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Our thoughts on the NHS Five Year Forward View

By Alex Kafetz

Over the years the NHS has been used to strategies, plans and even a couple of roadmaps, but today gets its first forward view. Simon Stevens has published the NHS Five Year Forward View, a joint publication by NHS England, Public Health England and the regulators, but it has Stevens’ blueprint all over it after six months in the job.

It’s a statement of intent from an organisation that still needs to convince the NHS (and perhaps itself) that it has a long-term future as a commissioning board responsible for spending much of the £110bn health budget. Indeed, some would say it’s brave to publish a five-year plan and believe it can be implemented with less than six months to go before a general election with an uncertain outcome.

In fact, the document doesn’t tell us anything surprising: Stevens and his acolytes have been trailing it for a few months, including at the Cambridge Health Network in September. It acknowledges that the NHS is unsustainable and that a radical upgrade is needed in prevention and public health to address this, giving patients greater control and breaking down the silos between care settings.

It’s mercifully free of targets such as cancer tests within a week or better diagnosis of mental health – this is clearly being left to the political parties. But patient participation, localisation and service redesign – such as for emergency and urgent care, are writ large. Smaller hospitals are given rescue packages as a number of options are suggested for them to remain open but viable. Competition is not mentioned.

At ZPB, we welcome the section on exploiting the information revolution, which cites that 86 per cent of adults use the internet but only 2per cent report using it to contact their GP. It acknowledges the polarised approaches to NHS technology strategy – from the highly centralised national procurements to the ‘letting a thousand flowers bloom’ approach – have not yielded the shared benefits needed. Nationally NHS England will focus on ‘the electronic glue’, which enables different parts of the NHS to work together. Locally procured systems must meet nationally specified interoperability and data standards.

The newly-formed National Information Board will focus on transparency of performance data; an expanding set of NHS-accredited health apps; interoperable electronic health records; online GP appointments and electronic prescriptions and of course, care.data.

We look forward to working with our clients to shape their strategies and conversations to align with the newly established board. The NHS will inevitably enter choppy waters as the election looms, but this five year forward view shows it the course to navigate.