cycle of growing shortages, increased pressures on staff and declining quality of care for patients. issues and the options cited to tackle them. There are many local and regional examples of where this is working. While the vision is for leadership that is both compassionate and diverse, its current assessment is that, while this is present in some parts of the NHS, it is ‘not yet commonplace’. The resulting document, the NHS long-term plan, was published on 7 January 2019. This includes introducing quality markers for primary care, highlighting best practice in identifying carers and providing them with appropriate support. Why do delayed transfers of care occur? These infographics illustrate some of the key statistics when it comes to leadership in today's NHS. The NHS is a complex system, which can sometimes make it difficult to understand – especially working out who is responsible for what. The focus on prevention is welcome, although the challenge will be to turn rhetoric into reality, given the poor track record of following through on previous good intentions. NHS long term plan is the only solution but it needs leaders with values, good governance, excellent staff and patient engagement. This explainer sets out how general practices are contracted and paid in England, looking at the services they. read looks at work underway and makes sense of all the terminology. For nearly a decade, the NHS has experienced a significant slowdown in funding growth, while demand for services – and the cost of delivering those services – has grown rapidly. Long read The King’s Fund is an independent charity working to improve health and care in England. The plan pushes health inequalities firmly up the agenda. Our updated long. The NHS explained: how the health system in England really works | The King's Fund Primary care networks will be expected to take a proactive approach to managing population health and from 2020/21, will assess the needs of their local population to identify people who would benefit from targeted, proactive support. To achieve this, as well as the previously announced 25 per cent increase in nurse undergraduate placements, the plan commits to funding a 25 per cent increase in clinical nursing placements from 2019/20 and an increase of up to 50 per cent from 2020/21. 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. Much of the detail relating to these initiatives is left to the recently published Planning Guidance. When will these ideas be taken more seriously and implemented? For example, NHS organisations will be required to have a chief clinical information officer or chief information officer at board level by 2021/22. Brexit and the end of the transition period: what does it mean for the health and care system? Learner reviews The King’s Fund is an independent charity working to improve health and care in England. clocking in at a weighty 120 pages. In this video Siva Anandaciva, Chief Analyst at The King’s Fund, explores how we can understand the NHS through how well it manages its budget. We. 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 2028. The plan sets a long-term ambition to train more staff domestically. 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. Jonathon Holmes looks at what. NHS long-term plan explained. The King’s Fund has published an explanatory report, Fit for the Future, that sets out the main commitments in the plan. National leaders deserve credit for targeting measurable improvements in health outcomes and the focus on child health is very welcome. The King's Fund response to the NHS long-term plan This is an ambitious plan that includes a number of commitments which – if delivered – will improve the lives of many people. In this video Sally Warren, Director of Policy at The King’s Fund, provides an overview on how the COVID-19 will impact the NHS in the long-term. Despite ongoing concerns about operational performance in emergency care, the plan does not make any commitment on the four-hour A&E target, postponing any decision to restore performance standards until the Clinical Review of Standards reports in the spring. 2011 marked a turning point in long-term mortality trends in the UK, with improvements tailing off after decades. Digital technology will also facilitate service transformation, including the redesign of outpatient services and reorganisations of pathology and diagnostic imaging services. Although on current forecasts the NHS as a whole is expected to be in balance in 2018/19, many individual providers and commissioners are struggling to eliminate deficits. answer some of the most frequently asked questions we receive about health and social care. Whilst there are some hints at investment and recognition that voluntary doesn't mean 'free', it's concerning that subsequent announcements suggest that the NHS itself is going to recruit staff to deliver social prescribing. So, as 2021 begins Siva Anandaciva looks back at the key. This means that much is riding on the ability of local systems to deliver. Transform means to change. NHS leaders have done what was asked of them by delivering a forward-thinking plan that sets out how the NHS will spend the additional money promised by the government. and supporting people to live independently – and yet they are poorly understood compared to other parts of the NHS. This is an ambitious plan that includes a number of commitments which – if delivered – will improve the lives of many people. How has digital health policy developed since the early stages of digitisation? The first test of this will come with the Spending Review, and whether the government reverses the damaging cuts made to the public health budget. This is recognised in the plan and reflected, for example, in the commitment to align regulation through a new ‘shared operating model’ across NHS England and NHS Improvement, and the emphasis placed on the performance of systems as well as organisations. A&E requires a joined-up response across all services. Whether they continue after the transition phase will depend on the outcome of the ongoing negotiations. Workforce shortages are currently the biggest challenge facing the health service. How many doctors and nurses are there? next 10 years. 