NHS Long Term Plan and Hertfordshire’s response...Hertfordshire and West Essex Sustainability and Transformation Plan • Huge changes in health and society since NHS started in

Hertfordshire and West Essex

Sustainability and Transformation Plan

NHS Long Term Plan

and Hertfordshire’s

response



• Huge changes in health and society since NHS started in 1948

• NHS under increasing pressure in a number of areas

• Funding has slowed while demand for services – and the cost of

delivering those services – has grown rapidly

• Struggling performance eg. missed waiting time targets

• Budgetary pressures – especially for providers

• Workforce shortages

• June 2018 Government announced new five year funding settlement for

NHS and asked for new ten year plan

• Plan builds on five year forward view and subsidiary strategies

• Developed by NHSE in consultation with frontline health and care staff,

patient groups and other experts

• Plan published on 7 January 2019

NHS Long Term Plan and its context



Ambitions in the NHS Long Term Plan

Making sure

everyone gets

the best start

in life

• Reducing still births and mother and child deaths during birth by 50%

• Support during and after pregnancy including perinatal mental health

• Child and young people’s health – tackling obesity, support for children

with cancer, increased funding for mental health

• Right care for children with LD, reducing waits for autism assessments

• preventing 150,000 heart attacks, strokes and dementia cases

• education and exercise programmes for patients with heart problems

• diagnosing more cancers early

• spotting and treating lung conditions early

• More ental health care

• increased funding for primary and community care incl rapid community

response teams to avoid admissions and speed up discharges

• bringing together different professionals to coordinate care better

• helping people to live independently at home for longer, support for carers

• further progress on dementia care

• giving people more say about their care, especially towards end of lives

World-class

care for major

health

problems

Supporting

people to age

well

• preventing 150,000 heart attacks, strokes and dementia cases

• education and exercise programmes for patients with heart problems

• diagnosing more cancers early

• spotting and treating lung conditions early

• More investment in mental health care

• increased funding for primary and community care incl rapid community

response teams to avoid admissions and speed up discharges

• bringing together different professionals to coordinate care better

• helping people to live independently at home for longer, support for carers

• further progress on dementia care

• giving people more say about their care, especially towards end of lives



• Universal Personalised Care

• people will get more control over their own health and receive

personalised care when they need it

• Local organisations will increasingly focus on population health

• moving to Integrated Care Systems

• Deliver more services within the community

• Digitally-enabled Care will go mainstream

• Comprehensive new workforce implementation plan

NHS Long Term Plan Summary



NHS Long Term Plan Summary

• Increase in access to urgent care services

• Integrated Urgent Treatment Centres/Access

• Primary Care Extended Access

• Primary care Networks

• Supporting people to age well

• Taxpayers Investment will be used to maximum effect

• Return to financial balance

• Achieve cash-releasing productivity growth of at least 1.1% pa

• Reduce grown in demand for care through better integration

and prevention

• Reduce unjustified variation in performance

• Make better use of capital investment and accounting



Total Population

1,525,147

Mostly Well

(68%)

People with Long Term

Conditions

(21%)

People with complex

needs

(11%) - 43% of total

spend

Age 70+

198,269 (13%) population

(24%) (42%) (34%)

Adults 16-69

1,006,597 (66%)

Population

(69%) (22%) (9%)

Children & Young People

0-15

320,280 (21%) population

(94%) (5%) (1%)

HWE STP Population Health Management

Population Health Profile – The Challenge



Challenges this presents for us locally

• Reducing health inequalities – targeting the most deprived

• Challenges in workforce across all professionals and sectors

• Demand management and ‘being clear’ so the public know what

they can expect from the NHS

• Developing community based services and sustainable primary care

• Investing and testing in new services to improve early diagnosis

such as straight to test in cancer

• Investing in prevention and making prevention everybody business

• Progress of NHS digitalisation through the use of ERS, virtual

consultations



ICA/CCG

(500k)

Locality (100-150k)

Primary Care Networks

(PCNs) 30,000-50,000

population

Sustainable hospital services

Specialist care (including Mental Health)

Standardised pathways

New models of care

Local delivery/implementation

3x core DGH services

Specialist complex/frail

Urgent Treatment Centres

Extended Access

Planned care in the community

Multi Practice Integrated

MDTs/Workforce

Social prescribing and support/PPGs

CHC/Care Homes

Delivering

Integrated Care

Opportunities for working together



Musculoskeletal,

pain and

rheumatology

Gynaecology

Diabetes

Frailty

Respiratory

Ophthalmology

New models of care already being delivered





• Integration around community services – joint teams working in

localities

• System wide focus on expanding personalisation, choice and control

through integrated personal budgets and better person-centred

planning

• System wide working with local community assets – a ‘Connected Lives’

approach to how frontline staff operates across health and social care

• Pioneering an assistive technology approach – complementing and

improving quality of care and quality of life through the appropriate use

of tech.

• Renewed focus on prevention and intervention – how do we intervene

and support at an earlier stage



Thank you

&

Questions

Documents

NHS Long Term Plan and Hertfordshire’s response...Hertfordshire and West Essex Sustainability and Transformation Plan • Huge changes in health and society since NHS started in