The 10 Year Health Plan: What do we need to deliver?

There is a new ten-year plan for the NHS. It will “focus efforts on preventing, as well as treating ill-health”; make “out of hospital care a much larger part of what the NHS does”; and “upgrade technology and digitally enabled care.”

Are we talking about the 10 Year Health Plan that will be published next summer? Yes and no. In order, these quotes come from The NHS Plan in 2000, the Five Year Forward View in 2014, and The NHS Long Term Plan in 2019.

But they closely mirror the three shifts that the present government wants to see – from hospital to community, treatment to prevention, and analogue to digital. If these three shifts are not new, then the question is: how do we make them a reality this time?

All new services represent a cost to the NHS

Technology is going to be an important part of the answer, but for that to happen we need some new thinking. We need to make sure that technology is not seen as a ‘nice to have’ or even as an ‘enabler’ of change, but as an essential, everyday tool.

And we need a shift in mindset as to what that technology looks like, so that we can move away from time and capital-intensive IT programmes, and adopt revenue-funded, zero-footprint platforms that drive efficient, high-quality pathways that work for clinicians and patients alike.

Hospital to community

How does this work in practice? Consider the ‘left shift’ from hospital to community and primary care settings. This can deliver many benefits for patients, including faster access to care and reduced travel times and costs.

However, it will generally be more efficient for clinical expertise to remain in acute settings, serving larger populations. So, the key is to get the mix right, and to move aspects of the pathway, rather than the whole pathway, into the community.

Tele-dermatology is a great example of how this can be done.