The Government has published the plan for NHS development over
the next 10 years. The summary is reproduced below. In January 2001, we were
supplied with a copy of the NHS Plan related to primary care and this
is summarised below the main plan. Although we are allowed to quote from the documents quite
freely, the information is still subject to Crown Copyright. We must display the
title of the document which is:
The NHS Plan
A plan for investment
A plan for reform
The plan can be viewed online at http://www.nhs.uk
The summary is available free of charge
from
The Department of Health
PO Box 777
London
SE1 6XH
Fax 01623 724524
e-mail doh@prolog.uk.com
The summary is available in English, Hindi, Punjabi, Gujarati, Urdu, Bengali,
Chinese, Vietnamese, Greek, Turkish, Somali and Arabic. It is also available as
an English audio cassette tape and in braille and large print.
The full version is available from The
Stationery Office priced £15.
The Stationery Office has a branch in Birmingham: 0121 236 9696. Orders by phone
0845 702 3474 or fax 0870 600 5533 or e-mail book.orders@theso.co.uk
The full version can also be downloaded as a PDF document (1.1Mb) from the NHS
website http://www.nhs.uk/
The NHS Plan
A plan for investment
A plan for reform
A Summary
This is a Plan for investment in the NHS with sustained increases in funding.
This is a Plan for reform with far reaching changes across the NHS. The purpose
and vision of this NHS Plan is to give the people of Britain a health service
fit for the 21st century: a health service designed around the patient. The NHS
has delivered major improvements in health but it falls short of the standards
patients expect and staff want to provide. Public consultation for the Plan
showed that the public wanted to see:
 | more and better paid staff using new ways of working |
| reduced waiting times and high quality care centred on patients |
| improvements in local hospitals and surgeries. |
In part the NHS is failing to deliver because over the years it has been
underfunded. In particular there have been too few doctors and nurses and other
key staff to carry out all the treatments required. But there have been other
underlying problems as well. The NHS is a 1940s system operating in a 21st
century world. It has:
| a lack of national standards |
| old-fashioned demarcations between staff and barriers between services |
| a lack of clear incentives and levers to improve performance |
| over-centralisation and disempowered patients. |
These systematic problems, which date from 1948 when the NHS was formed, are
tackled by this Plan. It has examined other forms of funding healthcare - and
found them wanting. The systems used by other countries do not provide a route
to better healthcare. The principles of the NHS are sound but its practices need
to change.
The March 2000 Budget settlement means that the NHS will grow by one half in
cash terms and by one third in real terms in just five years. More money will
fund extra investment in NHS facilities ...
| 7,000 extra beds in hospitals and intermediate care |
| over 100 new hospitals by 2010 and 500 new one-stop primary care centres |
| over 3,000 GP premises modernised and 250 new scanners |
| clean wards - overseen by 'modern matrons' - and better hospital food |
| modern IT systems in every hospital and GP surgery |
...and investment in staff:
| 7,500 more consultants and 2,000 more GPs |
| 20,000 extra nurses and 6,500 extra therapists |
| 1,000 more medical school places childcare support for NHS staff with 100
on-site nurseries. |
But investment has to be accompanied by reform. The NHS has to be redesigned
around the needs of the patient. Local hospitals cannot be run from Whitehall.
There will be a new relationship between the Department of Health and the NHS to
enshrine the trust that patients have in frontline staff. A new system of earned
autonomy will devolve power from the Government to the local health service as
modernisation takes hold.
The Department of Health will set national standards, matched by regular
inspection of all local health bodies by an independent inspectorate, the
Commission for Health Improvement.
The National Institute for Clinical Excellence will ensure that cost
effective drugs like those for cancer are not dependent on where you live. A
Modernisation Agency will be set up to spread best practice.
Local NHS organisations that perform well for patients will get more freedom
to run their own affairs. There will also be a £500 million performance fund.
But the Government will intervene more rapidly in those parts of the NHS that
fail their patients.
