Making the NHS Long Term Plan a reality: The challenge ahead

The NHS Long Term Plan that was released last week threw few surprises and continues the journey upon the path we are already on. Yet that takes nothing away from the fact that this is an ambitious plan. Essentially the key tenant of the plan is a renewed focus on expanding services outside of main site hospitals, in the direction of a more co-ordinated, preventative and individualised way for patients.

Making the plan a reality is now the biggest challenge facing the NHS. This is something we will be exploring over the coming months, and we are keen to hear your views.

Whilst there are a number of key issues, the focus for what we can positively help with include:
• Roll-out of ICS’s across the country
• Continued expansion of Urgent Care and Out-of-Hospital Care services
• Increase in Mental Health budget and performance metrics for Adult Mental Health
• Accelerated Turnaround Process for 30 worst financially performing Trusts
• Achieving Financial Balance by 2020/21
• Creating a more flexible workforce
• Improvements across Cancer and Stroke particularly

The NHS workforce plan due to be published later in the year, will be a fundamental moment in assessing whether the Long Term Plan can be effectively delivered. Together with the difficulty of delivering such a scale of transformation within the financial constraints. These two factors seem to be key in determining the eventual effectiveness of the plan.

Specifically looking at finance, the Long Term Plan states that the provider sector will return to balance in 2020/21. A new financial recovery fund will phase in a restoration of financial balance but what will this look like in reality is still uncertain. For example, will it create financial sustainability as opposed to just a bail-out fund which could be considered unfair to other Trusts not worthy of this funding. In addition, a faster financial turnaround process will be implemented for the worst performing trusts, currently standing at 30. Whilst great to read and sound in theory, it makes me question why this hasn’t been in place previously if the answers to these significant problems have been known all along. Having worked with countless Trusts in turnaround to provide solutions to their problems I will be most interested to hear the detail of this new approach.

There will also be a move to integrated care systems across the whole country by April 2021. This could create some activity on the interim market as second and third wave systems look to utilise the experience of senior managers who have led early adopters.

We believe that the NHS Long Term Plan will collapse or prosper depending on whether the outcomes are achievable both now and in the longer term. It is vital that performance and financial recovery trajectories, alongside productivity expectations are sensible but also the leadership are given the right, and moreover, effective levers with which to make meaningful change.

In short, whilst the Long Term Plan is a significant step forward, and we should be optimistic, several questions remain unanswered. Foremost is, to what extent will NHS Organisations and its leadership teams be given the right backing and authority to make significant changes. There should be no illusions about the scale of the challenge ahead. So what do you think these are?

We are interested in hearing now about the biggest challenge you will have to overcome in making this a reality.