NHS Long Term Plan > 자유게시판

• 목록
• 답변
• 글쓰기
• 게시판 리스트 옵션
  • 수정
  • 삭제

The NHS has actually been marking its 70th anniversary, and the national argument this has unleashed has centred on 3 big facts. There's been pride in our Health Service's long-lasting success, and in the shared social dedication it represents. There's been concern - about financing, staffing, increasing inequalities and pressures from a growing and ageing population. But there's also been optimism - about the possibilities for continuing medical advance and much better results of care.

In looking ahead to the Health Service's 80th birthday, this NHS Long Term Plan takes all 3 of these truths as its beginning point. So to prosper, we need to keep all that's excellent about our health service and its place in our national life. But we need to tackle head-on the pressures our personnel face, while making our additional funding go as far as possible. And as we do so, we must accelerate the redesign of patient care to future-proof the NHS for the decade ahead. This Plan sets out how we will do that. We are now able to because:

- first, we now have a safe and enhanced financing path for the NHS, averaging 3.4% a year over the next five years, compared with 2% over the previous five years;
- second, due to the fact that there is wide agreement about the changes now required. This has been confirmed by patients' groups, professional bodies and frontline NHS leaders who given that July have all helped form this plan - through over 200 different events, over 2,500 separate reactions, through insights used by 85,000 members of the public and from organisations representing over 3.5 million individuals;
- and 3rd, because work that kicked-off after the NHS Five Year Forward View is now beginning to flourish, supplying practical experience of how to cause the changes set out in this Plan. Almost whatever in this Plan is currently being implemented effectively someplace in the NHS. Now as this Plan is executed right across the NHS, here are the big changes it will bring:

Chapter One sets out how the NHS will relocate to a brand-new service model in which patients get more alternatives, better assistance, and properly joined-up care at the best time in the optimal care setting. GP practices and medical facility outpatients currently supply around 400 million in person appointments each year. Over the next 5 years, every patient will have the right to online 'digital' GP assessments, and revamped healthcare facility support will have the ability to avoid as much as a 3rd of outpatient consultations - saving patients 30 million trips to hospital, and conserving the NHS over ₤ 1 billion a year in brand-new expenditure avoided. GP practices - generally covering 30-50,000 individuals - will be funded to collaborate to deal with pressures in primary care and extend the range of hassle-free regional services, creating genuinely incorporated groups of GPs, neighborhood health and social care personnel. New broadened community health teams will be required under new national standards to provide fast assistance to individuals in their own homes as an option to hospitalisation, and to increase NHS assistance for people living in care homes. Within five years over 2.5 million more people will take advantage of 'social prescribing', a personal health budget, and new assistance for handling their own health in partnership with clients' groups and the voluntary sector.

These reforms will be backed by a new warranty that over the next 5 years, financial investment in primary medical and neighborhood services will grow faster than the total NHS spending plan. This dedication - an NHS 'first' - creates a ringfenced regional fund worth a minimum of an extra ₤ 4.5 billion a year in genuine terms by 2023/24.

We have an emergency care system under real pressure, but also one in the middle of extensive modification. The Long Term Plan sets out action to ensure clients get the care they require, fast, and to relieve pressure on A&E s. New service channels such as urgent treatment centres are now growing far much faster than medical facility A&E attendances, and UTCs are being designated across England. For those that do need healthcare facility care, emergency situation 'admissions' are progressively being treated through 'very same day emergency care' without need for an overnight stay. This design will be presented across all acute medical facilities, increasing the percentage of intense admissions typically released on day of attendance from a 5th to a 3rd. Building on hospitals' success in enhancing results for significant injury, stroke and other important diseases conditions, new medical standards will make sure clients with the most major emergencies get the very best possible care. And building on current gains, in collaboration with local councils further action to cut delayed healthcare facility discharges will assist maximize pressure on healthcare facility beds.

Chapter Two sets out brand-new, funded, action the NHS will take to enhance its contribution to avoidance and health inequalities. Wider action on avoidance will help people remain healthy and likewise moderate demand on the NHS. Action by the NHS is an enhance to - not a replacement for - the crucial role of individuals, communities, government, and companies in shaping the health of the nation. Nevertheless, every 24 hr the NHS enters into contact with more than a million people at moments in their lives that bring home the individual effect of disease. The Long Term Plan therefore funds particular brand-new evidence-based NHS prevention programs, including to cut cigarette smoking; to decrease weight problems, partly by doubling enrolment in the effective Type 2 NHS Diabetes Prevention Programme; to limit alcohol-related A&E admissions; and to lower air contamination.

