Source:  Link to main document: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/implementing-the-nhs-five-year-forward-view-kingsfund-feb15.pdf

Publication format:  PDF (36 pages)

Date of publication: February 2015

Summary of driver: This is the implementation plan for the NHS Five Year Forward View, which was published October 2014 and proposes major change within the NHS over a five year timeframe. The implementation plan describes why the changes need to be made, makes practical proposals to remove barriers to healthcare and how the new implementation models can be supported. The report highlights the levels of funding required to meet this vision and the need for the NHS to have high-quality and consistent leadership.

Key features of driver:

The document lists four key drivers, each with recommendations for action and finishes with a summary of recommendations

How services are commissioned and paid for

• Innovations in commissioning and contracting – NHS commissioners to be supported by national bodies in order to achieve this
• Importance of investing in the development of system leaders
• Development of federation/networks/super partnerships (multispecialty community provider) to enable general practices to deliver a wider range of services
• Provision of proactive care in the community
• Integrated commissioning- combining CCG and NHS England funding
• NHS commissioners to work with interested general practices as pilot MCPs.
• Formation of primary and acute care systems- single organisations to provide NHS services (GP/hospital/mental health/community care) running as virtual or physical organisations
• Innovation in payment systems- capitated budgets/pooled budgets/integrated personal commissioning

How the NHS is regulated

• Improvements in quality of health and social care- CQC to survey patients and service users
• Whole-system intervention regime to support challenged health economies
• NHS England and Monitor should review current rules on procurement and tendering to enable creation of new care models
• Opportunity for local areas to have access to central legal advice

How improvements in care are delivered by local leaders

• Development of leaders at all levels in the NHS
• Providing all NHS staff with the skills and support requires to improve patient care
• Every NHS organisation to take responsibility for the development of leaders and providing staff with skills in quality improvement
• National bodies to develop explicit strategy for quality improvement
• Currently most NHS leaders are organisational leaders and the Five Year Forward View is aligned with system leaders
• Provider leadership- outlined in the Dalton review

How might a transformation fund contribute?

• King’s Fund has argued for a transformation fun d to help provide financial support through change
• Prime role is for transformation fun to pump-prime new care models whilst existing models are decommissioned
• Important to recognise that some health economies may gain, some may lose and new organisations may be created
• Looking to how mental health moved from hospital care to community services and lessons learned

Where next?

• Care models set out in the Five Year Forward View are a starting point and not the end of the story
• Commitment to real-time evaluation and learning
• Creation of vanguard sites to fast-track new care models
• Imbalance between the opportunities offered by the Five Year Forward View and the current situation of financial deficits/A&E pressures/waiting time performance
• National bodies have the responsibility to reinforce the idea that the delivery of the Five Year Forward View is as important an operational performance

Primary audience: NHS England, NHS Commissioners, NHS Providers

Impact on library policy/practice:

None of drivers are specifically aimed at libraries but there opportunities for libraries.

• The recommendation for ‘Leadership and improvement expertise’ when referring to the NHS becoming a learning organisation states ‘national support for improvement being provided through small teams of credible experts’. We are the credible experts in our field (p20).
• Vision of NHS becoming a learning organisation (as outlined in Berwick report 2013) is a great opportunity to expand and promote our skill sets and services (p20).
• Providing all NHS staff with the resources required to update their skills – literature search training/critical appraisal training/how to access information online, I order to improve patient care.
• Undertake literature searches on the relevant subjects and promote current awareness on leadership and community topics.
• Possibility of keeping GPs engaged with library and knowledge services.

 

Date last updated: February 2015

Due for review:  December 2016

Group member responsible: LK

Tagged: Commissioning, Leadership, National policy, Quality and Improvement, Workforce