For the first time social services and the NHS will come together with
new agreements to pool resources. There will be new Care Trusts to commission
health and social care in a single organisation. This will help prevent patients
- particularly old people - falling in the cracks between the two services or
being left in hospital when they could be safely in their own home.
For the first time there will be modern contracts for both GPs and
hospital doctors. NHS doctors work hard for the NHS. But the contracts under
which they work are outdated. There will be a big extension of quality-based
contracts for GPs in general, and for single-handed practices in particular. The
number of consultants entitled to additional discretionary payments will rise
from half to two-thirds but in return they will be expected to increase their
productivity while working for the NHS. Newly qualified consultants will not be
able to do private work for perhaps seven years.
For the first time nurses and other staff, not just in some places but
everywhere, will have greater opportunity to extend their roles. By 2004 over
half of them will be able to supply medicines. £280 million is being set aside
over the next three years to develop the skills of staff. All support staff will
have an Individual Learning Account worth £150 per year. The number of nurse
consultants will increase to 1,000 and a new role of consultant therapist will
be introduced. A new Leadership Centre will be set up to develop a new
generation of managerial and clinical leaders, including modern matrons with
authority to get the basics right on the ward.
For the first time patients will have a real say in the NHS. They will
have new powers and more influence over the way the NHS works:
| letters about an individual patient's care will be copied to the patient |
| patients' views on local health services will help decide how much cash
they get |
| patient advocates will be set up in every hospital |
| if operations are cancelled on the day they are due to take place the
patient will be able to choose another date within 28 days or the hospital
will pay for it to be carried out at another hospital of the patient's
choosing |
| patients' surveys and forums to help services become more
patient-centred. |
For the first time there will be a concordat with private providers of
healthcare to enable the NHS to make better use of facilities in private
hospitals - where this provides value for money and maintains standards of
patient care. NHS care will remain free at the point of delivery - whoever
provides it.
These far reaching reforms to the service will result in direct improvements
for patients.
Patients will see waiting times for treatment cut as extra staff are
recruited:
| by 2004 patients will be able to have a GP appointment within 48 hours
(click here to see more information on this site) and
there will be up to 1,000 specialist GPs taking referrals from fellow GPs |
| long waits in accident and emergency departments will be ended |
| by the end of 2005 the maximum waiting time for an outpatient appointment
will be three months and for inpatients, six months. |
The treatment of cancer, heart disease and mental health services - the
conditions that kill and affect most people will improve with:
| a big expansion in cancer screening programmes |
| an end to the postcode lottery in the prescribing of cancer drugs |
| rapid access chest pain clinics across the country by 2003 |
| shorter waits for heart operations |
| hundreds of mental health teams to provide an immediate response to
crises. |
Older people use the NHS more than any other group. This Plan will provide
them with both better and new services:
| nursing care in nursing homes will be free |
| by 2004 a £900 million package of new intermediate care services to allow
older people to live more independent lives |
| national standards for caring for older people to ensure that ageism is
not tolerated |
| breast screening to cover all women aged 65 to 70 years |
| personal care plans for elderly people and their carers. |
The NHS Plan will bring health improvements across the board for patients but
for the first time there will also be a national inequalities target. To help
achieve this we will:
| increase and improve primary care in deprived areas |
| introduce screening programmes for women and children |
| step up smoking cessation services |
| improve the diet of young children by making fruit freely available in
schools for 4-6 year olds. |
The NHS Plan will require investment and reform to make it work. But the
funding is there to support change and it is backed by the key organisations in
the NHS. There is a new national alliance behind a reformed, patient-centred
NHS. These are the most fundamental and far reaching reforms the NHS has seen
since 1948. It will take time to get there but over the next few years the NHS
will be modernised from top to toe.
For further information about copyright of
this information e-mail copyright@hmso.gov.uk
The practice's copyright notice below does not refer to any Crown Copyright
material.
