These priorities include cancer, cardiovascular disease, maternity and neonatal health, mental health see separate section below , stroke, diabetes and respiratory care. In cancer care, the plan aims to boost survival by speeding up diagnosis. It includes a package of measures to extend screening and overhaul diagnostic services with the aim of diagnosing 75 per cent of cancers at stages I or II by A review of cancer screening programmes and diagnostic capacity will also be undertaken to report back in the summer.
The maternity and neonatal section builds on the measures being implemented following the National Maternity Review with the aim of halving still births, maternal mortality, neonatal mortality and serious brain injury in newborn babies by Among a range of commitments, continuity of care during pregnancy, birth and after birth will be improved, bed capacity in intensive neonatal care will increase in areas where this is currently lacking and mental health services and other support for pregnant women and new mothers will be improved.
The plan sets out a number of actions to improve detection and care for people with cardiovascular disease CVD and respiratory disease, prevent diabetes and improve stroke services. The aim is to prevent up to , cases of heart attack, stroke and dementia over the next 10 years. In line with the Forward View and the General practice forward view , improving care outside hospitals is one of the headline commitments in the plan. The plan confirms that general practices will join together to form primary care networks — groups of neighbouring practices typically covering 30—50, people.
Practices will enter network contracts, alongside their existing contracts, which will include a single fund through which network resources will flow. There is also a strong emphasis on developing digital services so that within five years, all patients will have the right to access GP consultations via telephone or online. This will involve developing multidisciplinary teams, including GPs, pharmacists, district nurses, and allied health professionals working across primary care and hospital sites.
Over the next five years, all parts of the country will be required to increase capacity in these teams so that crisis response services can meet response times set out in guidelines by the National Institute for Health and Care Excellence NICE. As with primary and community services, national leaders have used the long-term plan to reassert their commitment to improving mental health services, both for adults and for children and young people.
It also highlights the need for capital investment, as identified by a recent review of the Mental Health Act, to ensure suitable therapeutic environments for inpatients. There are two significant commitments to developing new models of care. The first is to create a comprehensive offer for children and young people, from birth to age 25, with a view to tackling problems with transitions of care.
There is also a strong focus on improving care for people with learning disabilities and autism. Commitments include increasing access to support for children and young people with an autism diagnosis, developing new models of care to provide care closer to home and investing in intensive, crisis and forensic community support.
The plan commits to rolling out urgent treatment centres UTCs across the country by so that urgent care outside hospitals becomes more consistent for patients. The plan estimates that up to one-third of all people admitted to hospital in an emergency could be discharged on the same day by rolling out this model.
Ambulance services are tasked with implementing the recommendations of a recent review of operational performance led by Lord Carter and will be subject to a new commissioning framework. Unlike some previous NHS strategies, the long-term plan does not assume that moves to strengthen primary and community care will reduce demand for inpatient hospital care. Instead, its plans for hospital bed numbers and staffing assume that acute care will grow broadly in line with the past three years although the plan does not specify what figure it is using for this.
The plan includes an ambitious pledge to use technology to fundamentally redesign outpatient services over five years. It is not yet clear what this redesign will involve. Although the plan notes that these changes will have implications for how waiting times performance is calculated, there is no commitment to meet the 92 per cent target for week waits.
Instead, over five years, the volume of planned activity will increase year-on-year to reduce long waits and cut the number of people on the waiting list currently more than 4 million. The commitment to reduce long waits is given teeth by the reintroduction of fines for providers and commissioners where patients wait 12 months or more. Reducing delayed discharges from hospital remains a priority. The plan aims to cut the average number of daily delayed transfers of care DTOC beds to around 4, and maintain that level over the next two years before reducing it further DTOC beds averaged 4, in November Changes to primary and community care may help here, although investment in social care will also be crucial.
The plan signals changes to the configuration of hospital services. Trusts will be supported to collaborate to improve services for example, through provider groups and, where appropriate, formal mergers will be green-lighted.
Further consolidation of specialist stroke services is also signalled and there is a commitment to a standard delivery model for smaller acute hospitals serving rural populations. When the Prime Minister announced the new funding settlement, she was clear that, over time, all NHS organisations should get back into balance. The penultimate chapter of the plan sets out how this will be achieved.
Much of the detail relating to these initiatives is left to the recently published Planning Guidance. The problems currently being experienced by providers partly reflect flaws in an NHS financial regime that is in desperate need of reform. The measures in the plan — which follow on from changes to the system of central financial support already announced by national NHS bodies — are an effort to address this. There are a number of measures aimed at supporting delivery of integrated care and incentivising system-based working to improve population health.
Workforce shortages are currently the biggest challenge facing the health service. The plan explicitly recognises the scale of this challenge and sets out a number of specific measures to address it.
However, many wider changes will not be finalised until after the Spending Review, when the budget for training, education and continuing professional development CPD is set.
