NHS England strategy: foundations for improvement

NHS England has published its business plan for 2015/16, Building the NHS of the Five year Forward View.

Priorities

The new document sets out the organisation’s priorities to deliver high quality care and services and value for money whilst advancing the NHS Five Year Forward View agenda and laying the groundwork for to the future health and care system, not to mention spending an additional £1.83 billion in Government funding. The strategy is based around four broad aims:

1. Improving health
2. Designing the NHS around patients
3. Galvanising whole system change for future clinical and financial sustainability
4. Putting in place the foundations for improvement to happen

Priorities include improving care and access to cancer treatment, mental health, learning disability and dementia services; tackling obesity and preventing diabetes, improving urgent, emergency and primary care services, as well as elective and specialised care.

Citizen drivers and data

Within the ‘foundations for improvement’ domain, there is an expressed aim to use data, technology and science more effectively in order to ‘improve accountability, choice and outcomes for all patients, activate citizens to take more control, reduce the administrative burden on frontline staff and support the NHS as an engine of science and economic growth’.

Harnessing the information revolution and making use of digital health technologies to create a ‘modern digital knowledge economy in health and care’ is seen as central to empowering patients to take more responsibility for their health and also have a greater role in service design and decision-making, alongside active efforts to support public and patient participation more generally. This is to include improved access to clinical information, support for patients to manage their own health and more control over care provision.

An NHS Citizen programme will develop a system for allowing staff and citizens to be involved in improvement of health and care services, whilst a National Information Board will bring together representatives from the NHS, public health, clinical science and social care as well as members of the public and local government to map out responsibilities for delivering digital care and improving data standardisation and security. A review of NHS leadership and improvement bodies will make recommendations on how to ensure that there is capacity to respond and adapt to innovation to deliver better care.

Harnessing science and technology

Investing in the benefits of innovation is seen to extend to harnessing science and technology, and the strategy states the aim to accelerate the ‘adoption of cost effective and affordable new treatments and diagnostics and combining different technologies and new ways of working’ to transform healthcare and enhance wealth creation in international markets.

This will include creating regional National Innovation Accelerator sites to trial innovations and report findings, and supporting adoption of proven innovations via ‘analysis of variation’. The 100,000 Genomes Project is cited as a catalyst for this sort of transformational change, leading to ‘improved prediction and prevention of disease, more precise diagnosis and more personalised treatments and care’. With this in mind, a second set of NHS Genomic Medicine Centres will be selected in the coming year, so that the whole of England is covered by their operation.

Enabling innovation – delivering equitable change?

The strategic aims of NHS England are broadly in line with many of those of the PHG Foundation, as set out in our 2015 health innovation manifesto – creating a sustainable NHS by harnessing information in new ways and empowering individuals to take more responsibility for their own health and care. However, the devil may be in the details. The manifesto contains much more specific (though still ambitious) objectives to be met by health service funders and strategists than the sweeping aims of the new NHS England document; we look to see genuine incentives and systems for data sharing, practical safeguards for that data and enabling measures for evaluation of innovations to be put in place.

In particular, whilst welcoming efforts such as the proposed National Innovation Accelerator sites, and indeed the NHS Genomic Medicine Centres, the real difficulty lies less in proof-of-concept trials (important as these are) than in cascading the adoption of beneficial innovations outside a research-linked situation and outside centres of excellence, to front-line NHS staff up and down the country. Only then will the NHS really be making the best use of science for patient benefit.