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New health service delivery plan sets ‘fanciful’ targets

PORTER: The plans ignore the reality that the NHS is chronically underfunded

NHS managers and politicians have failed to tackle the fundamental funding pressures undermining the delivery of health and social care – and a new plan to turn the health service around is ‘fanciful’.

That is the warning from doctors leaders after the publication of NHS England’s ‘Next Steps on the Five Year Forward View’ – a new document that outlines plans to address health service performance.

It claims to provide solutions to the crisis in the NHS, including turning around the everyday struggles in general practice, improving cancer care, tackling emergency department crowding and putting extra funds into mental health.

NHS England also suggests the plan – to be rolled out through 2017/18 – will see the health service become ‘the most integrated in the Western world’, particularly through the further development of the controversial STP (sustainability and transformation plan) process.

But doctors leaders said the plans ignore the harsh reality that the NHS is underfunded and is at breaking point.

BMA council chair Mark Porter said: ‘The NHS is one of the best, and most efficient, healthcare systems in the world, which this report rightly highlights. However, rising demand and years of chronic underfunding mean the NHS is now at breaking point.

‘This plan contains many good measures but does not address the fundamental funding pressures undermining the delivery of health and social care. The efficiency targets set in this plan are fanciful, given that most hospitals have been pushed into the red.

‘The constant calls for more GPs to be available for longer is not matched by the reality on the ground – far from delivering 5,000 extra GPs promised by the Government, figures from earlier this week show that the number of full-time GPs is, in fact, falling.’


A cover for cuts

Earlier this year, BMA research revealed that the STP process – which the NHS England plan says is moving on to its next steps, including some of the 44 ‘footprint’ areas of the country being given more powers – required £9.5bn in upfront capital to work and that the process would include £26bn of savings across the country.

Dr Porter said: ‘There is a lot of emphasis on the role of STPs and a belief that they are sufficient to resolve the crisis. Yet we already know that the vital funding needed to carry out these plans simply isn’t available. Given the scale of the savings required in each area, there is a real risk that these transformation plans will be used as a cover for delivering cuts, starving services of resource and patients of vital care.

‘At a time when our hospitals are in deficit, GPs are unable to keep up with the number of patients coming through the surgery door and staff are working under impossible conditions, we need an honest look at the pressures facing the NHS and how to give the investment needed to match the promises made. We spend less on health than other leading European economies and cannot continue to do more, with less.

Above all it’s time to end the chronic underfunding of our health service and put together a long-term plan to help solve the ever-growing issues around staffing and funding the health and social care system as a whole.’


Promised improvements

Speaking at an NHS England board meeting on Thursday, NHS England chair Malcolm Grant said the project, which he referred to as ‘the delivery plan’, had been the result of ‘quite an amount of negotiation’ with the prime minister, the Treasury and Department of Health.

NHS England claims the plan sets out how it will ‘deliver practical improvements in areas prized by patients and the public – cancer, mental health and GP access – while transforming the way that care is delivered to ease pressure on hospitals by helping frail and older people live healthier, more independent lives’. It aims to:

  • Improve cancer care, aimed at saving an extra 5,000 lives a year through new one-stop testing centres, screening programmes and state-of-the-art radiotherapy machines.
  • Boost mental health services by increasing beds for children and young people to cut out-of-area care, more beds for new mothers and more mental health professionals in the community and hospitals to prevent crisis admissions.
  • Increase access to GP services with everyone benefiting from extended opening in the evenings and weekends, newly designated ‘urgent treatment centres’ and an enhanced 111 service to ease pressure on emergency departments.
  • Provide better care for older people by bringing together services provided by GPs, hospitals, therapists, nurses and care staff, cutting emergency admissions and time spent in hospitals.
  • Drive efficiency and tackle waste to make money invested in the NHS go further in delivering the services and staff that patients want, including the latest treatments and technology.

NHS England chief executive Simon Stevens said: ‘Heading into our 70th year, public support for the NHS is as strong as ever but so too are the pressures on our frontline staff.

‘Today we chart a course for practical care improvements for the next few years. We do not underestimate the challenges but, get these right, and patients, staff and the tax-paying public will notice the benefits.’

Read more: NHS at breaking point

The BMA has produced a paper highlighting the key areas of interest for doctors in the NHS England Next Steps for the Five Year Forward View document

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