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NHS long-term plan features new model for A&Es

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A new “same day” model for emergency departments and a further cash boost for primary and community services are to be set out in the NHS long-term plan, being launched today.

Health Service Journal reports that the long awaited plan, which NHS England also pledged would save “almost half a million more lives” by reducing premature mortality, will also propose new access targets for mental health and a big expansion of personal health budgets.

The government also confirmed that a workforce strategy – previously slated for publication alongside the NHS plan – will not be ready until “later this year”.

And Ms May declined during a BBC interview to repeat a pledge she made in June that the £20bn funding boost would ensure the NHS gets back to meeting its statutory targets.

The national commissioner also said ahead of the plan that one of the major short-term priorities would be a new target to “ensure every hospital with a major A&E department has ‘same day emergency care’ in place”. It is understood this amounts to setting up new ambulatory care units.

NHS England said these would mean “patients can be treated and discharged with the right package of support, without needing an overnight stay”. Its statement indicated the proposals on accident and emergency would be targeted for the first or second year of the plan.

Meanwhile, health and social care secretary Matt Hancock told Sky News the plan would commit £4.5bn real terms growth to primary medical and community services over five years – £1bn more than the £3.5bn of funding originally announced for the sectors in November. This will see funding for those services grow faster than the NHS overall. NHS England said it would fund “a new service model”.

On personalised care, the Department of Health & Social Care told HSJ the “comprehensive model for personalised care” – which includes social prescribing, personal health/care budgets, and care planning – would be extended to 2.5 million people over five years. This will include 500,000 personal health budgets – up from fewer than 40,000 currently.

NHS England said its primary care plans, and new treatments, “coupled with early detection and a renewed focus on prevention [would] stop an estimated 85,000 premature deaths each year”.

This will include stopping 150,000 heart attacks, strokes and dementia cases “while more than three million people will benefit from new and improved stroke, respiratory and cardiac services over the next decade”.

“Patients will benefit from services ranging from improved neonatal care for new parents and babies to life changing stroke therapy and integrated support to keep older people out of hospital, living longer and more independent lives,” it added.

It also confirmed its commitment that mental health funding would rise by “at least £2.3bn a year by 2023-24”, which should see it rise slightly as a share of NHS spend.

The plan follows ministers announcing last year the NHS would receive a 3.4% five-year NHS funding settlement.

NHSE also said in its statement it had been “realistic about inevitable continuing demand growth from our growing and ageing population, increasing concern about areas of longstanding unmet need [and] the practical realities of phased workforce expansion”.

NHS Providers said the “NHS frontline wanted an ambitious plan” but warned: “We must avoid an undeliverable wish list that makes too many promises as over promising sets the NHS up to fail.”

The Nuffield Trust said “the goals of this ambitious plan look right” but warned that the biggest barrier to achieving them would be resolving the workforce crisis, which was tied up with the UK’s exit from the European Union and its ability to retain and recruit foreign workers.

Responding to the plan, Ian Hudspeth (Con), chair of the Local Government Association’s community wellbeing board, welcomed the focus on prevention, early support and reduced health inequalities.

However, he added: “We feel this is a missed opportunity for the government to also launch its long-awaited adult social care green paper and proposals for the sustainable funding of these services.

“To help the NHS make its extra funding go further and alleviate the pressures on the health service, it is essential that the government plugs the £3.6bn funding gap facing adult social care by 2025 and reverses the £600m in reductions to councils’ public health grants.

“The current system of social care is unsustainable and will buckle under the weight of demand unless the government urgently invests in these essential services, which protect health, prevent sickness and are the surest way to reduce hospital admissions.” 

In her BBC interview yesterday, Ms May said proposals to make the social care system sustainable in the long-term would be brought forward ”at the earliest opportunity”.


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