17.12.15
Tighter targets across the board in NHS 2016-17 mandate
NHS England has set out its goals for both 2016-17 and 2020, including improvements to service delivery, measurable progress in patchy areas and more patient choice.
In its new mandate for 2016-17, the national body said it will start publishing data on avoidable deaths per trust annually, supporting NHS Improvement help these trusts in implementing improvement programmes from March 2016.
It will roll out four clinical priority standards in all relevant specialities to 25% of the population.
By the end of the decade, the NHS is expected to roll out seven-day services in hospitals to all of the population to ensure service consistency.
Providers must achieve a significant reduction in avoidable deaths, with all trusts calculating marked reductions in annual measurements.
NHS England will support NHS Improvement to substantially increase the amount of trusts rated ‘outstanding’ or ‘good’, including by reducing the amount of time they spend in special measures.
There must be measurable progress towards reducing the rate of stillbirths, neonatal and maternal deaths and brain injuries caused during or soon after birth by 50% by 2030, but with a quantifiable reduction by 2020.
The national body will also support the health service to move towards a new culture of learning from clinical mistakes, including by improving the number of staff who feel their organisation acts on concerns raised by employees.
Goals in relation to patient experience include expanding the personal health budget programme to 50-100,000 people (as opposed to 4,000 currently), and improving patient choice in maternity, end of life care and for those with long-term conditions. It has pledged to produce a plan with specific milestones for improving patient choice by 2016-17.
And it has promised to provide CCGs with “aggregated Ofsted-style assessments” for their performance. This would allow them to benchmark against other commissioning bodies and determine whether national intervention is needed.
The new Ofsted-style CCG framework for next year will include metrics to measure progress on NHS planning guidance priorities, including overall assessments for each cancer, dementia, maternity, mental health, learning disabilities and diabetes – as well as metrics on efficiency, core performance, technology and prevention. By the end of the first quarter in 206-17, NHS England will publish the first overall assessment for these six clinical areas.
Cancer
As expected, it hopes to deliver the recommendations of the cancer taskforce by 2020, including guaranteeing 28-day referrals and improving one-year survival to achieve 75% for all cancers combined (up from 69% currently).
But by the next financial year, it has promised to achieve the 62-day cancer waiting time standard, as well as support NHS Improvement in achieving substantial progress towards the national standard of a six-week waiting time between referral and testing.
It will agree a trajectory for increases in diagnostic capacity required to 2020, and invest £340m in providing cancer treatments not routinely provided through the Cancer Drugs Fund.
NHS deficit
To balance the NHS budget, it has pledged to secure £1.3bn of efficiency savings through Lord Carter’s recommendations alongside NHS Improvement by 2016-17, as well as collaborate with local authorities on continuing healthcare spending.
It will deliver trust deficit reduction plans, particularly through the new £1.8bn ‘sustainability and transformation fund’, and ensure a balanced financial position across the trust sector by the next financial year.
NHS England must also reduce spending on agency staff by at least £0.8bn in order to reduce this further until 2020.
It will roll out the second cohort of Right Care methodology to another 60 CCGs – which its chief financial officer, Paul Baumann, described as the key to delivering utmost value for money.
There will be measurable improvement in primary care productivity, particularly by supporting community pharmacy reform.
Furthermore, NHS England will team up with CCGs to support the government’s aim to increase NHS cost recovery up to £500m by 2017-18 from overseas patients, and ensure CCGs’ local estates strategies can support the goal of releasing £2bn and 26,000 new homes through surplus land by 2020.
New models of care
The new models of care must cover 20% of the population designated as being “in a transformation area” in order to provide access to better GP services (including weekend and evening access and same-day appointments for over 75s) and progress on the integration of health and social care, urgent and emergency care, and electronic record sharing.
NHS England will publish practice-level metrics on the quality of, and access to, GP services. With HSCIC, it will provide GPs with benchmarking information for named patient lists.
Health and social care
NHS England has promised to ring-fence £3.5bn within its allocation to CCGs to establish the Better Care Fund for the purposes of integrated care.
It will also consult with the Department of Health and the Department for Communities and Local Government before approving spending plans drawn up by each local area by March 2017 for health and social care integration.
Mental health
By 2016-17, 50% of people experiencing a first episode of psychosis must have access to treatment within two weeks. A target of 75% of people with relevant conditions must have access to talking therapies within six weeks, and 95% within 18 weeks.
NHS England will agree and implement a plan to improve crisis care for all ages, including investing in more places of safety.
It will oversee the implementation of locally-led transformation plans for children and young people’s mental health, which should particularly improve prevention and early intervention measures.
It has also pledged to implement the recommendations from the upcoming mental health taskforce.
More details of the NHS England mandate for next year can be found here.