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Forum reflection – why the refreshed NHS Long Term Plan is a must

A few weeks ago, our Managing Director, Karina Malhotra, took part in the latest Westminster Health Forum – ‘Priorities for delivering long-term progress in the NHS’. We analyse the main highlights here.
Published on
February 20, 2023

A few weeks ago, our Managing Director, Karina Malhotra, took part in the latest Westminster Health Forum – ‘Priorities for delivering long-term progress in the NHS’.

The idea being that more focus needs to be on long-term, sustainable fixes rather than short-term, immediate ones.

While the government recently indicated that it has no plans to bring forward the refreshed NHS Long Term Plan imminently, and the current Health Secretary, Steve Barclay, is said not to be a fan of ‘airy long-term strategies’, many in the sector believe it is very important – especially as the picture now is very different to pre-pandemic.  

Here, we provide a quick summary of the main points of note that came from the event.  

Moving service delivery forward

Karina was on the panel titled: ‘Moving forward service delivery – increasing elective care capacity and tackling waiting lists, reform of urgent and emergency care, and taking forward ICSs as the delivery bodies for joined-up, accessible local care’, where she zoned in on elective care.

In the original NHS Long Term Plan, outlined in 2019, there were a number of elective care focuses, namely:  

  • to deliver more patient-centric care;
  • use technology to fundamentally redesign outpatient services and;
  • a commitment to increase activity to reduce long waits and the size of the waiting list.

Karina agreed with the other speakers that the NHS needs a longer-term view, arguing that we currently have too many ‘short-term, knee-jerk solutions going into the NHS that are just not aligned well enough’.

Even more so when you consider the NHS is now in an arguably much worse position than it was in 2019 – obviously heightened by the pandemic – which would seem to call for a long-term vision to fix the issues.

According to recent figures, the total waiting list size is currently c7 million – up from c4 million pre-pandemic – of which 85% are waiting on outpatient pathways and some 15% are waiting for surgery. Meanwhile, around 150,000 patients are waiting over 65 weeks for elective care (compared to zero in 2019), 370,000 are waiting over a year (versus 1,500 in 2019) and 1,500 are waiting more than two years for treatment (against zero in 2019).  

In 2021/22, the most recent year for which we have data, there were 2 million fewer elective outpatients and surgeries compared to 2019.

All of which goes to show the scale of the challenge facing the NHS in returning to, and then surpassing, pre-pandemic levels. The latest NHS Operating Guidance for 2023/24 has, as a key priority, the goal of reducing elective long waits and cancer backlogs, as well as increasing activity to greater than pre-pandemic levels (by circa 30%).

But the numbers above show how tricky those ambitions will be without a long-term, joined-up approach.

What can be done?

“So how do we move forward?” Karina asked. “This is where I think the long-term plan really needs to come into its own. Even in the absence of calling it a long-term plan, there definitely needs to be a focus on what comes next.”

Karina pointed to what helped the NHS deal with the unprecedented challenges of the pandemic head-on, and how learning these lessons could help move the service forward. This included local solutions by local leaders (and not relying on a one-size-fits-all approach), true integration, pooling resources, and using data to provide actionable insights.

She highlighted how using data intelligence as the foundation for designing interventions is particularly critical at this stage. She gave an example of where Acumentice had delivered predictive waiting list modelling to ensure that a London ICS made the best use of its resources in the long-term, taking into account its local population needs.

The well-attended online conference also had sessions on developing primary care services, priorities for enabling service development and achieving long-term strategic goals, and various questions and comments from the floor. But the common thread throughout was a need for a joined-up, long-term vision rather than short-term fixes or sticking plasters.

Westminster Health Forum runs a regular programme of online conferences focusing on all aspects of healthcare. We will next be speaking at an event on Thursday 8 June titled: ‘Utilising data to drive health and social care developments’. You can book your place here.

For updates on the latest conferences, you can follow Westminster Health Forum on Twitter.  

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