NHS Long Term Plan: Recent Developments

NHS England’s Long Term Plan (LTP) was published in January 2019. It was accompanied by a press release that predicted the plan would “save almost half a million lives” with action on major conditions and investment in “world class, cutting edge treatments”. The LTP followed the announcement in June 2018 by the then Prime Minister, Theresa May, of increased funding for the NHS. This was set to average 3.4% each year during the period from 2019/20 to 2023/24, compared to average growth of 2.2% in each of the previous five years. The Government has stated that an NHS Funding Bill will be brought forward to set out the funding commitment in legislation.

The aims of the plan were to maximise the impact of the extra funding, tackle the pressures faced by NHS staff in England and take advantage of new health technologies. The LTP included measures intended to change the way NHS services in England are provided and increase the coordination of NHS services with local authorities, the care sector and the voluntary sector. Although the objectives of the plan were welcomed by stakeholders, concerns were raised that success would be contingent upon various factors, including: funding; staff capacity; the implementation framework; and local leadership. Since January 2019, several milestones in the execution of the plan have been reached. These include:

• The Interim NHS People Plan was published in June 2019.
• The Implementation Framework was published the same month.
• Local systems have developed their five-year strategic plans to set out how they would improve services and achieve financial sustainability. These were expected in November 2019, but their publication was postponed as a result of the pre-election ‘purdah’ period.

The Health Foundation, the King’s Fund, and the Nuffield Trust have commented that the plan had a renewed emphasis on “collaboration”. This represented a shift away from the “competition” extended by the so-called ‘Lansley reforms’ advanced by the Health and Social Care Act 2012. In the LTP, NHS England made recommendations for changes to this legislative framework. Although the plan stated that it did not require changes to the law to be implemented, it did argue that “amendment to the primary legislation would significantly accelerate progress on service integration, on administrative efficiency, and on public accountability”. There has been a consultation into the proposed legislative changes, the response to which was published by the NHS in September 2019. The Government has stated that it “will bring forward detailed proposals shortly” following the recommendations.