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What the planning guidance means for the NHS

2016/17 and beyond

At a time when the NHS is planning for 2016/17 and beyond, this briefing considers some of the key publications and policy announcements that have come out in the wake of the 2015 Spending Review and offers a commentary on what they might mean for the future landscape of the NHS.

Key messages

  • The approach set out for 2016/17 and beyond represents a watershed moment for the NHS.

  • Changes to the way the system works, such as the introduction of multi-year allocations and the shift towards place-based systems of care – if implemented well – will give the NHS strong foundations from which it has a chance of achieving sustainability in the long term.

  • The place-based approach represents an important acknowledgement that the now-widespread deficits are not simply a provider problem and that creating a sustainable financing model requires commissioners, providers and local authorities to work together.

  • Guidance from central bodies signals an end to the post-Francis era. It has been made clear that the system has reached a point where finance must be given much greater priority.

  • Gone too are core elements of the Health and Social Care Act 2012, in particular, the emphasis on competition and the principle of autonomy, with national bodies re-asserting control in order to get a strong grip on finances and performance.

  • Frontloading of the Spending Review settlement means that, if and when the NHS has the capacity to progress from deficit reduction to transformation, it will be doing so against a backdrop of much smaller funding increases. It is inconceivable that the NHS will be able to achieve both financial sustainability and large-scale transformation within these financial constraints.

  • The numerous and complex demands being placed on the NHS come at a time when many organisations are already under huge pressure. National bodies should be clear about the most important priorities, recognising that not everything can be delivered within the funding available.

  • Leaders will need to work collaboratively in place-based systems of care. It will be critical that organisations engage staff at all levels in achieving sustainability and delivering transformation, and focus on improving value for patients and not crude cost-cutting.