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Big questions left unanswered in long-term strategy for NHS

An extra £20 billion has been promised to the NHS over the next five years. Credit: PA

Today at last the long-term strategy for the NHS in England will be published.

So long-term, it will take the health service right through the next decade, which is no mean feat.

NHS England’s Chief Executive, Simon Stevens, has written the plan at the request of the prime minister. He says it can save up to half a million lives by focusing on killer conditions and getting people to live healthier lifestyles.

An extra £20 billion promised to the NHS over the next five years will be used to help achieve this. But how?

Well, we’re told diagnosis of major diseases will be made easier and quicker with technology, mental health provision will increase and patients will be looked after better in the community - keeping them out of hospital, ensuring they live longer and healthier lifestyles.

This all sounds plausible when you take into account that GPs, local community and mental health will get a third of the extra funding.

So, less money you might say, going straight to hospitals.

Getting people to live healthier lives will be a part of the strategy. Credit: PA

The buzzword today is integration. Few really know what that means, but in essence it’s about the NHS working better with local authorities who control social care in the community.

It might seem crazy that this isn’t joined up already, but it’s not, and while local authority funding has decreased, care in the community has had to be scaled back, putting huge pressure on hospitals.

That will change we’re told. It’ll all be joined up, hospitals will be able to discharge elderly patients more freely and community care will take over.

That’s all well and good but there remain some big unanswered questions. We’ve been waiting two years for a Social Care green paper, which will consult on the best way to fund and manage social care in England.

Without any plan to tackle the financial crisis in that system, it’s hard to see how the vision in this 10 year NHS plan can be achieved.

Health secretary Matthew Hancock. Credit: PA

That, along with dwindling local authority budgets, seems right now a fantasy. The health secretary Matt Hancock has promised the Social Care green paper will be published in the coming weeks so all eyes will be on whether it can deliver what the NHS needs.

It is also admirable to encourage healthier lifestyles and to offer healthy living programmes to those most at need, but that pledge is at odds with the massive cuts to public health budgets.

Local authorities, in charge of those finances, have had to cut back on key services which ultimately help those with drink problems, drug problems and weight problems. How will the government achieve this pledge if councils aren’t given extra money to keep vital service?

My last point is who will deliver this? The staffing crisis in the NHS is not a joke. Around 100,000 doctors and nurses are needed and unions have warned that this figure will just keep rising. If there are no medics to deliver this, the plan is pretty much pointless.

The government has promised to tackle staffing in the service at a later date, but until that happens there will always be a fear this plan can’t be delivered in full.

There is a lot of good in this plan. Of course there is. But until these questions are answered there will, I think, always be doubters.