Health Service Focus

18.03.19

Old lock, new key? Sizing up the NHS Long-Term Plan

Source: Advertisement feature

Tom McCarthy, managing partner at Niche, sizes up the NHS Long-Term Plan.

“It's the economy, stupid,” was coined by Bill Clinton’s election strategist, James Carville, in 1992 to emphasise the single most important issue to voters. The mantra became established thinking; the economy was thought to trump all other areas of policy. The NHS Long-Term Plan shouts out “it’s integration, stupid,’’ throughout its 133 pages. The not so new theory of integration has been posited as the way to develop a ‘future fit’ NHS, with the next decade acting as the springboard.

Integration, a more joined-up and coordinated NHS at both the service delivery and planning level, will be the panacea for a whole host of issues currently faced. Money will be fed into developing primary medical and community health services, and into a host of clinical priorities (especially mental health). The ultimate aim is increased capacity, more responsive care, reduced upstream pressures (especially on overstretched acute hospitals) and so a rebalanced NHS morphing gradually from cure to prevention.

The idea of ‘fracking’ money in at the primary and community level hoping for resultant benefits will take a real leap of faith.

It’s unlikely that there will be placard waving fracking protesters turning up at the doors of the new neighbourhood teams complaining about the resource push into their integrated neighbourhood hubs. However will the benefits be realised? The Nuffield Trust recently noted that they have reviewed over 40 evaluations of ‘integration’ projects and none delivered the intended benefits.

However, assuming the fracking process goes well, it will directly lead to financial winners too. Primary Care Networks will have their ‘shared savings scheme’ and acute hospitals will also receive a fracking ‘dividend’ as their future funding will not be offset by assumptions about reduced system demand.

So all the new integrated systems have to do is:

  • Propose and develop new integrated models of working;
  • Assess the pathway interdependencies across systems;
  • Allow for variability in performance in setting new care delivery thresholds and standards;
  • Ensure patients can be tracked as they flow through the new pathways of care;
  • Model the workforce needed with the right skills and competencies;
  • Ensure the governance systems are in place to mitigate the turbulence of major change;
  • Keep a look out for any untoward outcomes of change;
  • Set up proper evaluation frameworks to see if what we are doing is actually making a difference; and
  • Model the funding flows to ensure systems are delivering better VFM, and of course measuring the fracking ‘dividends’ to be paid out.

This requires a whole new skill set for Integrated Care Systems and within that, NHS managers and leaders. Capacity, patient flow and demand planning skills (as well as reliable models and analytic systems) have traditionally been hard to source within the NHS workforce. Complex analytical and data science professionals are as rare as hen’s teeth and the requirement for this capability is now more urgent than ever if we are to unlock the potential of the long-term plan.

Simulating a single provider’s supply and demand interactions has been hard enough for most organisations to achieve. Now add to this the need to model how care is delivered, and actual patients treated, across multiple providers within an integrated and seamless new system and the complexity ‘tends towards infinity’. But this is the task, this is the challenge, this is the agenda, and a future proofed NHS is the prize.

Here at Niche, ‘capacity, demand and patient flow modelling’ is one of our core offers alongside governanceindependent investigations, and large-scale evaluation studies.

 

FOR MORE INFORMATION:

E: info@nicheconsult.co.uk

T: 0161 785 1000

W: www.nicheconsult.co.uk

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Lack of progress around growing waiting list could fuel surge in negligence claims against the NHS

22/03/2019Lack of progress around growing waiting list could fuel surge in negligence claims against the NHS

A rise in negligence claims against the NHS has been predicted by the government’s spending watchdog as it warns that “insufficient p... more >
Department of Health announces day surgery shake-up in Northern Ireland

22/03/2019Department of Health announces day surgery shake-up in Northern Ireland

The Department of Health (DoH) has announced “radical plans” to shake up day surgery across Northern Ireland. Thousands of routi... more >
‘Impossible’ for healthcare trust to remain open with 280 jobs set to go

22/03/2019‘Impossible’ for healthcare trust to remain open with 280 jobs set to go

A 150-year-old private health trust has announced it will have to close, with all services and 280 staff expected to be lost. All Hallows He... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Personal Health Budgets: empowering individuals

20/03/2019Personal Health Budgets: empowering individuals

Jon Baker, PHBChoices director at NHS Shared Business Services (NHS SBS) believes that the extension of Personal Health Budgets (PHBs) is a great opportunity for clinical commissioning groups (CCG) to expand and improve care provision – provided that the right infrastructure is in place. The personalisation agenda is transforming our NHS as we continue to migrate from a one-size-fits-all model of care towards care provision that i... more >
read more blog posts from 'the scalpel' >

comment

Staying curious with the Shadow Board Programme

20/03/2019Staying curious with the Shadow Board Programme

Kirstie Stott, director of The Inspiring Leaders Network, discusses organisational and system curiosity alongside the work of the Shadow Board Pr... more >
Fiction as Therapy

20/03/2019Fiction as Therapy

Elaine Bousfield of ZunTold Publishing – a press specialising in fiction for children and young people – discusses ‘Fiction as ... more >
Capturing funds for the NHS estate

20/03/2019Capturing funds for the NHS estate

Aahsan Rahman, department head of town planning at NHS Property Services (NHSPS), looks at an alternative and perhaps underutilised funding sourc... more >
The digital revolution for healthcare is now!

20/03/2019The digital revolution for healthcare is now!

Richard Corbridge, chief digital & information officer at Leeds Teaching Hospitals NHS Trust, focuses on the practices his trust has put in p... more >
A Critical Moment for the NHS

07/03/2019A Critical Moment for the NHS

As part of our guest blog series, chief executive of NHS Employers, Danny Mortimer, reflects on a recently published Health Foundation ... more >

interviews

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >