The much anticipated report, the NHS Five Year Forward View1, launched today by Simon Stevens, the Chief Executive of NHS England, developed through consultation with key stakeholders, including patient groups.2
It articulates why change is needed, what that change might look like and how it can be achieved and highlights the need to close the widening health inequalities gap, improve the quality of care and tackle the pervasive funding challenges. It confirms that the vision of "universal healthcare, irrespective of age, health, race, social status or ability to pay" has not changed, but that the world has, and that the NHS needs to change to take advantage of the opportunities that science and technology can bring to help staff, patients and carers.
The Plan provides a five-year plan for evolving the NHS, to create a more equitable care landscape, better able to cope with surging demand on services and, at the same time, tackle the much trumpeted £30 billion funding gap that will develop by 2020-21 if change doesn't happen. The key actions proposed are:
a greater emphasis on prevention of ill health, because "the future health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health". The report therefore backs comprehensive action on obesity, alcohol and other health risks and supports new workplace incentives and stronger public health powers for local government giving patients more control on their own care, including shared budgets and support for unpaid carers, and developing better partnerships with voluntary organisations and local communities to meet unrelenting demands removing the siloes between primary care and hospitals, physical and mental health and health and social care to provide a more seamless and efficient service. With far more care delivered locally, supporting people with multiple health conditions, not just single diseases, and key services, such as stroke, provided in specialist centres developing and delivering new models of care, including greater alignment between national NHS bodies to provide meaningful local flexibility, and more investment in workforce, technology and innovation. There is no "one size fit all" solution rather different local health communities will be supported to choose from a small number of radical new care delivery options and supported to implement them. These include: