Healthcare delivery
of healthcare, which not only needs to be coordinated and – to an extent – integrated, but also requires exceptional leadership at all levels, in new or re-shaped organisations. This is all a big ask – when demand for services in all areas has never been greater. There is a distinct lack of detail in the Plan, with no specific priorities highlighted. Nor are there trade-offs or any timelines for how all this might be implemented. It is surely important to know where the dominoes are, so no more are knocked over. We are left with a breathless array of ideas but little idea what the next steps might be. The leadership at the centre, i.e. NHS England, is being amalgamated into the Department of Health – with many job losses. Integrated Care Boards will still exist but with a new function, and some of their board members removed. Local government is being made responsible for local health plans where the ICBs have spent the last few years adding detail to theirs. There is little information about financial aspects of the Plan although we are informed there will be a new financial framework for the NHS later in the year. Overall, there is much to be welcomed in the Plan but, as so little is detailed and so much is to change, it feels a little uncontrolled.
What of the staff? There is to be a new Workforce Plan developed with NHS leaders, unions and employers over the next six months. There is a section on the workforce here, which briefly states that every member of staff will have their own personalised career coaching to help them develop new skills and practice at the top of their capability. Modern employment standards will be
developed and introduced in April next year. There is also a plan to update and reform employment contracts considering modern incentives and rewards for high quality and productive care. A review will be undertaken to develop guidance on the best use of existing terms and conditions of service. Agency staff will be reduced down to less than 10% over time and individuals encouraged to join local staff banks. More nursing apprenticeships will be created in areas with the greatest need.
Conclusion There is more, much more than the space here precludes expanding on, but take a look at the government’s executive summary and it can shed light on many different aspects of this ambitious Plan. However, as mentioned, it is rather light on implementation and delivery timelines; how much autonomy the current leaders will have to take action on
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to work well for patients and take the strain off some overworked professionals.
CSJ
References 1. Department of Health and Social Care (England) 2025 Fit for the future: the ten year Health Plan Accessed at
https://www.gov.uk/ government/publications/10-year-health-plan- for-england-fit-for-the-future
their aspects of the plan; and how it will it be coordinated with other elements of care. It is a recipe for chaos, in some aspects, so one hopes that the new relationships fostered at the development of the ICBs (with hospital providers, community and primary care, as well as local government) can provide a basis for delivery of this complex new way of working. If it can be put into place, it has the opportunity
2. Lord D’Arzi -DHSC England 2024 An Independent investigation of the NHS in England Accessed at
https://www.gov.uk/government/ publications/independent-investigation-of- the-nhs-in-england
3. NHS Confederation 2025. Ten year Health Plan: what you need to know. Accessed https://
www.nhsconfed.org/publications/ten-year- health-plan-what-you-need-know
4. Ibid
Ascannio -
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