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Annual Report highlights Five Year Forward View
NHS England Chief Executive, Simon Stevens, has pointed to the publication of the Five Year Forward View as one of the most significant moments of the past year.
He highlights the shared direction of the NHS for the next five years as NHS England publishes its second Annual Report and accounts today.
In his introduction to the 2014-15 Annual Report, Mr Stevens states: “It was a year in which the Health Service responded – largely successfully – to wide-ranging operational pressures. But, as importantly, it was a year in which patients’ groups, caring professionals and national leaders came together to chart a shared direction for our country’s NHS for the next five years.”
The report also sets out the priorities going forward, with Mr Stevens adding: “Among our mission-critical tasks over the next five years is fundamental redesign of how services are provided – blurring the old boundaries between GP and hospital care, physical and mental health services, health and social care.
“2015-16 represents Year One of the Five Year Forward View. So, for the year ahead, NHS England has identified key commissioning priorities for improvement. These include cancer care, mental health, learning disabilities, and obesity and diabetes prevention.
“Our care redesign focus will be on primary care, urgent and emergency care, and maternity services. And we will be working with communities and frontline services across England to support a variety of new ‘Vanguards’.”
NHS England Chairman, Sir Malcolm Grant, highlights the unprecedented pressure the NHS frontline has faced, stating: “Demand has continued to increase and we have faced intense pressure on services over the winter. Thanks to the dedication and hard work of people across the service the NHS has continued to maintain such high quality services and care for our patients.”
Sir Malcolm also points to the Five Year Forward View, the need for redesigned care and a major drive to support the NHS’s future sustainability.
He adds: “There is a dawning sense of realism. It is now widely understood that the rate of increase in demand for our services runs well ahead of anticipated growth in GDP so that we cannot expect it to be matched by increases in funding.
“The status quo cannot hold. We need to carry through transformation rather than throwing yet more money at outdated models. Nobody should believe this will be an easy process.
“Transformation on this scale needs strength of purpose, unwavering commitment, and investment to support innovation and to release the entrepreneurial energies within the NHS, to bring care closer to people’s homes and communities, and to support the empowerment of patients to better manage their own health through modern technologies.”
As well as setting out its performance over the last year and its priorities for 2015-16, the report outlines some of NHS England’s most significant achievements, the annual accounts, and gives a Directors’ report.
How does NHS England monitor its financial effectiveness with current fund allocations? Is there any use of Operational Research methods to indicate best allocation of funds or, indeed examine use of funds in specifirc areas?
The fund allocations formula is based on advice by the independent Advisory Committee on Resource Allocation (ACRA). ACRA’s advice is based on statistical modelling of the need for health services by academic researchers, and these models include for example age and health status. The formula is set out in the Technical guide published at: https://www.england.nhs.uk/2014/03/27/allocations-tech-guide/. CCGs manage the use of their allocated resources in specific areas, while NHS England monitors ongoing performance across the commissioning sector.
A number of tools are available to CCGs when prioritising their spending, some of which use approaches from Operational Research, such as the Star decision support tool (see http://www.rightcare.nhs.uk/index.php/2013/06/star-a-new-approach-to-priority-setting-for-commissioners/). As part of an approach to ensuring financial sustainability in response to the challenges as set out in the Five Year Forward View, NHS England is giving particular focus to delivering allocative efficiency in the commissioning system. For example, one element of this approach includes exploring variation through commissioning for value data.
Nice to see the NHS is pulling all funding for the disabled people. 18 months ago i was promised a new arm as i was born without a right hand and part of my arm i am now told funding has been pulled and also if the current one is not repairable i will be left with no arm at all basically making me more disabled and unable to do my job. I am disgusted with the NHS and their narrow thinking. perhaps if someone on the board had a disability they would understand. Also nice to see i pay tax and national insurance for other peole to use but not me. i had to go through my local MP, local paper and compain 5 years ago when this happened then and o shock nothing has improved in 5 years, i now have no choice to take legal action, also go to the national papers to see where i stand as i have had the same model hand 32 years!!! new ones have been developed but i have never moaned that i don’t get one all i want is if the current one is not repairable i get another one the same so i can continue the basic use to do every day things. thanks again NHS i pay my way never moan never in trouble but my tax and national insurance goes to others not me
It is not the case that NHS England is pulling funding for disabled people. The investment decisions NHS England made in July [link: https://www.england.nhs.uk/2015/07/02/annual-investment-decisions/%5D will help us to improve and extend thousands of lives for years to come through prevention, identification and treatment – including for people with disabilities.
When NHS England makes these very difficult decisions about which specialised services and treatments to invest in, we rely on NICE wherever possible, and make use of the best available evidence as well as extensive engagement with clinical experts, patient representatives and the public. NHS England have also established a Prosthetics subgroup which reports to the Complex Disability Equipment Clinical Reference Group, within which prosthetic services sit. This group consists of patients, their representatives, clinicians and representatives from the professional bodies and the prosthetics industry.
The subgroup recently developed the clinical commissioning policies for microprocessor prosthetic knees and multi grip upper arm prostheses but it was agreed they needed to undertake more work on strengthening the clinical evidence and the links with potential to benefit. It is anticipated this work will be completed for further consideration by NHS England in the autumn.
Routes still remain open to clinicians for patients with exceptional clinical need to access a certain treatment or service, even where a clinical commissioning policy has not been approved. Any patient who has already got a multi-grip prosthetic limb should continue to have this funded, including replacements, as long as their clinician feels there is a clinical need. You should therefore discuss the best treatment option for you with your clinician.
It would help if NHS England was “at home” to answer practices’ plans to develop and address the nees of the FYFV, e.g. how they access the PMIF.
We have a vision for an integrated Health & Social Care Hub that will have space for our local family carers organisation, AgeUK, &etc as well as JobCentre+, our local college of education, the police, and others. We have the oportunity of an in-town site.
I think our local NHS England team is carrying 50% vacancies and is “waiting for guidance”. I expect the guidance to come rather too late to allow anyone to access the funding.
Simon Stephens needs to look to his organisation and enable them to make decisions in a more timely fashion than has been the case for the last couple of decades.
The Primary Care Infrastructure Fund was launched in January 2015 and in March we announced that 721 schemes had received support in principle for funding in 2015/16 (subject to due diligence).
Many of these schemes will help practices make modest improvements and increase clinical capacity.
It is expected that, for future years, funding will support more strategic schemes that are linked to local estates strategies. We will announce the process for future funding in the autumn.