NHS Long Term Plan

What does this mean for libraries?

Increases in demand from students, such as nursing students on placement in NHS organisations, and increases in medical student numbers will have an impact on the workload of LKS, and may require the introduction of new services to support them, such as having access to good WiFi or lockers, and more collaboration with university library services.

A move towards more Integrated Care Systems, and potentially more collaborative working under the auspices of Sustainability and Transformation Partnerships (STPs) could have implications for LKS that have SLAs with only some local organisations, and more work may need to be done to encourage organisations that currently don’t contribute to LKS to do so, so that all staff in an area have equitable funded access.

LKS are ideally placed to help get better value for the NHS and get the most out of the investment in it by making the evidence base accessible and encouraging its use and application. It could be a good opportunity to promote time saving services such as current awareness and mediated evidence searches. LKS can also support innovation and change through encouraging and supporting knowledge management.

There may be a need to help NHS staff become more familiar with digital systems, particularly to help retain staff that are less confident with IT. While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

With the focus on preventing illness, LKS will have a role to play in supporting the provision of good-quality health information for patient and carers.

Katie Nicholas of Health Education England has prepared a useful summary of references to evidence, knowledge, innovation and Topol in the NHS Long Term Plan.

Source: NHS England

Link to main document

Date of publication: January 2019

Summary of driver:

This is the first stage in planning for the next ten years of the NHS in England. Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) will have until the autumn to say how they are going to implement the plan locally.

It is said to be ambitious but realistic.

There are three main areas of health and care this plan aims to tackle:

1. Making sure everyone gets the best start in life

This includes taking further action on childhood obesity, increasing funding for children and young people’s mental health, reducing stillbirths and mother and child deaths during birth by 50% and delivering the best treatments available for children with cancer, including CAR-T and proton beam therapy.

2. Delivering world-class care for major health problems (both physical and mental)

This includes preventing 150,000 heart attacks, strokes and dementia cases, spending at least £2.3bn more a year on mental health care, delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24, and saving 55,000 more lives a year by diagnosing more cancers early.

3. Supporting people to age well

This includes increasing funding for primary and community care by at least £4.5bn, bringing together different professionals to coordinate care better, developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home and upgrading NHS staff support to people living in care homes.

The planned means to do this include:

1. Doing things differently

This includes encouraging more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities.

2. Preventing illness and tackling health inequalities

This will include action on helping people stop smoking, overcome drinking problems and avoid Type 2 diabetes.

3. Backing our workforce

There are planned thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. There will also be work to improve staff retention.

4. Making better use of data and digital technology

Among other plans, there will be a new NHS App, better access to digital tools and patient records for staff.

5. Getting the most out of taxpayers’ investment in the NHS

Identifying ways to reduce duplication in how clinical services are delivered, and make better use of the NHS’ combined buying power to get commonly-used products for cheaper, and reduce spend on administration.

Budget 2018: What it means for health and social care

A policy briefing is available for LKS staff to share in their organisations. Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust. Feel free to reproduce it (with acknowledgement).

What does this mean for libraries?  The budget applies directly to NHS funded services but not education and training tariffs where a large proportion of library funding is derived from. It is useful for library staff to understand the priorities and pressures in order to support the organisations they serve.

Source: The Health Foundation, The King’s Fund, The Nuffield Trust

Link to main document

Date of publication: November 2018

Summary of driver: The budget outlined an increase to the NHS England budget (not capital, public health or education and training) of £20.5bn at estimated 3.4% increase per year by 2023/24. However, higher inflation will mean the increase is less than 3.4%; the real terms increase will be confirmed by the 2019 spending review. A long term plan about how the money will be spent is expected by the end of the year. Funds will be allocated to mental health, social care, disabilities grant and staff salary rises. The document considers where the funds will come from and what this means for NHS funding.

How is the NHS performing? June 2018

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? With services under great pressure, there is a greater need for library and knowledge services to support effective and efficient healthcare. As well as making health care provision safer, K4H impact case studies demonstrate that LKS can help make cost savings, and can support health service transformation.

