Rachel Power
Chief Executive

We have now made our formal submission to NHS England in response to its consultation on the new Ten Year Plan for the NHS. You can read it in full here, or carry on reading below for a summary of what we say.

NHS England has been required to produce this plan much more quickly than would be ideal. It was a condition of the announcement of new funding for the NHS this summer, and the idea was for it to be published alongside this autumn’s Budget, along with the green paper on social care. We’ve seen, through our involvement with this work, the frantic pace that NHS England officials have had to work at in order to get their ideas out for consultation at all – the political circumstances have made a more thorough engagement, with opportunities for patients to bring their ideas to the table at the earliest stages, impossible.

Unfortunately this rather hectic period has in a sense been for nought, as the Budget has been scheduled for much earlier than expected – 29 October, rather than the second half of November as is more usual. Presumably this has been because final decisions on a withdrawal agreement from the European Union are expected in November, and the Government wants to get the Budget out of the way before then. This has meant that the plan for the NHS won’t be published alongside the Budget after all.

Happily this consultation exercise is not the only opportunity for patients’ views to be fed in. We expect that NHS England will be undertaking further engagement work to get patients’ views on the emerging findings from the consultation, between now and the plan being finalised. We also expect the new NHS Assembly to be created to oversee the implementation of the plan during 2019 and beyond. We will share details of these developments in Weekly News and in Patient Voice, our quarterly newsletter for members, as we have them.

Five values
The consultation asked a mix of very broad and very specific questions. The very first was what the core values underpinning the plan should be. We identified the following five.

  1. Public good
    The plan should approach securing the nation’s health and wellbeing both as a public good in its own right (relieving suffering and supporting people to live well) and as the essential stewarding of our national human resources (including ensuring that everyone makes the maximum contribution they can to the economic, social and cultural life of the nation, removing or overcoming any barriers to this that arise from ill health, care needs and disabilities).

  2. Ambition
    Our approach to health and care, as a society, must be ambitious. We should aim to extend services beyond their existing levels, not merely hold station; in response to demographic change we must ensure that people live longer in good health, not merely that they live longer; and care must be delivered to the best available standard, including for instance by implementing NICE guidance in full.

  3. Openness
    Probably the least attractive characteristic of the NHS, sadly, is that when patients are harmed it has an enormous cultural predisposition towards secrecy, defensiveness and blame; the new plan must therefore include ambitious approaches to ensure that the NHS is open and transparent with patients, and learns rather than blames.

  4. Equal partnership
    The NHS must work in equal partnership with patients, and those around them – their families, carers and everyone who matters to them; this must hold true from top to bottom, both through person-centred care planned to meet each individual’s needs, and through working with patients at every stage of service redesign.

  5. Equity
    The NHS’s status as a tax-funded service, delivered free at the point of use, ensures disparities in how people from different backgrounds experience healthcare are low by international standards; but it still has much to do to ensure it delivers equitably for all, not least by recognising differing needs among patients from different social and cultural background, and responding appropriately to all groups in order to reduce inequalities in healthcare outcomes.

Patient safety and barriers to change
Our response also looks at some of the things that the NHS might find particularly difficult to change, but where it is essential that it makes progress:

  • It is still far too ready to dismiss patients’ complaints when things have gone seriously wrong
  • It needs to be not only willing but actively keen to hear patients’ experiences, especially when they tell it things it would rather not hear
  • It needs a major cultural shift, so that not only is care planned and delivered with patients as equal partners, but the design of entire services is approached the same way
  • In order to shift care out of hospitals and into the community, it must undertake a shift of investment from acute care to primary and community services.

We expect the final plan will be published in November, and will give our response to it when it emerges.