For nursing, the aim is to reduce the vacancy rate from More accessible routes into nursing will also be introduced, including a new online nursing degree linked to guaranteed clinical placements and continued investment to support an expansion of apprenticeships, with new nursing associates starting in There is also an ambition to shift the balance from specialised to generalist roles in line with the needs of patients with multiple long-term conditions.
To support general practice, the intention is to continue to increase the number of other members of the primary care team, such as clinical pharmacists and physiotherapists, although much of the detail on this is again left to the forthcoming workforce implementation plan.
The plan sets a long-term ambition to train more staff domestically. In the meantime, it emphasises the need for a continued inflow of international recruits.
The forthcoming workforce implementation plan will outline new national arrangements to support NHS organisations with overseas recruitment and explore the potential to expand the Medical Training Initiative. By the end of the year period covered by the plan, the vision is for people to be increasingly cared for and supported at home using remote monitoring via wearable devices and digital tools.
Digital technology will also facilitate service transformation, including the redesign of outpatient services and reorganisations of pathology and diagnostic imaging services. This will involve NHS organisations putting in place electronic records and a range of other digital capabilities.
The Global Digital Exemplars programme will admit new organisations and create models for technology adoption and a shared record through Local Health and Care Record Exemplars.
To facilitate these changes, a number of policies previously announced by the Secretary of State have now become firm commitments. Similarly, to promote interoperability, there is now a commitment to introduce controls during to ensure that technology suppliers to the NHS comply with agreed standards.
Once established, the national workforce group will also consider a range of options to improve the NHS leadership pipeline, including expanding the NHS graduate management training scheme and the potential for a professional registration scheme for senior NHS leaders. All of these actions will build on existing recommendations in the national strategic framework, Developing people — improving care. The plan also says more will be done to develop and embed cultures of compassion, inclusion and collaboration across the NHS.
Specific actions include programmes and interventions to ensure a more diverse leadership cadre, a focus on increasing staff understanding of improvement knowledge and skills, and new pledges to better support senior leaders including improving the approach to assurance and performance management.
The aim is to simplify the structure. However, this was to be the start of many future reorganisations of health authorities over the next three decades. The Griffiths Report enshrines the general management function, removing the consensus management system of that is widely regarded as having failed.
It was an attempt to ensure that someone was in charge and could be held accountable. It leads to a major increase in managers' pay.
The Mental Health Act allows individuals who are assessed as being mentally ill and a risk to themselves or others, to be detained in hospital and given treatment. This is possible without patient consent for a certain period of time and with the consent of a relative thereafter.
Greenwood Press. The Warnock Report leads to the Human Fertility and Embryology Act , which states, among other things, that embryos can only be used for specific research purposes. This is regulated by the Human Fertilisation and Embryology Authority, which decides on a case-by-case basis whether to allow the research. He suggests that innovations to drive change should be treated as opportunities and nurtured rather than criticised or politicised. Enthoven concludes that it is necessary to create an environment that encourages quality and efficiency improvements.
Project represented a major shift from an apprenticeship style of nurse training, in which a student nurse was a hospital employee, to a system where student nurses were supernumerary, spending part of their time in higher education, and part on clinical placement. It paves the way for undergraduate nurse education in subsequent decades. The Green Paper sparks a fierce debate on the future of primary care. Among other points, the Paper suggests extra payments to GPs who offer specific services and the creation of integrated health care shops — inspired by Health Maintenance Organisations in the United States.
Both ideas make it to the White Paper in and remain prominent themes in the debate about primary care. This White Paper forms the basis for the new GP contract in , which sets out quality and financial incentives to improve the processes of delivering care, with extra pay for undertaking health promotion, screening and other preventative actions.
It leads to major increases in the skills and size of primary health care teams. It also aimed to introduce medical audit into hospitals and primary care, and introduced Trusts for hospitals with a proven ability to manage themselves, who were given greater freedoms.
The White Paper, Working for patients NHS reforms , proposes to introduce a split between purchasers and providers of care, GP fundholders and a state-financed internal market, in order to drive service efficiency. Both the GP contract and the Hospital contract resulted in substantial increases in salaries and pay, swallowing much of the money Labour had allocated to the improvement of the NHS.
Will the new GP contract lead to cost effective medical practice? The NHS and Community Care Act creates an internal market and a purchaser-provider split in which the purchasers mainly health authorities are handed budgets to purchase services from providers mainly acute hospitals and those providing care for people with mental health problems, people with learning disabilities as well as older people.
Not all GPs become fundholders, with non-fundholders having their services purchased for them by local health authorities. Critics accuse the Government of creating a two-tier system in which patients of GP fundholders are able to access treatment more quickly than those belonging to non-fundholding GPs.
Supporters of the policy claim that fundholding helps to deliver more efficient care. A further reduction in the number of weeks is debated in Parliament in but no changes are implemented.
The health of the nation - a policy assessed [PDF]. The Charter includes specific targets for waiting times for hospital treatment. The year then sees the introduction of provider performance tables based on these targets. The report by Sir Bernard Tomlinson, a distinguished neuropathologist, was another step in the recurrent campaign to rationalise hospital and medical school provision in London.