To assist tackle health inequalities, NHS England will base its 5 year financing allotments to areas on more precise assessment of health inequalities and unmet need. As a condition of receiving Long Term Plan financing, all major national programmes and every area across England will be needed to set out particular measurable goals and mechanisms by which they will add to narrowing health inequalities over the next 5 and 10 years. The Plan also sets out specific action, for instance to: cut smoking in pregnancy, and by individuals with long term psychological health problems; make sure individuals with learning impairment and/or autism get better assistance; supply outreach services to individuals experiencing homelessness; assist individuals with serious mental disease find and keep a job; and enhance uptake of screening and early cancer diagnosis for individuals who presently lose out.

Chapter Three sets the NHS's top priorities for care quality and outcomes enhancement for the decade ahead. For all significant conditions, results for clients are now measurably much better than a decade back. Childbirth is the most safe it has actually ever been, cancer survival is at an all-time high, deaths from heart disease have cut in half since 1990, and male suicide is at a 31-year low. But for the greatest killers and disablers of our population, we still have unmet requirement, unexplained regional variation, and undoubted opportunities for additional medical advance. These realities, together with patients' and the public's views on concerns, suggest that the Plan goes further on the NHS Five Year Forward View's focus on cancer, psychological health, diabetes, multimorbidity and healthy ageing consisting of dementia. But it also extends its focus to kids's health, cardiovascular and respiratory conditions, and learning disability and autism, amongst others.

Some enhancements in these locations are always framed as 10 year goals, given the timelines required to broaden capacity and grow the labor force. So by 2028 the Plan dedicates to drastically improving cancer survival, partially by increasing the percentage of cancers identified early, from a half to 3 quarters. Other gains can happen sooner, such as halving maternity-related deaths by 2025. The Plan likewise designates adequate funds on a phased basis over the next 5 years to increase the variety of prepared operations and cut long waits. It makes a renewed dedication that psychological health services will grow faster than the total NHS budget plan, developing a new ringfenced regional investment fund worth a minimum of ₤ 2.3 billion a year by 2023/24. This will make it possible for additional service growth and faster access to community and crisis psychological health services for both grownups and especially children and youths. The Plan likewise identifies the crucial value of research study and innovation to drive future medical advance, with the NHS committing to play its full part in the advantages these bring both to clients and the UK economy.

To allow these modifications to the service model, to avoidance, and to major medical enhancements, the Long Term Plan sets out how they will be backed by action on workforce, innovation, development and efficiency, as well as the NHS' total 'system architecture'.

Chapter Four sets out how present workforce pressures will be tackled, and staff supported. The NHS is the most significant employer in Europe, and the world's biggest company of extremely skilled specialists. But our personnel are feeling the strain. That's partly due to the fact that over the past years workforce growth has not kept up with the increasing demands on the NHS. And it's partially since the NHS hasn't been an adequately flexible and responsive employer, specifically in the light of changing staff for their working lives and careers.

However there are practical opportunities to put this right. University locations for entry into nursing and medication are oversubscribed, education and training locations are being broadened, and a number of those leaving the NHS would stay if employers can reduce workload pressures and use enhanced versatility and professional development. This Long Term Plan for that reason sets out a variety of particular labor force actions which will be managed by NHS Improvement that can have a favorable effect now. It likewise sets out wider reforms which will be finalised in 2019 when the workforce education and training budget plan for HEE is set by government. These will be consisted of in the comprehensive NHS labor force application plan released later this year, overseen by the brand-new cross-sector nationwide workforce group, and underpinned by a new compact in between frontline NHS leaders and the national NHS management bodies.

In the meantime the Long Term Plan sets out action to expand the number of nursing and other undergraduate places, making sure that well-qualified candidates are not turned away as takes place now. Funding is being guaranteed for an expansion of clinical positionings of approximately 25% from 2019/20 and up to 50% from 2020/21. New routes into nursing and other disciplines, including apprenticeships, nursing partners, online qualification, and 'earn and learn' support, are all being backed, together with a new post-qualification work assurance. International recruitment will be significantly broadened over the next 3 years, and the workforce implementation plan will likewise set out brand-new rewards for scarcity specializeds and hard-to-recruit to geographies.

