Thread by @mgolledgeGlos

Promised I would do that summary thread on the @NHSEngland #planningguidance for 22/23 so here it is......slightly longer than anticipated!

https://twitter.com/mgolledgeGlos/status/1474430033162866688

Priorities in the planning guidance are to be kept under review in light of #Omicron - and are based on a scenario of covid-19 returning to low levels. Planning timetable extended to April (draft due mid March) given existing operational pressures.

Announcements of a delay to putting ICS' on a statutory footprint to July 22 has already received quite a bit of attention such as here (remains subject to passage of Bill through Parliament): hsj.co.uk/integrated-car…

Financial arrangements for 22/23 will align to new ICS boundaries - shortly to announce 1 yr revenue & 3 yr capital allocations (remaining 2 yr revenue in H1 22/23).

10 priorities outlined in planning guidance as follows. This is alongside tackling health inequalities - england.nhs.uk/about/equality… & tackling climate change (ICB board require net zero lead and publish green plan).

1). Workforce - systems asked to grow workforce & wider culture activity (whole system workforce plan should reflect ambitions around recruitment (incl diversity), retention, wellbeing, apprenticeships & multidisciplinary working (virtual wards & D2A). @NHS_HealthEdEng support.

2). COVID-19 - Continue vaccine booster rollout, antibody treatments for targeted high risk cohorts & supporting patients with #LongCovid (£90m funding to support this latter area).

3i). Tackle elective backlog - ICS elective recovery plans (inpatient, outpatient, diagnostics) prioritising high clinical priority patients (incl. cancer + long waits). Goal of 30%+ elective activity by 24/25 (10% 22/23) than pre-pandemic. Performance targets eg. reduce OP FU.

3ii). Cancer - focus on reducing backlogs for people waiting for treatment & early diagnosis to reduce shortfall in 1st treatments. ICS cancer plan required (with Cancer Alliances) that should support timely presentation in primary care, faster diagnosis & targeted case finding.

3iii). Diagnostics - recovery of activity levels (120%+ pre pandemic levels) including investment plans - implementation of CDCs (3 yr capital allocations). Digital roadmaps are key here including pathology & imaging. £21m for networks to deliver on these priorities.

3iv). Maternity - Local Maternity Systems to deliver on functions & oversight from LMS Board. 7 #Ockenden actions to be delivered (donnaockenden.com/downloads/news…) & local plans to deliver Better Births incl. midwifery continuity of carer. Funding of £93m in baselines & programme funding

4). Urgent and Emergency Care - focus on preventing inappropriate ED attendances, timely admission to hospital for ED patients, reduce LoS and restore ambulance responses. 2 areas of focus for urgent and emergency care priority:

4i). Urgent & Emergency Care - Continue to deliver on 10pt action plan (england.nhs.uk/wp-content/upl…) incl. increase #NHS111 capacity, expand urgent treatment centre as front door for ED.

4ii). Transform community services - Deliver 2 yr system virtual ward rollout plan england.nhs.uk/wp-content/upl… Aim 40-50 per 100,000. Also 2hr urgent community response, #anticipatorycare, enhanced health care homes & plans to reduce community wait lists.

5). Improve Primary Care Access - Integration across community services, community pharmacy & PCNs. New roles in PCNs & expand no. GPs is priority. Focus on moving low acuity out of general practice & digital offer. Delayed DES' due April 22. Pharmacy, dental & optometry key.

6i). Expand & Improve Mental Health Services - Priority on crisis care provision all age & alternatives to A&E, continue MH services transformation & increase support for children. MH workforce plan needed & seek to eliminate out of area placements for young people - plan by June

6ii). Supporting people with learning disabilities & autism - SDF funding of £75m in 22/23 to increase health checks, reduce reliance on inpatient care & support admission avoidance including enhancing community based support.

7). Population Health & Health Inequalities - Development of plans by June 22 for population health. Prevention remains priority - tobacco treatment, improve lifestyle services, restore diagnosis & new models of care of key LTCs (resp, stroke, cardiology).

8). Digital - Ensure ICS' have core levels of infrastructure, digitisation & skills (core levels for providers by March 25 with plans by March 22 for 1st yr & costed plans by June 22). £250m funding in 22/23. Shared care record & NHS app rollout prioritised.

9). Making effective use of resources - To fully recover services, tackle elective backlog & meet LTP objectives. Financial frameworks for ICS' is key. Expected efficiency requirements & return to financial balance (ICB duty to breakeven).

10). Establish ICBs - Target date of July 22 (timescales adjusted as a result) with existing arrangements until then. Recruitment to continue to ICBs (timescales adjusted where needed) & further details on timeline in January. ICBs need 5yr plan by March 23.