Source: King’s Fund

Link to main document

Date of publication: July 2018

Summary of driver:

This is the 26^th quarterly report by the King’s Fund, and as well as looking back at what has happened over the past three months, considers the recently announced funding offer for the NHS.

• Services remain under substantial pressure – there are 4.2m waiting for consultant-led care
• There is little optimism that current A&E performance targets can be met
• Some NHS organisations are spiralling further into deficit while others are seeing their surpluses bolstered by centrally-released funding
• There are some positive signs of increased joint working between local providers and commissioners of care
• The recent announcement of a five-year funding offer for the NHS provides an opportunity to make good on previous attempts to deliver out-of-hospital services, including social care
• By March 2018 2,755 people had been waiting more than a year for treatment – the highest number since 2012/13
• The time by which 92% of patients are seen after a referral is now 22 weeks; the highest since March 2009
• GP referrals are growing at a slower rate than before but are still increasing
• Hospital-bed occupancy is at its highest level for eight years
• Emergency admissions in May 2018 were 5.6% higher than the year before
• 44% of CCG finance leads are considering extending waiting lists or reducing activity for certain elective specialties
• In March 2018 only 9 of 137 Trusts with major A&E departments me the 95% standard
• The overall 95% standard has not been achieved since July 2015
• By the end of the 2017/18 financial year the provider sector had a deficit of £960m
• The commissioning sector had an underspend of £955m due to underspending in central NHS England budgets
• Nearly two-fifths of CCGs are expecting to overspend their budgets next year
• 80% of CCGs are considering extending the number of low-value treatments and prescriptions that will no longer be funded
• 42% of Trust finance directors are expecting to end 2018/19 in deficit
• 51% of finance directors and 21% of CCG finance leads feel patient care has worsened in their area over the past year
• However, closer working through STPs and ICSs is starting to pay some dividends
• Acute Trusts account for 87% of Trusts in deficit
• The long-term NHS funding settlement, a Green Paper on social-care reform and a 10-year health and care workforce strategy – taken together – might provide the best opportunity in a decade for health and social-care services to both find some stability and use that stability as a base for more fundamental transformation and improvement.

The NHS 10-year plan: how should the extra funding be spent?

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries?

Whilst only suggestions from the King’s Fund, some of the points made are aims that have been stated before, and if implemented would have implications for LKS.

The integration of health and social care may mean new groups of staff to support, especially around social care staff who have not traditionally been served by NHS libraries. Whilst it make take many years to fully integrate health and social care, in some areas, the introduction of Integrated Care Organisations and Accountable Care Organisations may mean this happens much faster.

The suggested expansion of new roles such as physician and nurse associates may mean more staff undertaking courses whilst working, and nurse associates in particular may need more support for their learning locally. A re-balancing of staff towards primary and community care has implications for the way LKS support remote users that may find it difficult to access LKS in person.

The King’s Fund suggests more capacity among local leaders and less reliance on external regulators. LKS already support leadership education and development, but this may become more important in the future.

Various ways of tackling waste are mentioned, such as reducing the use of procedures of limited value, and tackling variations in practice. LKS are ideally placed to ensure that the evidence base of healthcare is used to provide consistent and effective care.

Source: King’s Fund

Link to main document

Date of publication: July 2018

Summary of driver:

The King’s Fund has outlined the priorities it believes should be at the heart of the NHS plan that the Government has asked the NHS to create, to show how it will use the extra funding it recently announced will be spent.

