In a post-Christmas seasonal rush of enthusiasm, the government heralds have been out in full voice to proclaim the benefits that the new 10-year Long Term Plan for future strategies and priorities for the National Health Service in England will bring to patients and staff.
Consultations with “patients’ groups, professional bodies (including the SoR) and frontline NHS leaders through over 200 events, 2,500 responses, insights offered by 85,000 members of the public and from organisations representing over 3.5 million people” gives policy makers the confidence the Plan is what is needed and what professionals and patients want.
Radiographers, other AHPs and medical professionals have a more world-weary view that visions for the NHS are great as long as they are properly funded and resourced.
The Plan does acknowledge in the first paragraph of the summary that “there’s been concern about funding, staffing” and a few lines later the document says, “we must tackle head-on the pressures our staff face, while making our extra funding go as far as possible.”
The government says it is committed to “secure and improved funding path for the NHS, averaging 3.4% a year over the next five years, compared with 2% over the past five years.”
Will it be enough? No, of course not, particularly when price inflation is taken into account, along with a population that continues to grow in numbers and in years of age.
And what does the Plan have to say about the workforce? There is a whole chapter headed ‘NHS staff will get the backing they need’, which acknowledges (with understatement) “our staff are feeling the strain due, in part, to the number of vacancies across many roles… NHS staff have continued to put patients first despite growing demand and rising pressure. We recognise this, and are committed to improving the working lives of all staff over the next few years and beyond.”
The document does set out steps to address the reasons why not enough people are being recruited, why staff attrition is so high, and the leadership the Service needs.
What does the Plan expect to achieve for our patients, who depend on diagnostic imaging and oncology services?
The document does acknowledge that “Capacity in diagnostic services has not kept pace with the growth in demand. We have fewer MRI and CT scanners per capita than most OECD countries, for example, while vacancy rates are 12.5% for radiologists and 15% for radiographers. Yet, the number of patients referred for diagnostic tests has risen by over 25% over the last five years. So delivering an effective, high-quality service requires investment in new equipment and staff, underpinned by a new model of diagnostic provision.”
In keeping with other announcements and strategies in recent years, the importance of early and faster diagnosis is emphasised. Specific mention is made of improving the delivery of the screening programmes, increasing uptake and “learning the lessons from the recent issues in breast screening”.
A faster cancer diagnosis standard will be introduced from 2020 to ensure patients receive a definitive diagnosis or the all-clear within 28 days of GP referral. This will be supported by the roll-out of new rapid diagnostic centres starting this year and increased investment in CT and MRI scanners, as well as more mobile lung CT machines.
By 2028, the intention is that 75% of cancers will be diagnosed at stage 1 or 2, meaning that an additional 55,000 people will survive for five years or more following diagnosis and three in four cases will be diagnosed early.
The current programme to upgrade linacs will be completed, as will the commissioning of the proton beam centres in London and Manchester.
“Faster, smarter, and effective radiotherapy will mean more patients are offered curative treatment, with fewer side effects and shorter treatment times.”
Every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan, and health and wellbeing information and support.
There is a great deal to applaud in this Plan
If we put aside our inclinations to be sceptical of high ambitions for the NHS, based on past experiences of government not following through with the resources and the energy to do what is necessary to deliver, the NHS Long Term Plan should be welcomed.
If all came to pass, as laid out in the Plan, the NHS would make significant progress in how patient services and care are delivered, and in how SoR members and other parts of the workforce are treated and respected as valued individuals.
As it has been over the previous 70 years, the next 10 years of the NHS’s development will be interesting.