NHS long-term plan ‘missed opportunity’ to resolve social care

7 Jan 19
The NHS long-term plan is a “missed opportunity” to clarify the government’s plans on the future of adult social care, council leaders have said.

The plan, published today by NHS England, focuses on early prevention and commits the biggest funding increases to community care, GPs and mental health services – but the Local Government Association warned that the social care system must also be supported.

NHS England said sustainability and transformation partnerships (STPs) and integrate care systems (ICSs) needed to design and implement their own setting out how they will deliver on the ambitions of the plan over the next five years.

But Ian Hudspeth, chair of the LGA’s community wellbeing board, said these ambitions “can only be fully realised if adult social care and public health services in councils are also properly funded”.

He added: “We feel this is a missed opportunity for the government to also launch its long-awaited adult social care green paper and proposals for the sustainable funding of these services.”

Jennifer Dixon, chief executive of the Health Foundation think-tank, agreed: “Continued cuts to public health and local authority budgets will hold back the NHS’s ambitions to keep people healthy and tackle unjust differences in health between the best and worst off.”

The plan, which sets out how the NHS’s £20.5bn will be spent over 10 years, commits £4.5bn to building a new service model where health bodies come together to provide better, joined-up care in partnership with local government.  

The NHS England document said: “Expanded community health teams will be required under new national standards to provide fast support to people in their own homes as an alternative to hospitalisation, and to ramp up NHS support to people living in care homes.”

Mental health services will receive at least £2.3bn a year by 2023-24 and A&E departments will be expected to have “same day emergency care” in place so patients can be treated and discharged without needing an overnight stay.

The plan draws on advice from frontline health and care staff, patient groups and others, also aims to improve value for money in the NHS by introducing new digital techniques and making back office savings of more than £700m.

Richard Murray, chief executive at the King’s Fund think-tank, said: “The NHS and social care are two sides of the same coin yet publication of the social care green paper has been delayed yet again. And while commitments for the NHS to do more to promote public health are welcome, cuts to local government funding for public health services underline the need for a more consistent approach across government to the population’s health.”

Murray noted that the plan also fails to answer questions on workforce shortages facing the NHS and detail on hospital waiting time targets.

Both the NHS long-term plan and the social care green paper have been beset by delays and were supposed to be published simultaneously, but the green paper is yet to be published.

It was initially delayed until autumn 2018 – to coincide with the long-term plan – but both were deferred until early 2019 due to Brexit discussions. A Department of Health and Social Care spokesperson told PF that the green paper is now due “in the coming weeks”.

Health secretary Matt Hancock said: “Whether it’s treating ever more people in their communities, using the latest technology to tackle preventable diseases, or giving every baby the very best start in life, this government has given the NHS the multi-billion-pound investment needed to nurture and safeguard our nation’s health service for generations to come.”

Other reactions

Glen Garrod, president of the Association of Directors of Adult Social Services, said:

 “The green paper and the NHS long term plan should have been developed in parallel. A major opportunity has been missed. The absence of clarity and certainty about future social care funding represents a major risk to the ambitions of this NHS Plan.”

Carrie MacEwen, chair of the Academy of Medical Royal Colleges, said: “It’s good to have a plan which sets a clear direction for the NHS and tackles many of the issues the academy has long been saying need to be addressed if we are to improve patient care.

“Our challenge now is to make sure it’s properly implemented and in this regard we, that is everyone who works in the NHS and patients who use the service, must all play our part if we are to make it a success.”

Fran Woodard, executive director of policy and impact at Macmillan Cancer Support, said: “This plan gives us confidence that providing high-quality cancer treatment and care will continue to be a priority for the NHS, thanks to the significant focus on cancer.

“However, in order to be able to deliver on these ambitions, priority needs to be given urgently to developing the right health and care workforce, with the right skills, to support people living with cancer into the future.”

Simon Gillespie, chief executive of the British Heart Foundation, said: “The plan’s strong focus on improving prevention and detection of heart and circulatory diseases and their risk factors has the potential to make a huge difference, ensuring that deaths rates fall further in the future. In addition, better care and support for people living with heart failure will significantly improve quality of life for many.”

Paul Farmer, chief executive of mental health charity Mind, said: “We are really pleased to see that mental health is such a key focus in the NHS long term plan and we welcome the £2.3bn set aside for mental health services.

“This is the kind of sustained investment we need to see to put mental health on an equal footing with physical health and, if delivered, this plan will make a difference to the lives of thousands of people with mental health problems.”

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