NHS Long Term Plan
The NHS Long Term Plan is a new plan for the NHS to improve the quality of patient care and health outcomes. It sets out how the £20.5 billion budget settlement for the NHS, announced by the Prime Minister in summer 2018, will be spent over the next 5 years.
The plan has been developed in partnership with frontline health and care staff, patients and their families. It will improve outcomes for major diseases, including cancer, heart disease, stroke, respiratory disease and dementia.
The plan also includes measures to:
- improve out-of-hospital care, supporting primary medical and community health services
- ensure all children get the best start in life by continuing to improve maternity safety including halving the number of stillbirths, maternal and neonatal deaths and serious brain injury by 2025
- support older people through more personalised care and stronger community and primary care services
- make digital health services a mainstream part of the NHS, so that in 5 years, patients in England will be able to access a digital GP offer
I continue to meet with Ministers on issues relating to the local health service and look forward to working with the government to ensure the NHS delivers for my constituents.
The Government recognises that the standard of ensuring at least 92% of patients start consultant-led treatment within a maximum of 18 weeks is not being met. However, at present, over one million National Health Service patients start planned treatment with a consultant each month and the majority are seen and treated within a maximum of 18 weeks. Furthermore, we have reduced the number of people waiting the longest (over 52 weeks) to start treatment from almost 18,500 in 2010 to just under 3,000 in October 2018.
For 2018/19, the Government has provided the NHS with an additional £1.6 billion to support and improve accident and emergency and elective care performance.
The Government has made Dementia a key priority and will implement the Challenge on Dementia 2020 (published in February 2015) in full to make this the best country to live in with dementia by 2020.
The Government continues to make progress against the ambitions set out in the March 2016 Implementation Plan which details how the commitments in the Challenge, across the four core themes of risk reduction, health and care, awareness and social action, and research will be met.
In addition, the Department is working with the adult social care sector to implement Quality Matters – a shared commitment to take action to achieve high quality adult social care for service users, families, carers and everyone working in the sector. Under the Care Act 2014, local authorities are required to shape their whole local markets to ensure that they are sustainable, diverse and offer high quality care and support for people in their local area.
Fostering: Staying Put
Since the introduction of Staying Put in 2014, young people in England have had the legal right to stay living with their former foster carers after they turn 18. I have received campaign emails from constituents asking the government to introduce a national minimum allowance for Staying Put to cover the cost of looking after a young person.
The Minister has outlined:
The government keeps the Staying Put policy under constant review, including through monitoring data from local authorities on take-up by young people, engagement with the sector, and reviewing information from Ofsted inspections of local authorities. Staying Put was also considered as part of the independent fostering review undertaken by Sir Martin Narey and Mark Owers, published in February 2018. Staying Put has helped thousands of care leavers to transition more smoothly from care to independence, and provides continuity of relationships and care arrangements. Latest data shows that in the year ending March 2018, 55% of 18 year olds chose to Stay Put – an increase of 4% on 2017.
The government does not believe that introducing a national minimum allowance for Staying Put carers is the right way forward. Unlike children in foster care, young people in Staying Put arrangements are adults and may be in work, or claiming benefits. These can be used to contribute to the cost of providing the Staying Put arrangement, in a similar way that young people who are still living at home with their parents may contribute to the cost of running the household. The current arrangements allow local authorities to consider all factors in relation to each local Staying Put arrangement, and to negotiate the amount that the carer receives on a case-by-case basis.
At the Autumn Budget the Chancellor announced an extra £410 million to address pressures on adult and children social care services, along with £84 million over five years to support up to 20 local authorities to improve their social work practice and decision-making, enabling them to work more effectively with the most vulnerable children and their families. This builds on the £200 billion the government has already made available to councils up to 2020 to provide services in the best interests of local residents, including those for children and young people.
Student Nurses- #FundOurFuture Campaign
I met with the #FundOurFuture lobby in Parliament to discuss their concerns and how we can better support student nurses. I also raised the issue during Health Questions and asked what more the Government can do to support student nurses financially as they go through college. The Minister explained that, at the moment, a student on the loan system typically achieves 25% more in their pocket than they would have had on the bursary, but the Government recognise that there are still pressures, which is why they have the learning support fund, the exceptional hardship fund and support for mature students.