To support present staff, more versatile rostering will become obligatory throughout all trusts, moneying for continuing expert development will increase each year, and action will be taken to support diversity and a culture of regard and reasonable treatment. New functions and inter-disciplinary credentialing programmes will allow more workforce flexibility across a person's NHS profession and between specific personnel groups. The brand-new medical care networks will offer flexible choices for GPs and broader main care teams. Staff and clients alike will gain from a doubling of the number of volunteers also assisting throughout the NHS.

Chapter Five sets out a comprehensive and funded programme to update technology and digitally allowed care across the NHS. These financial investments enable a number of the broader service modifications set out in this Long Term Plan. Over the next 10 years they will result in an NHS where digital access to services is widespread. Where patients and their carers can better handle their health and condition. Where clinicians can gain access to and communicate with client records and care strategies anywhere they are, with ready access to decision assistance and AI, and without the administrative inconvenience of today. Where predictive techniques support local Integrated Care Systems to prepare and optimise look after their populations. And where secure connected scientific, genomic and other data support new medical advancements and constant quality of care. Chapter Five identifies costed foundation and turning points for these developments.

Chapter Six sets out how the 3.4% five year NHS financing settlement will help put the NHS back onto a sustainable financial path. In ensuring the cost of the phased dedications in this Long Term Plan we have actually taken account of the current financial pressures across the NHS, which are a very first get in touch with additional funds. We have likewise been sensible about unavoidable continuing need development from our growing and aging population, increasing concern about locations of longstanding unmet requirement, and the broadening frontiers of medical science and innovation. In the modelling underpinning this Long Term Plan we have therefore not locked-in a presumption that its increased financial investment in neighborhood and primary care will necessarily lower the need for healthcare facility beds. Instead, taking a prudent method, we have actually offered for healthcare facility funding as if patterns over the past 3 years continue. But in practice we anticipate that if cities implement the Long Term Plan efficiently, they will take advantage of a financial and health center capability 'dividend'.

In order to deliver for taxpayers, the NHS will continue to drive efficiencies - all of which are then available to cities to reinvest in frontline care. The Plan lays out significant reforms to the NHS' monetary architecture, payment systems and incentives. It develops a brand-new Financial Recovery Fund and 'turnaround' procedure, so that on a phased basis over the next five years not just the NHS as an entire, however likewise the trust sector, local systems and individual organisations gradually return to monetary balance. And it shows how we will save taxpayers a further ₤ 700 million in minimized administrative costs throughout service providers and commissioners both nationally and in your area.

Chapter Seven discusses next steps in implementing the Long Term Plan. We will construct on the open and consultative procedure utilized to develop this Plan and reinforce the capability of clients, specialists and the general public to contribute by establishing the brand-new NHS Assembly in early 2019. 2019/20 will be a transitional year, as the regional NHS and its partners have the opportunity to form local implementation for their populations, appraising the Clinical Standards Review and the nationwide execution structure being published in the spring, as well as their differential local beginning points in protecting the significant nationwide improvements set out in this Long Term Plan. These will be united in a detailed nationwide execution program by the fall so that we can likewise appropriately appraise Government Spending Review choices on labor force education and training spending plans, social care, councils' public health services and NHS capital financial investment.

Parliament and the Government have both asked the NHS to make agreement propositions for how main legislation may be gotten used to better support delivery of the concurred modifications set out in this LTP. This Plan does not need changes to the law in order to be implemented. But our view is that amendment to the main legislation would substantially accelerate development on service combination, on administrative performance, and on public accountability. We advise changes to: develop publicly-accountable integrated care locally; to simplify the national administrative structures of the NHS; and eliminate the overly stiff competition and procurement program used to the NHS.

In the meantime, within the present legal framework, the NHS and our partners will be transferring to create Integrated Care Systems all over by April 2021, constructing on the progress currently made. ICSs bring together regional organisations in a pragmatic and useful way to deliver the 'triple integration' of main and specialist care, physical and psychological health services, and health with social care. They will have a key role in working with Local Authorities at 'location' level, and through ICSs, commissioners will make shared choices with suppliers on population health, service redesign and Long Term Plan application.