Nine ‘must dos’ for all local health systems in 2016-17

Every local health system will be expected to stick to nine ‘must dos’ for 2016-17, NHS England has revealed in its planning guidance for the years ahead.

The first of these is to develop a high quality and agreed ‘sustainability and transformation plan’ that will dictate the most locally critical milestone that must already be achieved in 2016-17.

Providers must return to aggregate financial balance, including secondary care providers delivering efficiency savings through Lord Carter’s £5bn productivity savings programme. They must also comply with the maximum total agency spend and hourly rates determined by NHS Improvement.

All organisations will be expected to develop and implement a local plan that addresses the sustainability and quality of general practice, including existing workforce and workload issues.

They must “get back on track” with access standards for A&E and ambulance waiting times to make sure at least 95% of patients do not wait more than four hours to be seen, and that all ambulance trusts respond to at least 75% ‘Category A’ calls within eight minutes. This will require making progress in implementing the urgent and emergency care review and associated ambulance standard pilots.

Similarly, there must be improvement against standards that dictate more than 92% of patients or non-emergency pathways must wait no more than 18 weeks from referral to treatment, as well as offering patient choice.

The 62-day cancer waiting standard must be met, including by safeguarding better diagnostic capacity, and the two-week and 31-day cancer standards must continue to be improved. Providers are also asked to make progress in ensuring one-year survival rates are kept by delivering a year-on-year improvement in the proportion of cancers diagnosed at an earlier stage.

Two new mental health access standards must be achieved and maintained: more than 50% of people experiencing a first episode of psychosis will start treatment with a NICE-approved care package within two weeks of referral, and 75% of those with “common mental health conditions” will be referred to the Improved Access to Psychological Therapies (IAPT) programme, treated within six weeks of referral (but 95% treated within 18 weeks).

At least two-thirds of the estimated number of people with dementia must be diagnosed.

Local pans must seek to transform care for those with learning disabilities, including by implementing better community provision, reducing inpatient capacity and rolling out treatment reviews aligned with published policy.

Lastly, all NHS organisations must develop and introduce an affordable plan to improve quality, particularly for those currently in special measures. They will also be required to publish avoidable mortality rates annually.


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