The NHS Improvement Plan - nhshistory

1 Executive summaryThe NHS Improvement PlanPutting People at the Heart ofPublic Services Crown copyright 2004 First published June 2004 Produced by the Department of HealthCHLORINE FREE PAPERThe text of this document may be reproduced without formal permission or chargefor personal or in-house NHS Improvement plan : Putting Peopleat the Heart of Public Servicessets out thepriorities for the NHS between now and supports our continuing commitment to a10-year process of reform first set out inThe NHS plan , in July the past seven years the NHS inEngland has been on a journey of majorimprovement. After decades of under-investment, the NHS has begun to turn itselfaround, with unprecedented increases in themoney it can spend. As its budget has grownfrom 33 billion to billion, the averagespending per head of population has goneup from 680 to 1,345.

2 2 That money has increased the capacity ofthe NHS to serve patients. It has helped givefaster and more convenient access to to GPs, accident & emergency care(A&E), operations and treatment is improvingwith every passing year. Quality is alsoimproving, as is the range of servicesavailable to the public. 3 These improvements have been madepossible by steady increases in the number ofNHS staff, who are even more focused on thepersonal care of individual patients and betterenabled to do so. The growth in money andstaff numbers has been matched by anunprecedented period of growth, expansionand modernisation in the buildings, equipmentand facilities available to care for in turn has enabled the NHS to providebetter quality care to patients, with safer andmore effective treatment, better surroundingsand services that better suit their lives.

3 TheNHS today is fairer as a result. The NHS isnow ready to ensure that care is much morepersonal and tailored to the The next stage in the NHS s journey is toensure that a drive for responsive, convenientand personalised services takes root acrossthe whole of the NHS and for all patients. Forhospital services, this means that there will bea lot more choice for patients about how, whenand where they are treated and much betterinformation to support that. For the millionsof people who have illnesses that they willlive with for the rest of their lives, such asdiabetes, heart disease, or asthma, it willmean much closer personal attention andsupport in the community and at home. 5 Complementing that drive for a high-qualitypersonal service for individual patients whenthey are ill, there will be a much strongeremphasis on prevention.

4 Death rates fromcancers, heart disease and stroke are alreadyfalling quickly. The NHS will take a greater andmore effective lead in the fight against thesebig killer diseases. It will lead a coalition tostop people getting sick in the first place andto make in-roads into inequalities in health. 6 In taking forward these reforms, the NHSwill continue to learn from other healthcaresystems. This will enable the NHS to continueto improve its performance as it aspires toworld class standards, where it is not alreadyachieving these. In the next stage, there willbe a stronger emphasis on quality and safetyalongside a continuing focus on deliveringservices efficiently, fairly and in a way that ispersonal to each of us. By 2008, the NHS inEXECUTIVE SUMMARY1 Executive summaryEngland will be seen increasingly as a modelthat other countries can learn the foundations 7 The investment and reform initiated in July2000 by The NHS Planhas delivered forpatients.

5 It is a track record of success, whichgives the confidence to support furtherinvestment and further reform. The money andthe changes promised in The NHS Planjustfour years ago have been made a reality forpatients, the public and the taxpayer. Thosewho argued that the NHS was beyond reform,were profoundly mistaken. The NHS hasdemonstrated that its enduring principles canprosper in the new At the core of this plan lies a continuingcommitment to the founding principles of theNHS: the provision of quality care based onclinical need, irrespective of the patient s abilityto pay, meeting the needs of people from allwalks of life. The programme is instilled witha resolve to ensure that the NHS meets theexpectations of all people in England: enablingand supporting people in improving their ownhealth; meeting the challenge of making a realdifference to inequalities in health; staying thecourse and supporting those with conditionsthat they will live with all their lives; and quicklytreating people with curable problems so thatthey can get on with their lives and live themto the a better service9 The NHS Improvement Plansets out the keycommitments that the NHS will deliver totransform the patient s experience of thehealth service over the next four years.

6 As partof this the experience of waiting for hospitaltreatment will change dramatically. 10 In 1997 patients waited up to 18 months fortreatment after seeing a GP, after seeing aconsultant, and after diagnostic tests. Thosetimes have fallen and now the maximum waitfor an operation is nine months and themaximum wait for an outpatient appointmentis 17 weeks. When this programme hasbeen delivered in four years time, the 1997maximum wait of 18 months for only part ofthe patient journey will have been reduced to18 weeks for the whole journey. The previouslong waits for GP referral, outpatientconsultations and tests are included in thatpledge. In four years time, waiting times fortreatment will have ceased to be the mainconcern for patients and the With much shorter waiting times fortreatment, how soon?

7 Will cease to be amajor issue. How? , "where?" and howgood? will become increasingly importantto patients. Patients desire for high-qualitypersonalised care will drive the new people greater personal choice willgive them control over these issues, allowingpatients to call the shots about the time andplace of their care, and empowering them topersonalise their care to ensure the qualityand convenience that they want. 12 From the end of 2005, patients will havethe right to choose from at least four to fivedifferent healthcare providers. The NHS willpay for this treatment. In 2008, patients willhave the right to choose from any provider, aslong as they meet clear NHS standards andare able to do so within the national maximumprice that the NHS will pay for the treatmentthat patients need.

8 Each patient will haveaccess to their own personal HealthSpaceonthe internet, where they can see their carerecords and note their individual preferencesabout their With waiting times no longer the main issue,the NHS will be able to concentrate more of itsenergies on providing better support to peoplewith illnesses or medical conditions that theywill have for the rest of their lives. TheDepartment of Health is also committed to aradical, far-reaching and ambitious approachto making a real difference to the quality of lifeof people who live with illnesses every the way we think about the NHS is oftendominated by the easy to understand model ofpeople with diseases being treated and cured,a very significant number of people are livingtheir lives with conditions that can t yet becured.

9 Diabetes, heart disease, asthma, some2 THE NHS Improvement plan mental illnesses and many other conditionsare medical problems that most people livewith from the time they are diagnosed. 14 The NHS will minimise the impact of theseconditions on people's lives and providepeople with high-quality personal care. It willenable and support people in managing theirconditions in a way that suits them, avoidingcomplications, maximising their health andhelping them to live longer lives. It will alsoimprove people's care closer to home throughspecialist nurses and GPs with a specialexpertise in their condition which will lead tofewer emergency admissions to hospitals whichcause anxiety for patients and their families andare a poor use of hospital resources.

10 The ExpertPatients Programme designed to empowerpatients to manage their own healthcare willbe rolled out nationally, enabling more peopleto take greater control of their own care and tolisten to themselves and their own symptoms,supported by their clinical team. The new GPcontract provides cash incentives to GPs whowork with their teams of nurses, social workers,the voluntary sector and other professionals toensure that people are given the high-qualitypersonal care they need to minimise theimpact of their illness or health Having reduced waiting to the point where itis no longer the major issue for patients andthe public, the NHS will be able to concentrateon transforming itself from a sickness serviceto a health service. Prevention of disease andtackling inequalities in health will assume amuch greater priority in the NHS.