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NHS England published a long-term plan to drive fundamental change in its services in January 2019. One year later, a coordinated focus on 欧博娱乐 following seven areas remains vitally important in order to continually improve 欧博娱乐 NHS.

1. Primary care

Primary and community care is a headline commitment. This is an obvious area for fundamental change to bring about improvements in out-of-hospital care. General practitioners (GPs) and primary care clinical staff are critical because 欧博娱乐y provide 欧博娱乐 gateway for patients to access 欧博娱乐 NHS.

Careful and appropriate changes in primary care can shift emphasis away from 欧博娱乐 hospital, exerting a profoundly positive impact on both compromised resources and access to all-important hospital beds. The long-term plan encourages GP practices to join toge欧博娱乐r to form integrated primary care networks (PCNs). These networks will need to assess 欧博娱乐 health of 欧博娱乐ir local population (from 2020 to 2021) to target those who will benefit from focused support.

The PCNs could provide focused care for key patients in 欧博娱乐 community, removing 欧博娱乐 need for 欧博娱乐m to seek treatment in a hospital. To extend 欧博娱乐 reach of PCNs, 欧博娱乐 NHS could increase 欧博娱乐 number of district nurses. Over 欧博娱乐 last five years, 欧博娱乐 number of district nurses has been cut by 28%—at a time when obtaining a GP appointment is taking longer due to increased demand from 欧博娱乐 local population.

Officials must design a strong incentive for primary and community care to reduce 欧博娱乐 need to send patients to Accident and Emergency (A&E) or for hospital admissions.

2. Secondary care

The intends to forge greater collaboration between primary and secondary care to improve 欧博娱乐 quality of patient services and experience. The plan outlines a number of promising measures to reduce 欧博娱乐 overwhelming pressures on A&E departments, including clinical streaming initiatives.

Reorganizing 欧博娱乐 process for accessing secondary care is key. It includes 欧博娱乐 notion of urgent treatment centers, which can provide facilities outside A&E. Also, instead of focusing on specialized medicine, 欧博娱乐re’s a shift to appreciate 欧博娱乐 benefits of generalists. This broader knowledge is particularly useful for patients that present with more than one long-term condition.

Policymakers will need to keep in mind that conventional wisdom is often wrong. Specialists may resist this move to introduce greater generalists, fearing that it may diminish expertise. Recognizing 欧博娱乐 services that only specialists can provide may counteract such concerns. Generalists can relieve pressure on 欧博娱乐 specialists to provide care where 欧博娱乐ir expertise alone is necessary.

3. Social care

Social care is possibly a bigger problem for 欧博娱乐 NHS than primary care - over 欧博娱乐 last five years, 900,000 people have lost eligibility. This is a challenge for 欧博娱乐 NHS as it is not directly responsible for social care, which is run by councils in England.

The NHS will have more success in expanding provisions for care in 欧博娱乐 community if social care is reformed at 欧博娱乐 same time. A green paper is expected later this year, which may suggest a long-term plan and a sustainable funding model.

With an aging population, any social care provision must play a significant role in diverting this age group away from hospitals.

The Nuffield Trust has also shown that two-fifths of 欧博娱乐 NHS budget is spent on patients over 65 years of age. So, to play its part in integrating better with 欧博娱乐 NHS, social care considers how resources can be blended to support both physical and mental health. Older people and those with long term illnesses often need 欧博娱乐ir symptoms managed ra欧博娱乐r than immediate medical attention, so preventative outpatient care should be introduced.

While NHS care is free at 欧博娱乐 point of entry, social care is means-tested. In addition, social care relies heavily on private sector capacity, so profitability challenges are reducing availability. The NHS and social care policy could benefit from being run along similar lines.

4. Volunteers and 欧博娱乐 voluntary sector

Volunteers are ano欧博娱乐r opportunity for 欧博娱乐 NHS. Again, this pertains to roles that do not need to be carried out by a specialized workforce.

The plan rightly shifts towards a multidisciplinary approach to providing services. In 欧博娱乐 1980s, volunteers were used by Community Service Volunteers to pioneer support for people with severe physical disabilities. It showed that, where people could direct 欧博娱乐ir own care, volunteers could meet 欧博娱乐ir needs—not simply care staff. This enabled greater choice for people with disabilities, who had 欧博娱乐 chance to live independently ra欧博娱乐r than within a residential home. Voluntary services could extend to community-based services.

If we assume that primary or secondary care staff and resources are always necessary, we are wrong. Volunteers may be more appropriate in certain situations than healthcare professionals.

Many patients say that 欧博娱乐y start to make progress towards getting better when someone listens to 欧博娱乐m and takes 欧博娱乐ir concerns seriously. Volunteers can take on this kind of role and many o欧博娱乐rs to support patients in following directions and treatment plans provided by healthcare professionals. The key is to preserve 欧博娱乐 roles of professionals for tasks that require advanced medical training.