Primary
care, general practice and the NHS Plan
(January
2001)
|
Primary care will provide a
greater range of services with control over £25 billion of the NHS budget. |
|
Resources will be directed at
improving professional working lives, increasing job satisfaction and
supporting GPs and other primary care staff in improving patient care. |
| Successful flexible multidisciplinary
working with respect for individual professionals will be developed further
to deliver better services to patients. |
| The practice will remain the
basic unit of primary care within a system in which standards are improved
and a wider range of more accessible services is offered. |
| Practices will be offered
greater freedoms and incentives as modernisation proceeds. |
| 3000 GP premises to be
substantially refurbished or replaced by 2004. |
| 500 one stop primary care
centres by 2004. |
| all GPs to have access to
NHSNet by 2002. |
| 50% of primary care trusts
(PCTs) to have electronic personal medical records by 2004. |
| electronic prescribing of
medicines by 2004. |
| at least 2000 more GPs and 450
more than now in training by 2004. |
| all Primary Care Groups to
become PCTs by 2004. |
| new Care Trusts to commission
primary, community and social care. |
| 1000 extra primary care mental
health workers. |
| 500 extra community mental
health workers. |
| a new national contract. |
| a major expansion of Personal
Medical Services pilots. |
| new arrangements for single
handed practices. |
| 48 hour appointment target by
2004. |
| practice staff to book hospital
appointments within guaranteed timescales. |
| NHS Direct to triage all out of
hours calls by 2004. |
| 1000 GP specialists. |
| nurses undertaking more roles. |
In order to free up GP time for some
of these extra tasks, current workload will be reduced.
|
Cabinet Office Study on reducing
the regulatory and bureaucratic burden on GPs. |
|
Extending the role of pharmacists
in repeat prescribing. |
|
Better use of receptionists and
practice nurses to deal with coughs, colds and minor ailments. |
|
Using NHS Direct for triage of
out of hours calls. |
|
Using electronic links to order
and receive test results and book hospital appointments. |
|
Using nurses and practice
therapists for certification and administration for other organisations. |
|
Using professional development
plans and IT to provide in-practice training at desk. |
|
PCTs able to take on the
bureaucracy of recruiting and paying staff. |
| National Electronic Library for
Health allowing swift access to the latest evidence on investigations, treatment
and prescribing. |
| Developing the role of practice
nurses and IT in maintaining registers, developing care plans and creating
recall systems.
|
Thursday 21st
December 2000: NHS Plan & number of GPs required. Joint review by BMA
& RCGP
|
The NHS plan is a bold attempt to bring the NHS up to the standards of our
European neighbours. It envisages a major increase in the number of
consultants in various specialities. General Practice has not fared as
well. An increase of 2000 GPs by 2004 is envisaged but 1100 of these were
already promised before the ambitious NHS plan was even thought about. The
British Medical Association and the Royal College of General Practitioners
joined forces (a rare event) to review the plan and have now published
their findings.
3,000 GPs required to provide "intermediate care" - patients too
unwell to go home but no longer requiring a hospital bed.
1,200 GPs to provide specialist GP services promised in the plan.
3,000 GPs to implement the various National Service Frameworks
standardising management of long standing conditions such as coronary
heart disease.
130 GPs to assist with annual appraisals of GPs.
Clinical governance issues will take up one session per week for each GP
so 3,000 GPs required to cover the gap in service provision.
The grand total of 10,330 does not take into account the target of
patients being seen by a GP within 48 hours to be introduced in 2004.
Also, research suggests that less than one third of junior doctors are
interested in becoming family doctors but half of all UK medical graduates
will need to enter general practice to maintain an appropriate balance
between GPs and consultants.
The Government assumes that changes in working practices, where other
primary care team members put their valuable time to best use, will make
up the shortfall.
The Minster Practice started work on its own plan for the 21st Century
in response to a challenge from Tony Blair at the end of 1999 and before
anyone knew about the NHS Plan that was going to be formulated. Part of
our plan is putting to test some of the principles necessary for the Government
to succeed in its largely laudable plan to improve the NHS Click
here for more information. |
Up to Top
| 
The Minster Practice, Lichfield
