Health bosses call for ‘decisive action’ and £8bn in Five Year plan

Decisive action must be taken to transform the provision of NHS care for patients, otherwise in five years’ time there will be a growing gap in healthcare delivery and funding, health bosses say. 

In the newly published Five Year Forward View – instigated by NHS England – it has been argued that more needs to be done tackle the root causes of ill-health. It also backs hard-hitting action on obesity, alcohol and other major health risks. 

Within the 41-page report it states that in order to deliver a better future for the NHS, action will be needed on three fronts to tackle: demand, efficiency and funding. 

It was suggested that more action on any one of the three will reduce the pressures on the other two. However, the report once again highlighted that an annual £30bn shortfall would open up by 2020. 

Focusing on prevention and looking after patients with long-term conditions outside of hospital is expected to save the NHS money, with efficiency savings of up to 3% possible by 2020, the report says. 

But even if the NHS achieves this ambitious target it will still have a deficit of £8bn if the NHS budget is only protected and not increased. 

Simon Stevens, chief executive of NHS England, said: “It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure the future that we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so.” 

The documents also sets out actions that will need to be taken in order to develop and deliver new models of care, including greater alignment between the national NHS bodies to provide meaningful local flexibility in the way that payment, rules and regulatory requirements are applied. It also proposes more investment in the workforce, technology and innovation.

In response to the report, NHS Confederation chief executive Rob Webster (pictured below) said: “The NHS requires a new burning ambition that we can all get behind – one that will deliver a 21st century health and care system for the future.

“The Five Year Forward View provides many of the elements necessary, not least proof that a system that is true to the founding principles of the NHS is achievable. That will take funding, efficiency and service change at pace and scale.”

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Nigel Edwards, the chief executive of the Nuffield Trust think tank, added that the report makes it crystal clear that the NHS cannot continue with 'business as usual' if it is to meet the needs of a diverse and ageing population. 

The report, which has been produced by six health bodies, stated that the NHS will take decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, and between health and social care. 

The Forward View also envisages much less healthcare being provided in hospitals and much more in community settings. 

RCP president Professor Jane Dacre said that the five-year plan offers several new models of care that echo the RCP Future Hospital report’s ideas of promoting integrated care and bringing care closer to the patient. 

“The variety of new care models suggested in this thoughtful plan show that NHS England recognises the need for a flexible approach to providing local services, and supports integration of primary, secondary and community care much more effectively than before,” she said. 

Proposals set out in the document include allowing GP practices to join forces into single organisations that provide a broader range of services including those traditionally provided in hospital; creating new organisations that provide both GP and hospital services together with mental health, community and social care; and sustaining local hospitals where it is the best solution clinically and is affordable and has the support of local commissioners. 

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David Bennett, chief executive of Monitor, said that if NHS is to provide the best service it can to the public, and live within its means, it has got to change the way it delivers care to people. 

“The Forward View sets out our vision of an NHS which can deliver better care and a better experience for patients, and is able to do more of this for however much money we can give it, and is therefore sustainable,” he said. 

Health secretary Jeremy Hunt welcomed the report, adding that the NHS could only continue to improve with “important reforms”. 

Discussing the report and funding, Chris Ham, chief executive of The King’s Fund, added that it “throws down the gauntlet” to the political parties to back fundamental changes to health services that could significantly improve care for patients. 

“But attention will rightly focus on the funding options,” he said. “While it is right to emphasise a three-pronged approach which focuses on managing demand and improving productivity as well as the need for additional funding, there is no escaping the size of the financial challenge facing the NHS. Even if the very challenging estimates for productivity improvements outlined here can be achieved, an additional £8bn a year in funding would be needed by 2020. 

The NHS Forward View was produced by NHS England, Public Heath England, Monitor, the NHS Trust Development Authority, Care Quality Commission and Health Education England, advised by patient groups, clinicians and independent experts. 

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