Although the government accepts most of the report , these headline recommendations are not implemented, with the exception of the eventual closure of the Middlesex. His recommendations on reducing in bed numbers, changes in specialty mix; and providing high technology services such as cardiac surgery in larger units do proceed.
There is also some emphasis on individual responsibility for health. Image: John Major, Prime Minister at the time. The Primary Care Act enables new possibilities for delivering primary care.
GP practices are encouraged to increase flexibility and choice. The White Paper, The new NHS: Modern, dependable , led by Frank Dobson, aims to replace the internal market and GP fundholding with a more cooperative, integrated system while retaining the purchaser—provider split. Organisational change is foreshadowed. The two new organisations aim to provide guidance on the use of technology and how to strengthen quality.
As a result of the public inquiry, led by Professor Ian Kennedy, an increasing emphasis is placed on quality, with outcomes increasingly seen as important to contracting and the provision of care. Department of Health Independent inquiry into inequalities in health the Acheson Report.
Revised targets for reducing infant mortality and increasing life expectancy at birth are set out in Public Service Agreements between the Department of Health and the Treasury. What is NHS Direct? NHS Direct, a national health line providing expert health advice and information, is established.
Two members of the Commission, Lord Lipsey and Lord Joffe, co-author a minority report that opposes the case made by the majority of the Commission for free personal care for all, financed from taxation.
When the Government responds with The NHS Plan in , a reduced version of this is implemented with nursing care to be provided free of charge, but with personal care remaining means tested. Scotland becomes the only country in the UK to offer free personal and nursing care at home. GPs, nurses and other workers come together under a new system of primary care groups PCGs to commission care on behalf of their local communities.
The Government claims that the reforms will lead to patients having closer contact with the professionals that decide what treatments they can have. Department of Health Saving lives: Our healthier nation. Our healthier nation outlines targets for improving public health, with a new focus on health inequality and the economic, social and environmental causes of ill-health.
It aims to increase healthy life expectancy and narrow the health gap. A Minister for Public Health is appointed. Interviewed on Breakfast with Frost , an early morning television programme, Tony Blair made an apparently impromptu and uncosted promise to raise spending on the NHS to the average European spend. The NHS Plan outlines a strategy for more doctors, more nurses, more beds and hospital building schemes by , with improved access to hospitals and primary care and a renewed focus — through performance targets — on decreasing waiting times.
A new model of financing is agreed: instead of public money, the Private Finance Initiative takes loans at high interest rates to design, build and operate hospitals building up huge commitments on future revenues. The Plan also sets out revised targets for issues such as waiting times. The first of a series of attempts to measure and publicise the quality of care delivered by hospitals, the hospital star rating system is modified each year and ends up being scrapped in The White Paper, Shifting the balance of power , sees the abolition of 95 health authorities, which are partly replaced by primary care groups PCGs and trusts and by 28 strategic health authorities SHAs , to provide regional management for the NHS and oversee the work of primary care trusts PCTs.
Mergers soon halve the number. Published in April , his report suggests that future funding needs will depend on the extent to which future demand for health care is reduced by good public health policies and by disease prevention. The report justifies what is to be a 50 per cent real-terms increase in NHS spending over the five years after its publication. A Council for the Regulation of Health Care Professionals is formed to provide advice, conduct investigations and encourage professionals to work together.
A new contract for GPs is negotiated, resulting in: more autonomy for practices about the range of services they provide; the ability to cease providing hour care; and supplementary pay for reaching standards set out in the Quality and Outcomes Framework. The new contract increases wages and pensions.
A guide for staff. It is also hoped that the change in pay and conditions will help to increase the recruitment and retention of staff in the NHS. This Act provides for the establishment of NHS foundation trusts, semi-autonomous acute trusts with greater freedoms; two new inspectorates — the Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection; and the recovery of NHS charges.
While the concept of practice based commissioning had been outlined in the White Paper, The new NHS , and in the NHS Improvement Plan in June , this paper outlines in more detail how those GP practices wishing to do so will be given indicative commissioning budgets. Accept additional cookies Reject additional cookies View cookies.
Hide this message. Home Health and social care National Health Service. The plan focuses on building an NHS fit for the future by: enabling everyone to get the best start in life helping communities to live well helping people to age well The plan has been developed in partnership with frontline health and care staff, patients and their families.
Share this page Share on Facebook Share on Twitter. Brexit Check what you need to do. Get a flavour of Rewired from the video below. You can book your place here. Terry Critchley 13 February I have never seen anything done by Government which approaches these phrases in practice. Why is this? Because the Government does not know how to create and implement a project, alpha to omega, as witnessed by nearly everything they do.
Such grand plans begin with as fanfare, the promise of almost unlimited funds and then …. No sponsor, no detailed objectives and deliverables, no team announced a body maybe , no milestones, review process, external quality assurance and all the other things which make a project bring home the bacon. In addition, you will search the internet in vain for a record of what is going on; e. Bertl 13 February
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