NHS 10-year plan will focus on primary care

The NHS has released details of its 10-year plan – including the proposed uses of the £20.5bn funding boost – and it intends to shift the focus from hospitals to primary care

General practice, mental health services and community care are set to receive the biggest funding boosts in the NHS’s 10-year plan, according to the BBC.

This is to shift the focus away from hospitals and towards primary care. Theresa May stated that this is intended to reshape “the NHS around the changing needs of patients”.Theresa May stated that this is intended to reshape “the NHS around the changing needs of patients”.

Experts have already begun to respond, with some saying that staffing problems will make ambitious changes to primary care problematic, and others adding that hospitals are facing too many problems to receive less of the £20.5bn share.

Currently, GPs, mental health services and community care account for just 25% of NHS spending. Hospitals take up the rest.

NHS England boss, Simon Stevens called the move a “practical, costed and phased route map” for the decade ahead.

GP and community care will receive £4.5bn extra of the £20.5bn boost, while mental health services will receive £2.3bn extra.

This additional funding is earmarked for increased digitalisation of GP practices, 24-hour mental health support, healthy living programmes, cancer testing centres and other services.

As a result of these changes, NHS England believes that the new vision could save 500,000 lives through preventative measures.

Responding to this news, Dr Chaand Nagpaul, BMA council chair, has warned that the NHS must look beyond its grand ambitions and ensure it addresses the harsh realities of healthcare today.

“Giving the substantial and growing pressures on the NHS, the announcement of the long-term plan represents an ambitious set of aims for the health service, but this must be underpinned by a strong set of deliverable actions.

“Fundamental to the expansion of cutting-edge treatments and digital consultations is to first get the basics right, such as the workforce. There is no use in opening the digital front door to the health service if we don’t have the healthcare staff behind it.

“While the government has highlighted plans to expand capacity and grow the workforce, very little has been offered in the way of detail. Given that there are 100,000 staff vacancies within the NHS, the long-term sustainability of the health service requires a robust workforce plan that addresses the reality of the staffing crisis across primary, secondary and community care. This will require additional resources for training, funding for which has not been mentioned in the long-term plan.

“There is also a pressing need to address immediate and short-term pressures given that doctors and NHS staff are routinely struggling to cope with rising demand and, as a result, are subject to low morale, stress and burnout. As well as the toll on wellbeing, this has a detrimental impact on recruitment and retention and, unless this is addressed, we risk a workforce plan without the doctors in the future to deliver it.

“The technological advancements announced by NHS England have the potential to benefit many patients in areas such as cancer, cardiovascular and stroke care but the aspirational targets must be matched by operational realities. It is welcome too that the government is recognising that patient mental health conditions deserve to have the same access and quality standards as those with physical health problems, which the BMA has long called for.

“The BMA supports increased investment in general practice and community care. This is imperative for effective future planning given the ageing population and the fact that doctors are treating patients with more complex needs, though we await further detail on how this will be delivered.

“With patients experiencing unacceptable waits in A&E, and waiting lists for surgery and appointments growing, we also need immediate, practical solutions and the necessary investment for hospitals to deliver both in the long and short-term.

“A renewed focus on prevention is welcome but the reality of the situation is that we are seeing a significant increase in obesity and related diseases along with worsening health inequalities exacerbated by years of cuts to public health budgets. The government must go further than what is outlined in the long-term plan and commit to population-wide measures, such as a minimum unit price for alcohol, restricting sugar levels in food, and greater restrictions on junk food marketing, if we are to achieve the necessary improvements to the health of the public.

“Narrowing inequalities cannot occur without adequate provision of social care which is not covered in the long-term plan. The BMA eagerly awaits the publication of the green paper on social care this year which must fully align with the long-term plan for the NHS.

“Ultimately, there is a need for honesty about how far the £20.5 billion over five years will stretch. This is well below the 4% uplift that independent experts have calculated is required, and below historic spending levels since inception of the NHS. World class care requires world class funding and the investment in the long-term plan will still leave the UK falling behind comparative nations like France and Germany.

“If we are to truly transform the care we give to patients, and create a sustainable, world-class health service, this long-term plan must deliver beyond grand ambition and address the realities faced by doctors, NHS staff and patients today.”

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