Health and Social Care Secretary Thérèse Coffey has committed to maximising use of the private health sector to expand NHS capacity as part of a package of measures in the government’s latest plan to improve NHS care.
The Plan for Patients also features the Adult Social Care Discharge Fund which aims to speed up the safe discharge of patients from hospital this winter to free up beds as well as helping to retain and recruit more care workers.
The £500m plan sets out interventions to improve access to general practice appointments, with the expectation that everyone who needs one should get an appointment at a GP practice within two weeks – and that the patients with the most urgent needs should be seen within the same day.
In addition to more support staff, an enhanced role for pharmacists and new telephone systems, changes will also be made to NHS pension rules to retain more experienced NHS clinicians and remove the barriers to staff returning from retirement, increasing capacity for appointments and other services.
This will include extending retirement flexibilities to allow retired and partially retired staff to continue to return to work or increase their working commitments without having payment of their pension benefits reduced or suspended, and fixing the unintended impacts of inflation, so senior clinicians are not taxed more than is necessary.
However the plans have been slammed by independent think tanks and doctors as “little more than tinkering at the edges” and “rearranging deckchairs on the Titanic”.
Critics highlighted there was little meaningful detail to how the proposals will be achieved and no solid plan for addressing the key subject of massive staff shortages.
Plan commitments include:
- An additional 31,000 phone lines available for GP practices to make it easier for patients to contact their practice
- To provide patients with quicker and more convenient access to treatment by increasing the use of virtual outpatient appointments
- Enhancing the availability of mental health support, through expansion and transformation of mental health services, including access to NHS talking therapies, children and young people’s mental health services and enhanced community support for adults living with severe mental illnesses and expanded support in schools
- The delivery of 160 community diagnostic centres in total, supporting the NHS to carry out up to 17 million tests by March 2025, with capacity for up to 9 million more per year once they are all fully operational.
- For local NHS (integrated care boards) to be held to account for the provision of dentistry in their areas, and their role in sharing best practice and innovative ways of commissioning and delivering NHS care.
- Amending the law to allow the General Dental Council to simplify registration for dentists not trained in England, so that they can start practising in the NHS more quickly. Government will also review the current NHS systems that authorise dentists to work for the NHS to help expand the workforce at a faster pace.
‘More patients suffering’
BMA council chairman Professor Philip Banfield said the government’s grand plan “at best lacks detail and at worst secures the fate of these services; meaning more patients suffering and more staff leaving.”
He noted there were lofty ambitions and admirable principles, but little to no concrete detail on how anything will be achieved, much of it has been announced previously, and there was no outline how exactly initiatives will be staffed.
“That the government sees increased use of the private sector and reliance on volunteers as the answer to the current workforce crisis is an admission that the system is broken, that ministers are failing patients and not properly valuing doctors and their colleagues working in the NHS,” he said.
“There is absolutely no mention of pay across the board – namely correcting the more than decade-long fall in real-terms income for doctors, which continues to crush morale and is once again driving colleagues towards the possibility of industrial action.
“The whole system is sinking and staff are sending out distress signals; this plan is unconvincing and amounts to little more than rearranging the deckchairs on the Titanic.”
Responding to the plan, David Hare, chief executive of the Independent Healthcare Providers Network (IHPN), said it was vital that government’s commitments were now urgently made a reality so that NHS patients were not “left languishing”.
“Recent IHPN research conducted with the Patients Association found that across England, patients need to travel just 13.2 miles – around 30 minutes by car – to cut over three and a half months off their NHS waiting time by choosing an alternative provider,” Hare continued.
“But with almost half of the public unaware of these rights, much more needs to be done to ensure the public are fully aware of the choices available to them, and we look forward to working with the government to ensure all blockers to patient choice are removed and that the independent sector can play its full role in the elective recovery.”
Grim winter ahead
The King’s Fund policy director Sally Warren said this was “little more than tinkering at the edges” and warned that despite the best efforts of NHS and social care staff, patients were facing a grim winter struggling to access over-stretched services.
“The scale of the challenge requires bolder action,” she said.
“The single most significant reason many people find it hard to access care is the chronic lack of staff across both NHS and social care. This existed long-before Covid-19 struck and has been many years in the making.
“Many of the other measures announced by the secretary of state, such as extending the emergency registration scheme for retired staff to re-join the NHS, changes to pensions, and a drive to enlist more health service volunteers, are welcome, but they are too little too late to avoid an extremely difficult winter.
“Addressing the staffing crisis will require a comprehensive, long term workforce strategy, and I hope the government comes good on its commitment to deliver one this autumn.“
‘Top priority’
Deputy prime minister and secretary of state for health and social care Thérèse Coffey, said: “Patients and those who draw on care and support are my top priority, and we will help them receive care as quickly and conveniently as possible.
“That is why we are publishing Our Plan for Patients, which will help empower and inform people to live healthier lives, while boosting the NHS’ performance and productivity.
“It sets out a range of commitments for our health service, ensuring we create smoother pathways for patients in all parts of health and care.”