We expect to find much to welcome in the NHS Long Term Plan, at least in its intentions. But the NHS has been great at plans, not great at really changing patterns of care, treatment and support.
‘Patient-‘ or ‘person-‘ centred care has been frequently promised since 2000.
Education for self management bloomed in the mid-2000s and was then neglected.
Care planning for everyone with long term conditions has been pledged since 2008.
Coordinated care was a major national commitment in 2013.
A new relationship with people and communities was foreseen in 2014.
And the legacy model of reactive, episodic care has stubbornly persisted beyond the landmark work of Wagner (chronic care model), Wanless (sustainability through engagement), and Marmot (social determinants of health).
So when the National Voices coalition looks at the Plan – and the process that follows – from the perspectives of people with health and care needs, we will need to sort ‘ambitions’ from likely delivery.
We propose five tests to PROVE the NHS is convincingly setting out the right direction.
P for personalisation
Is personalised (or person-centred) care embedded at the core of the future NHS – especially in relation to supported self management for people living with multiple conditions?
R for radical
Is the NHS committed to a radical shift of resource to primary and community care (integrated with other services and the VCSE) -- starting now and accelerating over the decade?
O for open and accountable
Will people from outside the NHS be properly engaged in redesigning services – and holding the NHS to account for its objectives?
V for voluntary sector
Can the NHS make good on partnership working? If it can’t, the Plan will fail.
Can it find ways to create high level, genuine, equal, respectful and coproductive partnerships with the VCSE sector – and fund them?
E for equality
Structural inequality is creating our industrial levels of ill health: can the NHS put inequalities at the heart of place-based, population health, targeting first and foremost the people with most to gain from personalised approaches?
The Plan is now expected between 12 and 21 December, if the Brexit gunsmoke ever clears.
When it arrives, check the five tests and let us know what you think.