Measures to support the mental health of 350,000 more young people and 380,000 adults; up to 500,000 lives could be saved through early detection; and 24-hour mental health support through 111 amongst the expected plans. But is the budget spread too thin?
Due to be published later today, the government 10-year plan for NHS England has been criticised by Labour as lacking both staffing and the funding to succeed. The plan, which will lead to “world class care” for patients according to Prime Minister Theresa May will outline how the £20bn extra funding by 2024 promised will be spent.
The plan has been developed with the ideas, experiences and insights of members of the public, front-line NHS staff, and the organisations that represent them, as well as working groups made up of local and national NHS leaders, clinical experts, and patient representatives. The long-term plan aims to outline the best ways to use the budget to best provide lifesaving treatment and care for patients and families, whilst reducing pressure on NHS staff and investing in important new technologies.
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— NHS England (@NHSEngland) January 7, 2019
Amongst the new plan, pledges to increase mental health maternity care, elderly support, earlier detection and prevention of diseases, as well as a focus on support and care for autism and learning disabilities are expected.
Concerns have been raised particularly around the staffing and funding outlined within the proposal. Shadow Health Secretary, Jonathan Ashworth, appeared on the BBC’s Andrew Marr Show and said “The funding isn’t sufficient and the staffing isn’t there”.
Health Secretary Matt Hancock admitted the NHS was short-staffed, but said that work was being done to solve the problem. He told the BBC that there are “record numbers of GPs in training” and there are “still lots of people” trying to become nurses in the UK.
The Prime Minister has said that the plan, coupled with the extra money announced last summer, has secured the future of the NHS. The budget is set to rise by £20bn a year above inflation by 2023, with £2bn allocated for mental health it was announced back in October. It has since been announced that GP and community care services are expected to receive £4.5bn from the overall £20bn increase. A detailed explanation of where this additional funding will come from has yet to be provided.
The additional £2bn each year towards mental health care is expected to be used to:
- Provide comprehensive mental health support across major A&E departments across the NHS.
- Pay for specialist mental health ambulances.
- Cover community services for those experiencing mental health problems.
- Create and fund specialist crisis teams working with schools, as well as social and young people’s mental health services.
- Create teams in schools to support those with mild to moderate mental health problems.
The overall increase for NHS England is equivalent to an annual real terms rise of nearly 3.5%, around twice the annual increase the NHS has received since 2010. The NHS 10-year plan is the first long-term plan of its kind in nearly two decades, since Tony Blair unveiled a new “fundamental” blueprint for NHS reform, which included a maximum six-month waiting time limit for referral for inpatient procedures, free fruit for infant school children, and an increase in funding for NHS staff in 2000.
The full NHS England 10-year plan is due to be unveiled later today. Key focuses the Prime Minister has outlined so far have included:
- Better mental health care support for children, young people and adults. Advice to be available from NHS 111, 24/7 by 2023.
- Improved maternity care safety and a greater provision of mental health support to tackle post-natal depression. This is set to include fathers for the first time, as well as doubling the support period for mothers from one to two years. Up to 24,000 more new mothers are expected to be able to access specialist mental health support by 2023/24.
- Greater mental health support for almost 350,000 young people and children, as well as 380,000 adults over the next five years.
- Greater control and choice for elderly people through the expansion of personal budgets. This is expected to allow individuals to decide what care they want whilst avoiding additional strain on hospitals.
- Better prevention and detection of diseases, with a particular focus on cancer.
- Increasing the NHS workforce (currently, one in 11 posts are vacant).
- Bringing the NHS into the digital age with online GP booking, prescription management, and health records.
The Prime Minister has also vowed that young people will no longer face restarting mental health treatment with adult services upon turning 18.
GPs, mental health and community care are expected to receive the biggest funding increases, as plans look to decrease the reliance on hospitals (which currently use around half of the £114bn frontline budget). Hospitals are expected to receive a smaller budget increase, which some experts have said may be a cause for concern with many trusts already missing all three key waiting time targets for A&E, cancer care, and routine operations.
NHS bosses have said that the new 10-year plan could save as many as 500,000 lives through its focus on prevention and early detection of strokes, heart problems, and cancer.
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— NHS England (@NHSEngland) January 7, 2019
Initial responses
Although many are waiting for details to be fully released before drawing a conclusion, some concerns have been raised. Despite the 2bn increase to the existing £12bn a year currently spent on mental health services in England, the Institute for Public Policy Research (IPPS) previously expressed concern that this figure is only half what is needed for the NHS to put spending more on par with that of physical health.
Chief Executive of th eHealth Foundation think-tank, Jennifer Dixon, has also prediction it will be ‘extremely tough’ to fulfil pledges outlined due to the scale of staffing shortages, rising pressure, and cuts to other parts of the wider healthcare system. While £20bn has been promised to the front-line NHS budget, this will not support social care and public health services such as stop smoking and weight management which, at the end of 2018, it was announced would be cut by over 4% in real terms.
Mark Rowland, Chief Executive at the Mental Health Foundation commented:
“We welcome the new commitments on prevention and mental health in the NHS long-term plan. In particular it is positive to see a much greater focus on children, students, perinatal mental health and community care.
“The evidence shows that investing in mental health early in the life course and at the first signs of distress will help prevent mental health problems in the future. It is good to see an NHS plan that looks beyond the political cycle and towards what is best for the health of our nation.
“If we are to tackle the current crisis facing our mental health, this increased investment in services needs to be matched by a commitment to the prevention of mental health problems. The plan recognises the importance of prevention for physical health and we need the same approach for mental health. It already recognises the role of all government departments in addressing mental health.
“In light of that, we are calling for the establishment of a cross government body to lead a public mental health approach in key areas such as education, criminal justice, housing and social care which could do much to address the causes of mental ill-health.”
Full details of the plan are set to be unveiled on Monday 7 January by NHS Chief Executive Simon Stevens and Prime Minister Teresa May. The 10-year plan will only affect NHS England. Scotland, Wales and Northern Ireland are expected to share an extra £4bn between them by 2023.
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