Next steps on the NHS Five Year Forward View

NHS England has published Next steps on the NHS Five Year Forward View.

This document reviews the progress made since the launch of the NHS Five Year Forward View in October 2014 and sets out a series of practical and realistic steps for the NHS to deliver a better, more joined-up service with the aim of a more responsive NHS in England in the future.

Additional links:

NHS Confederation: Ambitious NHS plan a ‘leap in the dark’, Confed chief warns

NHS Clinical Commissioners responds to Next steps on the NHS Five Year Forward View

Understanding NHS financial pressures. How are they affecting patient care?

The Kings Fund has published ‘Understanding NHS financial pressures. How are they affecting patient care?’

Understnading NHS financial pressures

Image source: https://www.kingsfund.org.uk/

Financial pressures on the NHS are severe and show no sign of easing. However, we know relatively little about their impact on patient care.

This study sought to investigate the impact of financial pressures in four very different areas of the health service: genito-urinary medicine (GUM), district nursing, elective hip replacement and neonatal services. The research used data analysis and interviews to explore different experiences across the system.

The researchers found that GUM and district nursing services were under particular strain. Both access to services and quality of patient care have been affected in ways that are difficult to detect with currently available metrics.

Within elective hip replacement services, activity has increased in recent years and patients remain happy with the outcome of their operations, but the latest data shows that average waiting times for treatment are starting to rise. Neonatal services appear to have largely maintained quality and access despite a number of longstanding pressures, although there is variation between units.

The findings create a challenge to the direction of travel set out in the NHS five year forward view of strengthening community-based services and focusing on prevention.

Read more here

5YfV for Mental Health: one year on

NHS England has published a report outlining the progress made in the first year of the Five Year Forward View for Mental Health | NHS Confederation

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Image source: NHS Confederation

The report sets out which areas are beginning to see improved access to care and outlines examples of good local practice in services. It also recognises the ongoing challenges, adding that there is more to do to “make a reality of the aspirations for transformation in mental health services”.

The report concludes by outlining that the infrastructure needed to sustain change has been put in place and in many areas people who use services are beginning to feel the benefits of the new and expanded services on offer. It cautions that this is a long term programme which goes beyond 2020/21, stating that further work will be needed beyond the first five years to continue to expand transformation of mental health services and meet the needs of the whole population.

Finally, the report acknowledges the hard work of staff and finishes by stating that “one year on, there is clear momentum behind this programme nationally and locally: the challenge now is to maintain and build on this to achieve next year and beyond”.

Highlights from year one:

  • Over 120,000 more people are expected to receive mental health care and treatment in priority services in 2016/17.
  • The Mental Health Investment Standard is planned to be met across England as whole in 2017/18 and 2018/19.
  • The first national access standards for mental health treatment have come into effect – with the waiting time targets met.
  • A new Mental Health Dashboard has been launched to provide unprecedented transparency of performance against key indicators.
    The first comprehensive all-age mental health workforce strategy has been co-produced for publication in April 2017.

The report also highlights that not all milestones have been met as planned with progress on workforce development taking longer than anticipated due to the complexities of delivering a strategy for such a diverse group of professionals.

Read the full report here

Productivity, Technology and the NHS

Productivity, Technology and the NHS, looks at the NHS in England approach to productivity improvement half-way through the implementation of NHS Engand’s ‘Five Year Forward View | Newchurch

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Image source: Newchurch

A core component of NHS England’s Five Year Forward View (5YFV), which underpinned the subsequent financial settlement agreed with the Government, was that NHS productivity would improve by 2.4% a year for each of the five years up to 2020/21. The 5YFV went further suggesting that its implementation could even result in sustained improvements of 3% a year in the longer term, a proposition which must have assumed sustained improvement in workforce productivity, given that staff costs make up some 70% of NHS expenditure. This proposition always looked ambitious and subsequent analyses of the NHS’s long-term productivity performance have served to underline the size of the challenge. However the Carter Review, published 12 months ago, underlined the scale of the potential improvements that could be made in the NHS’s dominant acute sector.

A key contributor to achieving the rate of productivity improvement underpinning the 5FYV, reinforced by Carter’s conclusions, was the adoption of new digital technologies. This faith in the impact of digital technology is despite the evidence of the last 20 years that would cast considerable doubt as to the productivity impact of the digital technologies programmes that the NHS in England and its predecessors have implemented.

An analysis of current performance and future plans at the national, Sustainability and Transformation Plan and trust level suggests that the NHS as a system gives little priority to productivity improvement. Furthermore current plans for the development and implementation of digital technologies are unlikely to have any significant impact on productivity, certainly within the lifetime of the 5YFV.

Read the full overview here

Read the full report here

Accelerating the adoption of person and community-centred approaches to health and care

A new relationship with people and communities: Actions for delivering Chapter 2 of the NHS Five Year Forward View | People and Communities Board

The report ‘A new relationship with people and communities’ outlines six high impact actions and related recommendations, supported by evidence and illustrated by examples. The actions address key pinch points in the NHS, where substantial progress can be made in the next 12 months, and where the actions can build energy around the broader agenda of changing the culture of healthcare. The annex – ‘Voluntary sector proposals’ – highlights approaches or interventions developed in the VCSE sector, which have been tested and evaluated and which have the potential for wider adoption.

Read the full overview here

Read the full report here

What’s New in Care Models: NHS England’s MCP flotilla

Tracking everything that’s new in care models and progress of the Five Year Forward View | By HSJ’s integration reporter David Williams.

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Late last year NHS England launched a great flotilla of new papers on MCPs (“a raft” doesn’t quite do justice to the sheer scale of the release), providing lots of significant new detail on how the new providers will be constituted and contracted.

The documents include the draft contract, a lot of things explaining what the contract means, a template alliance agreement for people who don’t want to go the whole hog, and a couple of papers aimed at GPs who might be considering getting involved.

Read the full news story here