1/9 Been touring the TV studios this morning giving reaction to the emerging Long Term Plan (LTP), following @10DowningStreet briefing yesterday and today's media stories / Ministerial interviews on TV shows. Some early thoughts below.
2/9 Key to view LTP in context. NHS frontline been facing difficult combo of rising demand, longest £ squeeze in NHS history & growing workforce shortages. Access to care, frontline workload & provider finances all been under pressure. LTP provides chance to recover lost ground.
3/9 Other key context is that whilst extra £ is welcome, it's no bonanza. Just returns NHS to average annual funding increases since 1948. Unusual bit here isn't size of new funding increase - it's last eight years of much lower than average annual increases: c1.5% vs 3.7% pa.
4/9 To plan is to choose. We all want to recover performance/finances; transform NHS, moving to new models of care; expand workforce; have world class mental health, community/primary care services & IT; significantly improve cardiovascular, maternity & cancer outcomes but....
5/9 Whole point of planning is to choose between different desirable outcomes, ruthlessly prioritising what to deliver...then ensuring priorities match available money, staff & change capacity / capability. Planning is not wishlist creation...it would be a lot easier if it was!
6/9 So we shouldn't cheer if LTP makes a series of over ambitious promises across too wide a range of priorities. We should cheer if it's hard headed & realistic with sensible progress across carefully chosen priorities and realistic delivery plans attached to each priority.
7/9 Vital LTP adds up & can be delivered: all commitments made - performance/finance recovery, transformation, extra new priorities - must, in total, be deliverable by frontline. That's not just a match to £, it's also a match to workforce and softer things like change capacity.
8/9 Big risk for NHS if LTP over-promises and service then fails to deliver. Whitehall / Parliament / other public services believe, with justification, that NHS "has got all the money". So if we don't deliver against "our own plan" that would, rightly, be a serious problem.
9/9 Been a very big ask for @NHSEngland/@NHSImprovement to get such a complex & wide ranging exercise completed so fast. Expecting NHS will need more time for detailed implementation planning. Hope this will continue with excellent level of trust leader involvement seen so far.
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