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. Subscribe to our newsletters to keep up to date with the world of health and social care and hear the latest news and views from The King's Fund. Support. The KingsFund: The NHS long-term plan explained On 7 January, the NHS long-term plan (formerly known as the 10-year plan) was published setting out key ambitions for the service over the next 10 years. The plan signals a clear focus on prevention, recognising that the NHS can take important action to ‘complement’ – but not replace – the role of local authorities and the contribution of government, communities, industry and individuals. There is also a strong focus on children and young people’s health. On 7 January, the NHS long-term plan (formerly known as the 10-year plan) was published setting out key ambitions for the service over the next 10 years. There is a commitment to rolling out the NHS comprehensive model of personalised care (which brings together 6 programmes aimed at supporting a whole population, person-centred approach), so that it reaches 2.5 million people by 2023/24, with an ambition to double that figure within a decade. are STPs and what do they mean for the NHS? Many of the measures build on previous initiatives, including the introduction of clinical streaming at the front door to A&E and the roll-out of NHS 111 services across the country. More than 1,900 delegates have attended Health and care explained, ranging from chief executives of charities to NHS leaders, students and representatives from government bodies. We need more community facilities, in the right place, and more care beds. We're doing it now, over half of episodes now starting digitally. 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 18-week waits. It’s made up of a wide range of different organisations with … 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 2019. The move towards a more interconnected NHS will be supported by a ‘duty to collaborate’ on providers and commissioners, while NHS England and NHS Improvement will continue efforts to streamline their functions. Commitments include the provision of alcohol care teams in a quarter of hospitals with the highest rate of alcohol dependence-related admissions, and a promise that by 2023/24, NHS-funded tobacco treatment services will be offered to all smokers admitted to hospital. These plans will be ‘brought together in a detailed national implementation programme’ in the autumn of 2019. This updated. We can also expect to see other benefits; evidence and experience from high-performing health systems demonstrates that having these capabilities enables teams to deliver better patient care and value for money while also delivering continuous improvements to population health. With changes to legislation unlikely to take place in the short term, the immediate priority for ICSs will be to continue making as much progress as possible within the existing legislative framework. This process prevents patients and staff to mindlessly go through the motions just for being told to do so. A 6 month wait to have a social worker visit where is this myth of person centred care. This will involve NHS organisations putting in place electronic records and a range of other digital capabilities. still problems with access and the quality of care experienced by people using services. To deliver ‘digitally enabled care’ as envisaged, the plan reiterates the previously stated ambition that all secondary care providers become ‘fully digitised’ by 2024 (a deadline that has slipped from the original target to be ‘paperless’ by 2020). National expectations are made clear and local systems will be accountable for contributing to national programmes on a ‘comply or explain basis’. The plan also says more will be done to develop and embed cultures of compassion, inclusion and collaboration across the NHS. A key part of the NHS long-term plan, primary care networks (PCNs) will bring general practices together to work at scale.But what are they? at the commissioning process in more detail, the organisations involved and how it is changing. Rather, its overarching goal is to support learners in the process of being taken out of what they already (believe they) know in order to be led into one of newfound realization, whilst simultaneously making them aware of their learning journey to allow for knowledge crystallization. To support this ambition and to ensure that local plans and national programmes are focused on reducing inequalities, specific, measurable goals will be set. The ... a national NHS leader … Long read One of the most important of these decisions – what to do about recovering waiting times standards – has been postponed. After eight years of austerity, there is now an opportunity to tackle the issues that matter most to patients and communities and to improve health and care. The King's Fund - On Christmas Eve 2020 a new EU-UK trade and co-operation deal was agreed. In this explainer, we set out the main commitments in the plan and provide our view of what they might mean, highlighting the opportunities and challenges for the health and care system as it moves to put the plan into practice. Leadership is honesty, sincerity, integrity, truth, justice, fairness and sheer determination to succeed or to lead successfully or to transform. The government seems to think that this can be overcome by 'technology'. the rapidly increasing backlog maintenance. There is also a strong focus on improving care for people with learning disabilities and autism. In addition to the key role the NHS has to play, progress will depend on action from local and central government. The long-term plan calls for a ‘fundamental shift’ in the way that the NHS works alongside patients and individuals. health policy moments of 2020 to consider the challenges and opportunities that the year brought. We also need to re-model hospitals to deliver new systems of care and need to address backlog maintenance which is a long term drain on funding and delivery. An introduction to the NHS; An introduction to the NHS. 10-year plan for how this funding will be used. The focus on ICSs and expanding new models of care builds on the agenda set by the Forward View. This is in the context of an increase in the aggregate deficit among NHS providers and commissioners from £554 million in 2014/15 to £1.85 billion in 2015/16. On Christmas Eve 2020 a new EU-UK trade and co-operation deal was agreed. It also encourages the national roll-out of carer’s passports, which enable staff to identify someone as a carer and involve them in the patient’s care and promises a more proactive approach to supporting young carers. The King's Fund is committed to tackling inequalities through the work we do and by using our voice to encourage change within the health and care system. This article is from the online course: The Spending Review, which is due to be published later this year and will outline the funding settlement for