It’s just over two weeks now since NHS England published the NHS Long Term Plan. Setting out the vision for the next 10 years of the NHS, the plan was heralded by many as the solution to the challenges facing the NHS. As the dust is now settling following the launch of the plan it’s time to review it in more detail; what does it actually mean for disabled people with complex needs and their families?
The Long Term Plan was first envisioned as part of the birthday celebrations for the NHS. July 2018 saw the 70th anniversary of our National Health Service and during the summer the Prime Minister announced a ‘birthday present’ of extra funding, equivalent to £20.5 billion extra by 2023/24. The baton was then passed to NHS England to develop a plan for how this money would be used to meet the changing needs of the population and deliver high quality services – this is the Long Term Plan.
The plan itself sets out the vision for the NHS in areas such as cancer care, addressing health inequalities and workforce. It’s fair to say that some areas of the plan are more developed than others, with many elements offering a lot of promises but very few answers or fully worked up solutions.
In the detail of the plan there are a number of proposals that Sense welcomes as we think these will have a positive impact on the people who we support. This includes the ambitions to tackle health inequalities for people with autism or a learning disability, increased access to social prescribing and a focus on more personalised care.
The proof of the Long Term Plan pudding will be in the eating. There are still a lot of unknowns, but also a lot of opportunities for us to shape and improve NHS services. What we need to be mindful of, however is that we don’t lose sight of the basic building blocks of what good quality health and care services look like.
Whilst new programmes, initiatives and promises are welcome, we mustn’t be distracted by these and ensure that the foundations of good care are built on. For example, we know that many of the people who we support find healthcare inaccessible due to information not being provided in a format they can access, or communication support not being provided. This is despite mandatory requirements such as The Accessible Information Standard existing. It is essential that we are getting these basics right alongside the bigger picture of the vision for the NHS of the future.
The Long Term Plan is, unashamedly, a plan for the NHS but can we and should we be fixing this in isolation? For disabled people with complex needs, the NHS is only one part of the jigsaw puzzle that makes up day-to-day life. Social care plays a huge factor in many people’s lives and it’s our opinion at Sense that health and social care cannot be treated in isolation; the NHS and social care are intrinsically linked.
We are not alone in this view, just last week the National Audit Office published research that concluded that without a long-term funding settlement for social care, it will be very difficult to make the NHS financially stable. Whilst it’s not all about the money, it’s an important point to be raised and a challenge to Government to be more radical in how we approach the health and care of our nation.
Sense, along with many other organisations, has been waiting for over 18 months now for the Social Care Green Paper. Whilst we know that a green paper is only the start of the process of reform, it is desperately needed. We have seen little to no progress in a long-term plan for social care since the green paper was promised, yet we know that during this time demand has increased and people won’t be having their needs met. The Local Government Association are currently predicting that social care will face a funding gap of £3.56 billion by 2025. We were therefore disappointed that, with the announcement of additional funding for the NHS that the opportunity to fully integrate this with plans for social care was missed, particularly as the timescales aligned.
The next steps of the Long Term Plan now fall to local areas, which need to set out how they will realise the plan in their locality. Key to this is engagement and involvement of disabled people with complex needs and people who use services. The question remains, however, how much impact can the Long Term Plan really have, when social care is being left behind?