of the plan next week with interviews on Sky News and the BBC’s Andrew Marr programme, and a newspaper column in the Mail on Sunday.

“The launch of the NHS long-term plan marks an historic step to secure its future and offers a vision for the service for the next 10 years, with a focus on ensuring that every pound is spent in a way that will most benefit patients,” she said.

“This will help relieve pressure on the NHS while providing the basis to transform care with world-class treatments,” said Ms May in the newspaper.

However, she admitted that the extra money would mean “less room for manoeuvre” for other areas of public spending, but that it was the right decision.

“The NHS has always been the country’s most beloved public service – there to provide outstanding care to us all whenever it is needed,” she added.

Speaking ahead of the plan’s release, Dame Donna Kinnair, acting chief executive and general secretary of the RCN, said: “Nurses and other professionals in the NHS share this level of ambition and the RCN welcomes a plan that keeps the NHS a world leader and true to its roots.

“But, when existing services are already under strain, NHS staff are waiting for a further plan to address the extra staff needed to keep care at the highest quality,” she said.

“The NHS in England is already short of more than 40,000 nurses and the figure is rising,” she said. “NHS England and the government must urgently address these chronic shortages to make the plan the success it deserves to be.”

“Without a solution to the growing crisis in social care, people will continue to suffer unnecessarily”

Jennifer Dixon

She added: “If the NHS is to better meet the needs of patients and the public, in these important areas of mental illness, cancer and long-term conditions, it must recognise the value of the highly skilled and qualified nursing workforce and the harsh realities on the NHS frontline.”

Unison head of health Sara Gorton said: “Encouraging people to take better care of themselves won’t alone solve the growing crisis in the NHS. That can only be halted with proper funding and a sensible plan to fill the huge staffing gaps that now exist in every part of the health service.

“Without the staff, there is no NHS,” she said. ”Ministers must say more about how they plan to address the staffing shortages that are playing havoc with the NHS’ ability to cope.

“Tackling the growing problem of violent attacks on staff and providing better support to frazzled and overwhelmed employees would encourage many to stay in the NHS. Improving training would allow others to add to their experience and move into more senior jobs,” said Ms Gorton.

She added: “Proper and prompt funding of social care would also reduce the pressure on the health service. These are huge challenges and ones that the government must not duck if the NHS is to continue to be there for us all.”

Jennifer Dixon, chief executive of the Health Foundation, said: “The prime minister’s promises to improve mental health and other NHS services are welcome, but making them a reality will be extremely tough given growing pressures on services, chronic staff shortages, and cuts to other parts of the health and care system.

“While £20.5bn extra funding promised for NHS England by 2023-24 is generous compared with other public services, it is barely enough to keep pace with growing demand for care,” she said. “This means trade-offs are inevitable.”

Ms Dixon also highlighted the challenges of Brexit, cuts to council public health budgets and the continued delay to the social paper green paper.

“Without a solution to the growing crisis in social care, people will continue to suffer unnecessarily, and more pressure will be piled on the NHS,” she said. “Yet the government’s green paper on social care funding is still yet to appear.

“Continued cuts to public health and local authority budgets will hold back the NHS’s ambitions to keep people healthy and tackle unjust differences in health between the best and worst off,” she said. “Next year’s public health grant would cut spending by £240m in real terms.

“And a no-deal Brexit risks making the NHS’s workforce problems even worse,” she said. “Currently there is a shortage of around 100,000 doctors, nurses and other crucial NHS staff.”

Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “The government is right – we need to do much more to improve the health of the nation through better prevention and detection of disease.

“But ambition is one thing, action is something else,” he said. “We will need to see more detail of how this will be achieved – budgets for public health have been significantly cut in recent years.

“And while we recognise the health and social care secretary’s desire to target people who are most in need of advice and support, this should not come at the expense of more blanket measures that are proven to have success, such as minimum alcohol pricing,” he said.

“We also welcome the ambitious plans to improve access to mental health services for children and young adults, and the public more generally. Providing more support for patients with depression and other common conditions, through treatments such as talking therapies, should help reduce the rising demand for mental health services,” said Mr Dickson.

”But other core areas of mental health services for the acutely ill are also under enormous strain and need more resources if they are to cope over the next few years. There is still a gap that needs to be filled between the government’s laudable ambitions and the reality on the frontline,” he said.

“What’s more, to meet the government’s ambitions for the NHS over the next decade we need the right staff with the right skills,” he said. “With 100,000 vacancies across the NHS in England, even if you gave the health service its £20bn up front, it would not be able to provide the care people need.

“It is, therefore, disappointing that the planned workforce strategy looks as if it will be delayed until later this year,” he stated.

“The NHS frontline wants an ambitious plan but, above all, a realistic and deliverable plan”

Chris Hopson

The chief executive of NHS Providers, Chris Hopson, said: “No one is more ambitious than NHS trusts to deliver world class standards of care for patients and service users and it is right that we should aim high.

“But the funding settlement – while welcome – does little more than cover rising costs and demand,” he said. “We’re also constrained by severe workforce shortages.

“The NHS frontline wants an ambitious plan but, above all, a realistic and deliverable plan,” he said. “A plan that’s crystal clear on how the NHS will recover the ground we’ve lost on finance and performance, that solves current workforce shortages and is realistic about how any new commitments are going to be paid for and staffed.”

He added: “We must avoid an undeliverable wish list that makes too many promises as over promising sets the NHS up to fail.”

https://www.nursingtimes.net/news/policies-and-guidance/nhs-plan-due-on-monday-but-workforce-chapter-to-come-later/7027294.article