local government including social care and public health, will therefore have an important impact on whether wider improvements in population health can be delivered, as will the Green Papers on social care and prevention when they are eventually published. But what does it really mean and, Health and wellbeing boards (HWBs) explained, What are health and wellbeing boards (HWBs) and what role could they play in developments such as integrated. Systems will be required to ‘streamline’ commissioning arrangements, which will ‘typically involve’ a single CCG across each ICS. In 2019/20, as part of the process of moving towards system control totals, sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) will be given more flexibility to agree financially neutral changes to control totals for individual organisations within their systems. Local areas have received indicative financial allocations for 2019/20 to 2023/24 and, in the short term, will be expected to develop plans for implementing the long-term plan’s commitments in 2019/20, a transitional year, as well as developing five-year system plans by the autumn. Yet it remains below the average increases of 3.7 per cent a year since the NHS was founded and is less than the 4 per cent annual increases we and others have argued are necessary to meet rising demand and maintain standards of care. As part of this, we aim to improve people’s understanding of the health and care system, how it works and how it is changing. Staffing is the number one issue on the King’s Fund list; 55,000 of the 1.3 million NHS workforce and 80,000 of the 1.3 million workers in adult social care are from countries within the EU. national action to support healthier lives. Focusing on comprehensive support recognises that mental health services work best when integrated with each other and the wider health and care system. On average, spending has risen by 3.7% a year in real terms, but it hasn’t been a continued steady increase over this time – there have been periods of relatively high and low growth. The King's Fund found evidence that more work is being “deflected” to nurses in GP surgeries, hospices and carers, and warned that patients are … An alternative guide to mental health care in England. Patients will notice changes to the front door of the urgent care system and to the configuration of hospitals in some places. The King's Fund is committed to tackling inequalities through the work we do and by using our voice to encourage change within the health and care system. Patients are likely to continue to face longer waits for treatment for the foreseeable future. Watch, An alternative guide to the urgent and emergency care system in England, This animation explains how the urgent and emergency care system fits together and shows how solving problems in. Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England, NHS England has recently changed the name of accountable care systems to integrated care systems. For example, NHS Digital’s latest estates publication tells us that two NHS hospitals still use coal-fired boilers; the occupied floor area of Addenbrooke’s Hospital would cover 58 football pitches; and Barts Health NHS Trust spent £13.9 million on inpatient food in 2019/20. 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). Also significant is the absence of any commitments to current waiting time targets - these are on hold until the clinical review of standards is published later in the year. 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. Over the past years successive Governments have spoken on, the integration between the NHS organisations and how they need to work in partnership with local authorities, and the voluntary organisations. The NHS long-term plan has been launched and long it indeed is, in every sense of the word. Collaborative, inclusive and compassionate leadership is essential to deliver the highest quality care for patients and tackle deep-seated. But does it work? It provides a view of what they might mean, highlighting the opportunities and challenges for the system as it moves to put the plan into practice. You can also submit requests for. See other articles from this course. The plan confirms the shift towards integrated care and place-based systems which has been a defining feature of recent NHS policy. It also needs good governance and accountability for managers and leaders and also to each and every staff. It is firmly focused on the future, rather than simply shoring up current models of care, and sets the right direction for the NHS by focusing on delivering joined-up, personalised, preventive care, and expanding primary and community services. Community pharmacy is a critical part of primary care in England, but its role and relationship to the. (23 January 2019). It is widely acknowledged that the NHS is already struggling to recruit and retain permanent staff with a shortfall of nearly six per cent in 2014. We explored how a wide range of organisations – across local government, the voluntary sector, the private sector and local communities – have it within their power to improve people’s health. All of these actions will build on existing recommendations in the national strategic framework, Developing people – improving care. It helps to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Broader progress on health inequalities will again depend on wider government action and the strength of local partnership-working. with high levels of unmet need and providers struggling to deliver the quality of care that older and disabled people have a right to expect. The plan recognises the important role that volunteers play in the NHS, committing £2.3 million to Helpforce, which has been charged with scaling capacity for volunteering in the NHS. Changes to the commissioning allocations for Clinical Commissioning Groups (CCGs) will support the plan’s focus on tackling health inequalities and better reflect need for mental health and community services. This should include reversing cuts to public health budgets and being bolder about using other mechanisms at their disposal including tax and regulation to drive improvements in population health. This settlement represents a substantial improvement on the funding growth the NHS has seen since 2009/10, which has averaged approximately 1 per cent a year in real terms. The King’s Fund is an independent charity working to improve health and health care in England. I do wonder why the plan makes patients wait until 2024 to have a "right" to digital access to their GP. 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