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The NHS Long-Term Plan – The right way forwards?

It is a relief to hear the ongoing Brexit saga has not entirely consumed all of the civil service’s time these last two years. This month, the government launched the NHS long-term plan to much fanfare.

The objective is laudable – to save almost half a million more lives with practical action on major killer conditions and investment in world class, cutting edge treatments including genomic tests for every child with cancer.

The plan envisages a more technologically advanced and better integrated NHS. To summarise some of the more eye-catching aspects:

  • A new guarantee of investment: £4.5 billion intended to uplift primary medical mental and community health services;
  • Mental health services alone will receive at least £2.3 billion a year in funding by 2023/24 to help two million more people (including children) who suffer anxiety, depression, and other related problems;
  • More digital GP consultations will be introduced for all those who want them with an emphasis on early detection and a renewed focus on prevention to stop an estimated 85,000 premature deaths each year;
  • Measures will be introduced to help prevent 150,000 heart attacks, strokes, and dementia cases with more than 3 million people intended to benefit from new and improved stroke, respiratory, and cardiac services over the next 10 years;
  • Neo-natal care is also expected to benefit, with improved services earmarked for new parents and babies;
  • New life-changing stroke therapy (including the potential use of artificial intelligence) to help provide the best stroke care in Europe;
  • Better integrated support to help keep older people out of hospital, and living independently at home.

All of this to be welcomed by those of us who have campaigned over the years for better healthcare standards against a background of financial austerity. 

The NHS England Chief Executive Simon Stevens reportedly said: 

‘‚Ķ.there’s been concern about funding, staffing, increasing inequalities, and pressures from a growing and ageing population and there’s also been legitimate optimism about the possibilities for continuing medical advance and better outcomes of care‘.

The proposals have been welcomed across the healthcare spectrum, including the Chair of the Academy of Medical Royal Colleges, the Chief Executive of the British Heart Foundation, the Chief Executive of Macmillan, and the Chief Executive of the mental health charity MIND.

Whilst all support the goals identified, many are sceptical as to whether the objectives listed are genuinely deliverable or even realistic.

For example the National Audit Office (NAO) has suggested in its annual report on the financial sustainability of the NHS in England that there are many underlying problems which first need to be addressed, never mind improving services in line with the ambitions of the plan. 

The report identifies ‘substantial deficits’ at some Trusts along with growing waiting lists.  Yet there are currently more than 100,000 unfilled NHS posts in England. Furthermore many experienced GPs are retiring early due to increased pressures of work in recent years, also contributing to this staffing crisis. 

The NAO is concerned that some of this new funding might be swallowed up to pay for more expensive agency staff for example, leaving insufficient funds for Trusts to pay for expanded services.

What’s more, the financial health of some Trusts is getting worse with the Department of Health and Social Care having to bail out those in the most difficulty to the tune of £3.2 billion in emergency loans in 2018 alone.

One wonders whether it might not be a better and more efficient use of taxpayer’s money to try and address these existing challenges within the NHS structure before or at least at the same time as expanding it. 

If however the plan results in or contributes towards an overall improvement in patient safety over the next 10 years as envisaged, that would be heartily congratulated by all.


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