What are the priorities laid out in 'Our Plan for Patients'? 

1. Ambulances

• Continue focus on improving admissions and discharge in Emergency Departments – e.g. through 24/7 mental health crisis helplines and making greater use of other settings such as walk-in centres or minor injuries units.
• Use remote monitoring to create more capacity in hospitals – the Plan aims to free up 7,000 extra beds this winter, 2,000 more than the aim in the latest planning guidance.
• Improve ambulance response times by recruiting more 111 and 999 call handlers and pursue digital solutions to enable ambulance trusts to better coordinate.

2. Backlogs

• Re-statement of existing measures, including funding and timeframes associated with the Elective Recovery Plan, changes to NHS pension incentives to improve retention, recruitment of 50,000 more nurses by 2024, and delivering further community diagnostic centres (as referenced in planning guidance).
• The Plan implies an acceleration of the hospital building programme.

3. Care

• A (kind of) new £500m adult social care discharge fund to support hospital discharge and address workforce issues – seen as replacement for the Hospital Discharge Programme which ended in March 2022 (and funded from existing health and care budgets). 

4. Doctors and dentists

• Set target of a 2 week wait for GP appointments, to be delivered by – changing funding rules for roles in the Additional Roles Reimbursement Scheme; allowing community pharmacists to prescribe more medicines; making 31,000 additional phone lines available to GPs and delivering ‘cloud-based’ telephone solutions.
• Improve the accessibility of dental treatment by simplifying dental registration rules and holding ICBs to account for the provision of dentistry.

What are the key changes in healthcare priorities and what do they mean for decision-makers across the NHS?

The flagship change in 'Our Plan for Patients' is the new target for all patients to see a GP within 14 days. That aside, much of the Plan is simply a restatement of pre-existing commitments, or a ramping up of initiatives which are already underway. However, we can infer some changes in focus areas across the health and care landscape:

• The Plan places less emphasis on mental health services than in recent NHS papers, such as the 22/23 planning guidance – it does not mention the 1.6 million-long waiting list for mental health services, for example
• The Plan also makes no reference to health inequalities or Population Health Management, despite this featuring as a priority area in the 22/23 guidance
• There is an increased emphasis on utilising digital tools to improve public transparency and enable patient choice – perhaps reflecting a subtle shift from 22/23 guidance priorities, which focuses on using digital technologies to improve the delivery of care and patient outcomes

The issues highlighted by the new health secretary won’t be news to anyone working in the NHS. They are, however, a reminder of some of the most serious challenges that decision-makers and practitioners will be confronted with this winter.

Coffey’s commitment to be “proactive, not prescriptive” acknowledges the autonomy that NHS leaders will continue to have in their respective parts of the system. That said, national level policy priorities inevitably set the agenda and shape regional and local leaders’ decisions – Our Plan for Patients is our first indication of what the new government’s plans for healthcare will be.

Author: Dan Hall, The PSC strategy team