Jane Hartley, Health and Wellbeing Associate, provides an overview of the recently launched NHS Long Term Plan and responses from the voluntary, community and social enterprise sector.
There is much to be welcomed by the VCSE in the newly published NHS Long Term Plan.
The plan is highly ambitious, perhaps too ambitious given the current state of our NHS in terms of workforce and investment challenges. It does, however, commit to increasing funding in key areas such as mental health, support for carers, prevention, volunteering in the NHS and reducing health inequality.
The extra costs to the NHS of socioeconomic inequality have been calculated as £4.8 billion a year in greater hospitalisations alone so it’s encouraging that the need for greater investment in communities with the widest gaps in health inequality has been recognised along with a commitment of an extra £1bn to these communities.
While recognition of certain areas in desperate need of funding was welcomed, responses across the sector stated the need for further clarification on delivery, as well as how a connected healthcare system will work without increased funding across the board.
It’s disappointing that a green paper on adult social care has been further delayed and an opportunity missed to demonstrate true commitment to integration of health and social care through publishing them together and identifying joint investment.
There is a recognition in the plan that the NHS needs a fundamental shift in how they deliver person-centred care, recognising the importance of ‘what matters to someone’ is not just ‘what’s the matter with someone’. The Richmond Group has welcomed the move to person-centred care, including:
• the expansion of social prescribing;
• the recruitment of link workers to support people in identifying and accessing what matters to them and;
• accelerating the roll out of Personal Health Budgets to give people greater choice and control over how care is planned and delivered.
Integrated Care Systems
The plan also demonstrates a welcome shift towards a wider population health approach and states that ‘local NHS organisations will increasingly focus on population health – moving to Integrated Care Systems (ICS) everywhere.
ICS replace Sustainability and Transformation Partnerships and are described in the plan as ‘bringing together local organisations to redesign care and improve population health, creating shared leadership and action. They will also provide stronger foundations for working with local government and voluntary sector partners on the broader agenda of prevention and health inequalities’.
Each ICS will be supported at a place based level by expanded collaborative teams of neighbouring GP practices who will work together as ‘Primary Care Networks’ working with local NHS, social care and VCSE serving ‘natural communities’ with populations of 30-50,000.
The notion of collaboration and community connectivity has been well-received however, as the Richmond Group have said, collaboration with “voluntary and community organisations who have so much evidence, insight and experience in service planning and provision” should be a defining feature of local strategies, harnessing the potential of a connected approach from the outset.
North East Integrated Care System
The regional ICS will cover the North East, North Cumbria and North Yorks and the NHS at a North East regional level is moving towards becoming an ICS from April 2019. Despite welcome signs of attempts at engagement of VCSE leaders in emerging structures and working groups, the VCSE sector is still very much a bit player in this emergent environment.
The NHS Plan states that every ICS will have: ‘a partnership board, drawn from and representing commissioners, trusts, primary care networks, and – with the clear expectation that they will wish to participate - local authorities, the voluntary and community sector and other partners’. We await details of the board membership for the NE ICS.
It is also imperative that the VCSE is engaged and recognised as a key partner in the emerging Primary Care Networks across the region particularly given the commitment to increase access to social prescribing through ‘Link workers within primary care networks working with people to develop tailored plans and connecting them to local community groups and support services.’