Gloucestershire CCG breast reconstruction provision for breast cancer patients
I have received a number of emails regarding local provision of reconstructive surgery for breast cancer patients following updated clinical advice included in Breast Cancer Now's report "Rebuilding My Body". I have contacted the CCG who have advised:
"NHS Gloucestershire Clinical Commissioning Group (CCG) has received correspondence from “Breast Cancer Now” drawing our attention to this report and the recommendations contained.
The CCG are now planning to conduct a review of our Individual Funding Request (IFR) policy on breast reconstruction post cancer treatment on the back of this letter and report. This will be jointly led by the IFR team and the Cancer Clinical Program Group (CPG)."
Immigration Health Surcharge
I recognise the excellent contribution made by those working in our health service from abroad and the IHS allows anyone in the UK on a work, study or family visa for longer than 6 months to access NHS services in the same way as UK citizens. Short-term migrants, including those on visitor visas, are generally charged for secondary care treatment by the NHS at the point of access.
In responding to this issue, the Minister for Immigration highlighted that while we welcome long-term migrants using the NHS, the NHS is a national, not international health service and that it is right those working in the UK temporarily contribute to the NHS financially. The Minister has explained that the changes better reflect the cost to the NHS of treating those who pay the surcharge, as the Department for Health estimates that the NHS spends £470 on average per person per year on treating those required to pay the surcharge.
NHS Visa Cap
I have received a number of emails calling for NHS staff to be exempt from the cap on tier two visas. The Home Secretary has announced that doctors and nurses will be taken out of Tier 2 visa cap. You can read this statement in full here: https://www.gov.uk/government/news/doctors-and-nurses-to-be-taken-out-o…
Mental Health: Helplines
The Department for Education supports the NSPCC through an £8 million grant over four years (up to 2020), as a contribution to funding ChildLine (a phone and online advice service for children) and the NSPCC’s National Helpline (for anyone with concerns or worries about a child).
NHS England’s Five Year Forward View for Mental Health sets out the current transformation programme to support children and young people’s mental health. In terms of our future plans relating to children’s mental health, the government has recently consulted on ‘Transforming children and young people’s mental health provision: a Green Paper’. A response to the consultation will be published before the summer recess.
The government will publish a social care Green Paper this summer which sets out the government's long-term plan for social care and also presents an opportunity to take a more fundamental approach to tackling the challenges carers face. Importantly, it also provides an opportunity to ensure we have a social care system which is sustainable for the future in terms of funding.
I have received a number of emails in relation to the Independent Age campaign. The Minister has provided the following response:
In developing the Green Paper, it is right that we take the time needed to debate the many complex issues and listen to the perspectives of experts and care users, building consensus around reforms which can succeed. The Department has undertaken a period of engagement where the Government is working with experts, stakeholders and users to shape the long-term reforms that will be proposed in the Green Paper. As part of this engagement, officials from the Department have met with Independent Age to discuss their report.
Pancreatic cancer is often diagnosed late as patients do not usually present to primary or secondary care until symptomatic. There is work underway on early diagnosis using biomarkers but this has not yet extended into clinical practice. Early diagnosis “decision aid tools” have also been explored for use among primary care but the predictive value of these are low so that it is not possible to practically differentiate patients with pancreatic cancer from the far larger proportion of patients without cancer but similar symptoms.
National Health Service services for pancreatic cancer have been significantly improved in recent years. This includes clearer diagnostic pathways; decision making by specialist multi-disciplinary teams; and the centralisation of pancreas surgery within specialist teams.
This now aims to further improve cancer survival by an extra 5,000 people and improve experience of care over the next two years, with a range of improvements including:
- Patients having better access to the latest treatments, with roll-out of the largest radiotherapy upgrade programme in 15 years, with an extra £94 million to be spent on equipping hospitals with state of the art linear accelerators;
- Patients being tested sooner with investment in greater diagnostic capacity, including 10 new Rapid Diagnostic and Assessment Centres. This will be measured through the new 28 day faster diagnosis standard which will be rolled out from April 2018; and
- Personalised care and support being offered to patients during treatment and for those recovering from cancer, improving their quality of life and experience of care.
The Five Year Forward View ‘Next Steps’ Plan is available at: https://www.england.nhs.uk/five-year-forward-view/