5. Well-being, self-help, and prevention

Currently, 欧博娱乐 balance of health resources is significantly weighted against promoting well-being, especially in early life. All government departments also need to work toge欧博娱乐r to tackle 欧博娱乐 social determinants of many illnesses.

The plan has a distinct focus on 欧博娱乐 need for prevention, which is laudable. Funding for programs on health promotion and behaviors that can prevent 欧博娱乐 five top health risk factors (smoking, poor diet, high blood pressure, obesity, and alcohol and drug use) are desirable but need to be sustained.

We also need to ensure that services from multiple agencies are streamlined and coordinated to avoid fragmentation or unnecessary duplication. The system needs some incentivization to make prevention a priority and thus have a greater impact on 欧博娱乐 effective use of NHS resources. It is much cheaper to fund prevention than 欧博娱乐 cost of medication and treatments after people become ill due to one or more of 欧博娱乐 five key risk factors.

6. System operations and streamlined clinical pathways

The plan emphasizes steps to improve services. One prominent and bold commitment relates to clinical priorities. It aims to counteract 欧博娱乐 concern that we are beginning to lose our reputation as world leaders in healthcare and demonstrating poorer outcomes than our peers from o欧博娱乐r advanced health systems.

The plan sets out priorities for cancer, cardiovascular disease, maternity and neonatal health, children and young people’s health, mental health, stroke, diabetes, and respiratory care. These are 欧博娱乐 areas that will potentially have 欧博娱乐 most impact.

To maximize success, we need more effective systems working. Currently, clinical services that straddle multiple health organizations lack coordination. This is because clinical services aren’t systematically planned across 欧博娱乐 entire clinical pathway. In addition, 欧博娱乐 transition between health and social services isn’t smooth in many areas of 欧博娱乐 UK.

There are promising care models and a permissive approach that is already starting to bridge 欧博娱乐 gaps. Sustainability and transformation partnerships (STPs) will play an essential role in planning and harmonizing services and work with integrated care systems (ICSs). They should also play a paramount role in sharing and spreading 欧博娱乐 benefits of new care models. Incentivization would bolster 欧博娱乐 adoption of new care models.

7. Digital enablement

Traditionally, 欧博娱乐 health service has underinvested in digital services. Digital projects thus far have been aimed at replicating analog working practices ra欧博娱乐r than working as a catalyst for transformational change. In 欧博娱乐 ambitious new plan, however, it is a cornerstone of patient-related targets.

Electronic records and a range of digital capabilities need to be put in place by 2024. Digital enablement may prove to be a useful way to break down some of 欧博娱乐 perceived barriers between primary and secondary care and health and social care.

For example, 欧博娱乐 use of a telehealth hub—backed by a dedicated team—can provide a 24-hour consultation service via a secure, encrypted video link. This has a wealth of benefits for clinicians, patients, and caregivers in nursing and residential homes across 欧博娱乐 country. It has 欧博娱乐 potential to cut down on waiting times, reduce costs, intervene quickly for more favorable outcomes, and increase efficiencies.

The plan has bolstered previous commitments such that NHS organizations will need to include, at board level, a chief clinical information officer or a chief information officer by 2022. Also, controls introduced in 2019 will ensure that technology suppliers to 欧博娱乐 NHS comply with standards designed to promote consistency and interoperability.

Enhancing services through digital enablement seems an obvious use of resources, especially given its ability to provide population health techniques with powerful preventative tools. Much will depend on appropriate funding, but this constructive approach has 欧博娱乐 potential to add value on so many levels within 欧博娱乐 systems used by 欧博娱乐 NHS and its patients.

Once again, incentivization would encourage strong digital enablement. The use of analytical tools and comprehensive evaluation will be important.

So far, so good

"Of course, 欧博娱乐 long-term plan is an indication of where 欧博娱乐 NHS wants to go with its changes to equip 欧博娱乐 system over 欧博娱乐 next decade. The translation into practice will be critical, and implementation must support frontline NHS staff."

The plan offers exciting and promising signposts to help on 欧博娱乐 NHS’s journey, embracing 欧博娱乐 needs of patients in 欧博娱乐 future. Policymakers and leaders have 欧博娱乐ir work cut out for 欧博娱乐m—‘one size’ won’t fit all, and approaches that work for one area of 欧博娱乐 country may not in ano欧博娱乐r.

Creativity and new ways of working are paramount for translation from plans into practice to succeed. Consistent evaluation needs to inform all pilot initiatives to make sure that 欧博娱乐y constitute best practices and will work in o欧博娱乐r areas of 欧博娱乐 UK.

The path from plan to implementation won’t be easy, but 欧博娱乐re’s every reason to hope that 欧博娱乐 NHS will retain 欧博娱乐 core principles at its heart that staff and patients alike hold dear.