A new 10-year NHS plan will “fundamentally rewire” the health service and put care on people’s doorsteps, the Prime Minister has said.
Sir Keir Starmer will use a speech in London on Thursday to unveil his vision for the NHS, which will focus on “three big shifts” in the way the health service operates.
The new plan, which will be published by the Government on Thursday, sets out how the NHS will move from analogue to digital, treatment to prevention, and from hospital to more community care.
The “status quo of hospital by default will end”, according to the Government, with care shifted into neighbourhoods and people’s homes.
By 2035, the intention is that the majority of outpatient care will happen outside of hospitals, with less need for hospital-based appointments for things like eye care, cardiology, respiratory medicine and mental health.
New neighbourhood health services will be rolled out across the country to bring tests, post-op care, nursing and mental health teams closer to people’s homes.
The aim is to give people access to a full range of services, leaving hospitals to focus on the sickest, with neighbourhood health centres opening at evenings and weekends.
These will be staffed by teams including nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff and paramedics.
New services will also include debt advice, employment support and stop smoking or obesity services – all of which affect people’s health.
Community outreach, with people going door to door, could also reduce pressure on GPs and A&E, the Government said.
The plans also outline training for thousands more GPs, as the Government pledges to “bring back the family doctor” and end the “8am scramble” to get an appointment.
Sir Keir said: “The NHS should be there for everyone, whenever they need it.
“But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future.
“That ends now. Because it’s reform or die. Our 10-year health plan will fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place.
“That means giving everyone access to GPs, nurses and wider support all under one roof in their neighbourhood – rebalancing our health system so that it fits around patients’ lives, not the other way round.
“This is not an overnight fix, but our Plan for Change is already turning the tide on years of decline with over four million extra appointments, 1,900 more GPs, and waiting lists at their lowest level for two years.
“But there’s more to come. This Government is giving patients easier, quicker and more convenient care, wherever they live.”
Health and Social Care Secretary Wes Streeting said the plan would deliver “one of the most fundamental changes in the way we receive our healthcare in history”.
He added: “By shifting from hospital to community, we will finally bring down devastating hospital waiting lists and stop patients going from pillar to post to get treated.
“This Government’s Plan for Change is creating an NHS truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home.”
In a bid to free up time, GPs will be encouraged to use artificial intelligence to take notes, while technology will be used to speed up the answering of calls to surgeries.
Dental therapists, who tend to carry out some of the straightforward work of dentists, could undertake check-ups, treatment and referrals, according to the plan.
And there will be a new requirement for newly-qualified dentists to practise in the NHS for a minimum period, intended to be three years, according to the Government.
Ministers also want to improve access to dental care for children, such as by allowing dental nurses to give fluoride varnish to children in between check-ups.
Royal College of Nursing (RCN) general secretary, Professor Nicola Ranger, said: ““A neighbourhood health service is a bold vision and it needs nursing staff in the driving seat.
“The Prime Minister must back up his plan with a clear one to turn around the shortage of nurses in all local communities.
“Moving care away from overcrowded hospitals is urgent and necessary but it will prove impossible whilst this part of the healthcare workforce is so depleted and undervalued.
“Crucial teams of district nursing and health visiting staff, who keep patients well and safe at home, have fallen by thousands in the last decade or more.”
Thea Stein, chief executive of the Nuffield Trust, said: “Top quality community services, like district nursing, end of life care and rehabilitation, are, in pockets of the country, already working around the clock to fit care around patients’ needs, working closely with GPs, charities and council staff.
“This approach is essential if we want to end the disjointed ways of working that too often leave patients to do the time-consuming and often bewildering job of joining up their own care.”
She said, however, that a lack of detail on how it will all work “casts doubt on whether it will stick”.
She added: “What’s more, care closer to home doesn’t mean care on the cheap.
“While ministers are always keen to cite examples of community services saving money, often this kind of care costs more, not less… let’s be under no illusion, this is not a money-saving measure.”
Sarah Woolnough, chief executive of the King’s Fund, said: “As the Government publishes its 10-year plan for health today, what patients, the public and those working in the NHS will want to know is, why it will be different this time, and how soon it will lead to improvements?
“When will it mean people can see a GP more easily, or get mental health support for their child, or not wait hours in A&E?
“There is plenty to welcome in the details we’ve seen so far, with the biggest changes outlined being about how people access NHS services, with the rollout of new neighbourhood health centres and a much greater role for the NHS app.
“At the King’s Fund our call for a fundamental shift of care from hospital to community and a more people-first approach has been echoed by successive governments, so, whilst welcome, the vision itself is not new, the radical change would be delivering the vision.”
The Government’s political opponents were sceptical about the plan, with Conservative shadow health secretary Edward Argar insisting that it must provide reform and “that reform must be real, it needs to be deliverable, and crucially it must deliver results for patients”.
He added: “But after the collapse of their Welfare Bill, the government’s tough talk seems meaningless. This Government has proven they cannot stand up to their own MPs or take tough decisions in the national interest.”
Liberal Democrat Leader Sir Ed Davey said the plan “will be a castle built on sand until ministers finally tackle the crisis in social care”.
He added: “Years of Conservative neglect pushed the NHS to breaking point, with overcrowded A&Es, people waiting weeks to see a GP and parents unable to find a dentist for their children.
“But the current Government’s failure to fix social care is leading to more of the same, as vulnerable people are stuck in hospital beds while their families are left in anguish.”
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