NHS Long Term Plan

NHS Long Term Plan
Name	NHS Long Term Plan
Published	January 2019
Author	NHS England
Country	United Kingdom
Language	English
Subject	Health policy

NHS Long Term Plan The NHS Long Term Plan is a strategic policy document published by NHS England in January 2019 setting priorities for healthcare delivery across the United Kingdom over a decade. It builds on prior frameworks such as the Five Year Forward View and interacts with organizations including Department of Health and Social Care, National Institute for Health and Care Excellence, and regional bodies like NHS Scotland and NHS Wales. The plan influenced policy debates in bodies including the House of Commons Health and Social Care Committee, British Medical Association, and think tanks such as The King's Fund and Nuffield Trust.

Background and development

The plan emerged from stewardship by Simon Stevens, leadership at NHS England, and successive secretaries including Matt Hancock within a context shaped by the 2018 Autumn Budget, the legacy of the National Health Service (NHS) founding under Aneurin Bevan, and policy reviews linked to the Five Year Forward View and NHS Long Term Workforce Plan. Drafting involved consultations with stakeholders such as the British Medical Association, Royal College of Nursing, Care Quality Commission, and patient groups like Citizens Advice, while responding to pressures visible in events such as winter crises at St Thomas' Hospital and system reports from NHS Digital and the Office for National Statistics.

Key commitments and objectives

The plan set goals addressing prevention and treatment across specialties includinggeneral practice, mental health, cancer, cardiology, and diabetes mellitus. Commitments included expanding primary care access via Clinical Commissioning Group transformation into Integrated Care Systems, increasing mental health services in alignment with guidance from NICE and commitments under the Mental Health Act 1983 reforms, and driving digital transformation through partnerships with organisations such as NHS Digital and initiatives echoing the Five Year Forward View. Targets encompassed waiting time reductions cited in standards from NHS Constitution for England, cancer pathway improvements reflecting recommendations from National Cancer Taskforce, and ambitions for prevention aligning with public health priorities set by Public Health England and regional boards like Health and Social Care Northern Ireland.

Funding and resource implications

Financial commitments in the plan were tied to funding settlements negotiated with HM Treasury and referenced figures from the Office for Budget Responsibility, building on allocations announced in the 2018 Autumn Budget and subsequent spending reviews. Resource implications included workforce expansion plans to recruit more consultants, nurses, and allied professionals referenced by the NHS Workforce Race Equality Standard, training bodies such as the General Medical Council, and capital investments in estates like Royal London Hospital. The plan projected implications for commissioning budgets managed by Clinical Commissioning Groups and fiscal oversight by NHS Improvement with accountability to Department of Health and Social Care.

Implementation and governance

Implementation relied on structural reforms including the evolution of Sustainability and Transformation Partnerships into Integrated Care Systems, oversight by NHS England and NHS Improvement and performance monitoring through the Care Quality Commission. Governance frameworks linked national targets to local delivery through Clinical Commissioning Group boards, chief executives of trusts such as Barts Health NHS Trust, and national bodies like the National Institute for Health and Care Excellence. Delivery involved coordination with devolved administrations in Scotland, Wales, and Northern Ireland, and engagement with professional colleges including the Royal College of General Practitioners, Royal College of Physicians, and Royal College of Psychiatrists.

Impact and outcomes

Reported outcomes cited by evaluations from organisations such as The King's Fund, Nuffield Trust, and parliamentary inquiries showed mixed progress: improvements in elective surgery pathways and cancer waiting times in some regions versus persistent pressures in emergency departments at trusts like Newcastle upon Tyne Hospitals NHS Foundation Trust. Mental health service access expanded in line with commitments referenced by NHS Digital datasets, while workforce shortages identified by the General Medical Council and Health Education England continued to affect capacity. Digital initiatives including expansion of NHS 111 online services and electronic record projects were piloted across trusts such as Guy's and St Thomas' NHS Foundation Trust.

Criticisms and controversies

Critics from groups including the British Medical Association, think tanks like Institute for Fiscal Studies, and select committees in the House of Commons argued the plan lacked sufficient funding certainty despite links to the 2018 Autumn Budget and that workforce planning underestimated recruitment challenges described by Health Education England. Controversies involved debates over the role of private providers such as Bupa and Virgin Care in service delivery, legal challenges invoking procurement rules overseen by the Competition and Markets Authority, and scrutiny over promised improvements during crises exemplified by high-profile incidents at Royal Free Hospital and coverage in outlets such as BBC News.

Category:Health policy of the United Kingdom