five year forward view - nhs england · nhs five year forward view 2 the nhs has dramatically...

Five Year Forward View

October 2014

Easy Read

NHS Five Year Forward View 2

The NHS has dramatically improved over the past fifteenyears.

Cancer and cardiac outcomes are better;

waits are shorter; patient satisfaction much higher.

Even during the global recession and hardship,progress has continued thanksto protected funding and thecommitment of NHS staff.

The NHS Five Year Forward View – easy read summary


But the quality of care thatpeople receive can bechangeable, preventable illness is widespread andhealth inequalities are deep-rooted.

Our patients’ needs arechanging, new treatment options are emerging,

and we face particular challenges in areas such asmental health, cancer...

...and support for frail older patients. Service pressures arebuilding.


Fortunately there is now quitea big agreement on what abetter future should be. TheFive Year Forward View setsout a clear direction for theNHS – showing why change isneeded and what it will looklike.

Some of what is needed canbe brought about by the NHSitself.

Other actions need new partnerships with local communities, local authoritiesand employers.

Some important decisions – forexample about money, onvarious public health measures and on local service changes – will needfirm support from the next government.


The first argument we make inthe Five Year Forward View isthat there needs to be a big improvement in helping people live healthier lives sothat they don’t get ill so much.This is called ‘Prevention’.

This is very important for:

the future health of millions ofchildren,

making sure the NHS can keepworking into the future

and how this effects howmuch money Britain has tospend.


Twelve years ago, a mannamed Derek Wanless wrotea report called ‘SecuringGood Health for the wholepopulation’. In the report, hewarned that unless the country took prevention seriously we would be facedwith a sharply rising burden ofavoidable illness.

Not enough has been done in the past to address that warning - and the NHS nowfaces the problems that DerekWanless warned about.

The NHS will therefore nowback hard-hitting national action on obesity,smoking, alcohol and othermajor health risks.

We will help develop and support new ideas in the workplace to help employees’health and cut sickness-related unemployment.


And we will advocate forstronger public health-relatedpowers for local governmentand elected mayors.

When people do need healthservices, patients will gain fargreater control of their owncare – including the option ofshared money to join healthand social care.

The 1.4 million full time unpaidcarers in England will get moresupport;

and the NHS will become abetter partner with voluntaryorganisations and local communities.


Second, the NHS will take steps to break down the barriers in how care is provided between family doctors and hospitals,

between physical and mentalhealth,

between health and socialcare.

The future will see far morecare delivered locally but withsome services in specialistcentres, organised to supportpeople with multiple healthconditions, not just single diseases.


England has many differenttypes of people and so oneway of providing care will notfit everywhere. Also it will notwork well if everyone has toomany different ways of caringfor people.

Different local health communities will instead besupported by the NHS’ national leadership to choosefrom a small number of newcare delivery options, andthen given the money andsupport to put them into action.

One new option will let groupsof GPs join with nurses, othercommunity health services, hospital specialistsand perhaps mental healthand social care to create integrated out-of-hospitalcare – the Multispecialty Community Provider.


Early versions of these ways ofworking are appearing in different parts of the country.We will learn from what workswell and what doesn’t.

A further new option will bethe joined hospital and primary care provider – Primary and Acute Care Systems – bringing together forthe first time general practiceand hospital services.

Across the NHS, urgent andemergency care services willbe redesigned to join together A&E departments,GP out-of-hours services, urgent care centres, NHS 111,and ambulance services.


Smaller hospitals will have newoptions to help them stayworkable, including makingpartnerships with other hospitals further away, andpartnering with specialist hospitals to provide more localservices.

Midwives will have new options to take charge of thematernity services they offer.

The NHS will provide more support for frail older peopleliving in care homes.

The basis of NHS care will stayas primary care. Because of allthe new work they will have todo, GPs will need new kinds ofsupport.


Over the next five years theNHS will put more money intoprimary care, and keep theamount of money the same tofund general practice nationally over the next twoyears.

GP-led Clinical CommissioningGroups will have the option ofmore control over the widerNHS budget.

The number of GPs in trainingneeds to be increased as fastas possible, with new optionsto help them want to stayworking as GPs.


To support these changes, thenational leadership of the NHSwill need to act clearly together, and make sure thatthe rules and ways of workingare able to be flexible to localneeds. We will support local leadership with new ideas.

We will put money into newchoices for our workforce, andimprove health technology –so that patients’ experience ofworking together with the NHSis much better.

We will improve the NHS’ ability to do research and useinnovation – new improvedways of working – includingmaking places where completely new NHS serviceswill be designed from scratch.


Monitor, NHS England and independent analysts haveworked out that there will be ahuge gap between resourcesand patient needs of nearly£30 billion a year by 2020/21.

So to provide the full and highquality care the people ofEngland clearly want from theNHS, action will be needed onall three fronts – demand (what is needed); efficiency (working in the bestway); and funding (how muchmoney is available).

The third argument is aboutusing money well. The NHS hasbeen working well in the pastbut it needs to work in betterways so that it can meet the demands of the next tenyears, use its money in the bestway and be as good as othercountries’ health systems.


We believe it is possible tomeet patient needs as long aswe take action on prevention,put money into new caremodels, keep up social careservices, and over time see improvements because wework in more efficient ways.

In modern countries spendingon health care is generally increasing. If we are to reflectthe growing number of peopleneeding to use health services, we need to spendmore on healthcare in thiscountry as well.

We know that the NHS will nothave enough money to continue to act as it does overthe next five years. Theamount lacking is about £30billion.


The Five Year Forward Viewsets out some ways as to howwe might make that amountless by 2020/21.

We believe that there are realistic and practical ways ofdelivering and improving services if everyone plays theirpart and that the NHS can remain a tax-funded organisation.

The Five Year Forward Viewsets out some new ideas forthe NHS – both in the way itdelivers services to peopleand in the way it manages itsfunding. However, anychanges to how the NHS isfunded or the amount ofmoney it receives will be up tothe government.


This easy read document was produced byCHANGEwww.changepeople.org

five year forward view - nhs england · nhs five year forward view 2 the nhs has dramatically...

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