The publication of the 10 Year Plan will bring ‘this era of top down control’ in the NHS to an end and pave the way for more radical approaches in primary care, health secretary Wes Streeting has said.
Speaking at the NHS ConfedExpo conference today, Mr Streeting said the NHS should not be ‘bound by traditional expectations of how services should be arranged’ and was open to new models such as ‘successful GPs’ running local hospitals or acute trusts providing primary care services.
His speech comes after the chancellor Rachel Reeves announced GP training as a priority investment area as part of an overall ‘record’ £29bn funding boost for the NHS in yesterday’s long-term spending review.
Ms Reeves explained that the new investment, which sees real terms day-to-day spending on NHS services increase by 3% on average, includes ‘up to £10bn’ allocated to technology and digital transformation, ‘GP training to deliver millions more appointments’ and rolling out mental health support to all schools.
Yesterday, however, the Treasury warned that this ‘record investment’ must go hand-in-hand with reform across the health service, to deliver 2% productivity growth each year and bring in £17 billion of savings over the next three years. These savings will be reinvested back into the health service and support a ‘radical transformation’ as set out in the 10 Year Plan being launched in July, it said.
Mr Streeting’s speech today ‘trailed’ some of the contents of the 10 Year Plan. He indicated that:
- there will be a ‘new operating model’ for the NHS, with more power devolved to the font line
- there will be clearer but fewer centrally mandated targets
- the ‘centre’ will continue to shrink with its main job being to ‘drive excellence’ and also deliver strengthened procurement
- The Foundation Trust model will be ‘reinvigorated’ and incentives and flexibilities from central control introduced for local providers delivering quality services
- Financial incentives will be applied to public health outcomes so resources will be tied to targets, which ‘all commissioners and providers will have a responsibility to meet’.
- a ‘new ear’ of NHS leaders will be developed with pay tied to performance.
- ICBs will still be commissioners of local health services.
- There will still be seven NHS regions that manage performance and oversee providers in their region.
‘It’s only through the combination of investment and reform that we will succeed in getting the NHS back on its feet and make it fit for the future,’ Mr Streeting said.
He added: ‘The NHS should not be bound by traditional expectations of how services should be arranged. I am open to our strongest acute trusts providing not just community services, as many already do, but also primary care, whatever services will enable them to meet the needs of their patients in a more integrated and efficient way. Indeed, I’d hope that those old fashioned labels – acute, community – become increasingly meaningless. And likewise, there is no reason why successful GPS should not be able to run local hospitals, or why nurses should not be leading neighbourhood health services.’
Meanwhile, yesterday’s spending review document said that the Government will ‘move money and care closer to where people live’, and that this ‘includes additional funding by 2028-29’ to support ‘the training of thousands more GPs’. However, it lacked specific details.
It said: ‘Additional funding will be provided to help bring back the family doctor through supporting the training of thousands more GPs, delivering millions more appointments a year.’
The BMA’s GP committee chair Dr Katie Bramall said that it is now ‘crucial’ to determine how that budget will be spent through allocations ‘in the coming weeks’.
And she pointed out that there needs to be ‘significant additional investment’ alongside a new wholesale GMS contract, which the Government committed to earlier this year during contract negotiations for 2025/26.
Dr Bramall said: ‘The announcement of a 3% rise for the Department of Health in the Government’s spending review defines the NHS budget until the next election – but of critical importance is determining how that budget will be spent through allocations in the coming weeks, which will make or break general practice.’
