NHS Five Year Forward View (“5YFV”)


To consider why change is needed, what success might look like, and how we might get there. The Forward View will provide:

  1. A clear vision, setting out the particular contribution that the NHS and others can make to the health of our nation, and the transformation required to meet the changing needs of current and future patients.
  2. A shared understanding of the extent and nature of the gap between where we are and where we need to be, including: the financial’ context for both demand and supply, the ‘health’ opportunity and the ‘care’opportunity – transformation requires all three to be addressed.
  3. A range of care models that could deliver transformation (the what) identifying the actions required at the local and national level to support delivery (how).
  4. Priority areas for targeting transformation, identifying what needs to happen to support delivery and the potential benefits for patients and taxpayers.
  5. Actions that we can take nationally to create the conditions for local action.


  • Set out the challenges and choices for action and further discussion.
  • Identify action that we can take nationally to create the conditions for local action to improve care for patients of today and tomorrow.
  • Greater clarity and consensus about our shared purpose and our respective roles and responsibilities in delivering this.

Work streams

In order to achieve our aims, the 5YFV will look at a range of issues including:

  • How can we improve the health of our population and what role might the workplace play in particular?
  • How can we support patients to be more active and engaged in their own health, and how can we improve the responsiveness of the NHS when they are ill?
  • What tangible steps can we take to support the carers and volunteers?
  • What are the new care models that could deliver integrated and responsive care, and how can we achieve delivery?
  • What is the true cost and value of the NHS to UK plc; how can we ‘future proof’ the NHS, taking advantage of technology, innovation and genomics?
  • What benefits will any recommendations provide for patients and taxpayers, and what is the underpinning model of change that will drive improvement?


  • The NHS and social care system is not short of reports or evidence. Therefore, in the majority of areas we will not be commissioning new work, and instead will examine existing research for review and challenge.
  • In particular, we will draw upon the extensive engagement and consultation that formed the basis of A Call to Action, and the five-year plans developed by CCGs and NHS providers.
  • We will not run yet another lengthy and costly engagement exercise, asking people what they want from health and health care. We will draw upon existing research and work with National Voices and NHS Citizens to hold a Review and Challenge session with patients, to ensure that we have heard what they have said and to provide a common sense check on emerging proposals.
  • We will seek active engagement with a wider list of stakeholders upon publication of the report, which we will use as the beginning of a conversation with the wider system.

We welcome any relevant comments, research or contributions for us to consider and would be grateful if these could be sent to

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  1. A key question is how can we hard-wire feedback from patients and citizens about their experiences of health and care in their local areas, not just at national level? The challenge then is for local services, CCGs and NHS England to learn from this feedback and use it consistently to improve services at all levels.

    It is only when health and care services regularly listen to their customers and respond to their feedback that they become truly accountable at a local level.

    We have a long way to go! We need ‘you said, we did’ at every level of the NHS, from individual wards, to GP surgeries. We need services committed to finding the most vulnerable communities and hearing how things can be improved so that the NHS works for all. The voluntary community sector can help to reach these citizens, provide a route to the hard to reach and use creativity to help transform services and reduce health inequalities.

  2. Rcal says:

    “To consider why change is needed, what success might look like, and how we might get there.”

    Sorry, this was the job Lansley decided to give himself. I am disgusted that a few £bn later a new organisation has been created to ask the same question and postulate answers. Sorry, Lansley’s answers are there in the Act.
    Including, delightfully, “No decision about me without me”.

    “We will not run yet another lengthy and costly engagement exercise, asking people what they want from health and health care.”

    Good – that should save a bob or two.

  3. I agree this is an excellent idea, there are plenty of experienced individuals who can work together to deliver plan.

  4. J. Lindo says:

    Excellent idea to not commission new work but to use and build on existing. I would further challenge NHSE to come up with a more user friendly acronym than 5YFV and an executive summary that is no more than 1 side of A4. Something that all NHS staff can remember and readily share with colleagues, patients and members of the public; something that we can all bear in mind when we are making both big and small decisions that affect the cost effectiveness of health care.

    • NHS England says:

      Thank you for your comment. This has been passed on to the 5YFV team.

      Kind Regards
      NHS England

  5. Mary Hawking says:

    Who will be undertaking this work, how will they be selected/appointed (internally or externally, what criteria and/or expertise required), how will they select which reports to consider, will there be any information – in the interests of Transparency – before the final report is published to allow for input beyond the committee(s) doing the work?
    If this report is going to be influential in influencing the future of the NHS, surely the public/patients need to be given a chance to have a say?

    • NHS England says:

      Hi Mary,

      Thank you for you comment.

      The work is being undertaken by an experienced team of healthcare experts led by Simon Stevens, drawing on existing consultation/ research and involving a range of national bodies and patient groups because, as you say, it is vital to ensure the view is relevant to patient and public experience.

      Kind Regards
      NHS England

  6. Christine Taylor says:

    Is there a timeline for this process, eg deadline for comments, publication of a draft, formal consultation period on the draft, and then final publication of the Five Year View?

    • NHS England says:

      Hi Christine,

      NHS England aims to publish a document in the Autumn.

      Kind Regards
      NHS England

  7. susan acott says:

    There must be a huge focus on primary and community care and transforming those services if anythong is to change. nothing short of the buy out of private contractor status and replacement with organised and managed primary care hubs will do

    • NHS England says:

      Hi Susan,

      Thank you for your comment, which has been passed on to the review team.

      Kind Regards
      NHS England

    • Paul O'Reilly says:

      There must indeed be a huge focus on primary and community care. Unless there is substantial investment within general practice and a firm commitment to sustain independent contractor status, then market forces will cause us to drift into the clinical and financial disaster that is the American style HMO.

  8. KAYE HARRIS says:

    Please could I have information on how to become part of the committee for NHS england. I feel I have a lot to give and my experience is from cradle to grave in nursing and management.

  9. Rosemary Cantwell says:

    17 August 2014

    Dear NHS England,

    Has anyone been informed how the Department of Health actually operates? – and who actually IS the “NHS” because does that include ALL the NHS agents ie nurses, doctors and healthcare professionals?

    How does the following work In your experience:

    1] The NHS complaints regulations make provisions for a complaint to be escalated to the Health Service Ombudsman if a complainant is dissatisfied with the outcome of their complaint locally.

    2] When complaints are escalated, it is important that these are investigated independently, free from political interference to ensure that there is no question of bias.

    3] The Health Service Ombudsman is completely independent of the Department of Health, the Government and the NHS.

    4] If a complainant is dissatisfied with the Ombudsman’s decision, they may make use of her own complaints process.

    5] The only recourse after the Ombudsman has made a final decision is to seek a judicial review. This involves making an application to the court. Application for judicial review needs to be made promptly – usually within three months of the Ombudsman’s decision.

    6] It is important that the Ombudsman is able to operate entirely independently.

    May I ask if the PHSO is allowed to obtain clinical advice from NHS registrants as this might impinge on the essential requirement for neutrality as opined above?

    Thank you so much.

    Rosemary Cantwell