• The centrepiece of the new plan should be a commitment to bring about measurable improvements in population health and to reduce health inequalities
• This depends on making further progress in integrating health and social care
• There should be a focus on: older people with frailty, people with complex needs and children
• Reforming the NHS from within needs much more emphasis, drawing on the intrinsic motivation of staff. This depends on building capability among leaders and staff as less reliance is placed on external interventions from regulators
• The Government must increase funding for the social care and public-health services provided and commissioned by local authorities
• The NHS and Government must work together to produce a comprehensive workforce plan and bring forward proposals to make social-care funding sustainable
• The Government’s new funding translates to an average annual increase of 3.4%
• Productivity in the NHS has grown by around 1.4% a year since 2009 and the Government wants this kept up for the next five years
• The OECD estimates that about a fifth of spending on health care makes no or minimal contribution to health outcomes this includes:
  • Adverse events
  • People who are in hospital because no appropriate alternatives are available
  • Administrative costs
• Ways of tackling waste include:
  • More generic prescribing
  • Tackling variations in practice
  • Reducing overuse of antibiotics and procedures of limited value
  • Reducing the transaction costs of the internal market
  • Reducing the number of national bodes
  • Reduce over-reliance on inspection and regulation
• There should be more use of social prescribing for things such as volunteering, arts activities, cookery, gardening etc
• Alternative solutions to those offered by the public sector are needed – these could come from charities
• The aim should be to work towards a single health and social-care system – a move to free personal care would cost an additional £14bn by 2030/31
• There is a need to train, retain and retrain staff
• Physician and nursing associate roles should be expanded and more use made of apprentices
• The workforce should be re-balanced to more primary and community staff
• Integrated care systems (ICSs) should be established in law as NHS bodies held to account on goals for improving population health
• Peer-to-peer connections should be enabled through learning networks, improvement collaboratives and communities of practice

A Fork in the Road: next steps for social-care funding reform

Optional wording for policy briefings ONLY: A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? 

This report would be of interest to library staff supporting social care organisations. It discusses a range of approaches to reforming funding for social care. Library staff who are providing services for social care providers should share this resource.

Source: King’s Fund

Link to main document 

Date of publication: May 2018

Summary of driver:

This paper outlines a number of options for the potential reform of funding for social care. It does not make recommendations, but considers each option provided, discussing the advantages and disadvantages of each and comparing them to each other. The models considered are:

• Maintaining the current system (at 2015/16 levels) and keeping pace with projected demand pressures until 2030/31;
• Restoring the quality and access that existed in 2009/10;
• A ‘cap and floor’ model, similar to the Conservative Party proposals at the 2017 general election;
• Free personal care (FPC), similar to the model in Scotland.

 

A Manifesto for Better Mental Health

Title of driver: A Manifesto for Better Mental Health

Source:  The Mental Health Policy Group.       (Rethink Mental Illness, Centre for Mental Health, Mental Health Foundation, Mental Health Network, Mind and the Royal College of Psychiatrists)

Link to main document:  Follow this link to view the pdf https://www.mind.org.uk/media/1113989/a-manifesto-for-better-mental-health.pdf

(MIND also has pages with links to the full text, a summary and some background information).

Publication format: PDF

Date of publication: August 2014

Summary of driver:

The manifesto is a call to any future government to prioritise mental health; and to commit to and work towards improvements to the provision of mental health services.

The manifesto focuses on five main areas with several suggested improvements and commitments for each.

Key features of driver:

The five areas the manifesto focuses on are:

• Funding for mental health.
• Mental health services for children.
• Improving the physical health care of people with mental health conditions.
• Improving the lives of those with mental health conditions.
• Improving access to mental healthcare services.

Within these area there calls for action around:

• Increasing funding so improvements can be implemented; and basing funding decisions on their impact on the delivery of mental and physical health services.
• Women’s access to mental health services during and post pregnancy.
• Mental health being part of the school curriculum.
• Training school nurses and teachers about mental health.
• Continued funding for evidence-based parenting programmes.
• Reducing avoidable deaths amongst those with mental health conditions
• Ensuing doctors monitor the physical health of people with mental health conditions.
• Applying the reduction of smoking targets equally to people with mental health problems – reducing the risks to their physical health.
• The Time to Change programme
• Combining employment support and health support for unemployed people with mental health conditions.
• Implementing maximum waiting times for mental health services.
• Crisis care and the Crisis Care Condordat.
• A national network of liaison and diversion mental health services, to work with the police and the courts.

Primary audience: Politicians, in the run up to the 2015 general election.

Impact on library policy/practice: No immediate direct impact on libraries identified.

If these ideas are taken up by a future government, there may in an increased interest in evidence-based information around the topics and service developments suggested.

This could influence the topics which libraries receive literature search and current awareness service requests for. This may also require collection development around these topics and to support strategy development.

Date last updated: October 2017

Due for review: October 2018

Group member responsible: FG