What the planning guidance means for the NHS: 2016/17 and beyond

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Part of Spending Review 2015

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.


Pat Mooney

Independent, public contributor, lay reviewer,
Comment date
16 February 2016
It seems that the NHS doesn't ever seem to seem to learn from best practice identified in partner Trusts and deliver these locally, instead of reinventing wheel and wasting significant resources whilst improvements in care decline. What is needed is to promote QI as the independent arbiter of best practice and enforced by the Board, not keDt to endless rounds of committee meetings.

Michael T Dean…

Interdisciplinary scientist,
Comment date
11 February 2016
My research, see 'Science Uncoiled' to be published this month, proposes trace element supplementation and acid air pollution abatement to prevent common mental and physical ailments. Implementing artificial intelligence modeled on the 'minion' chip in the brain could facilitate studies of orphan conditions, both would release NHS resources for international aid.


Comment date
08 February 2016
While i think long term planning is excellent within known financial packages early and promises kept ----we seem to be going round and round regarding one to one place based models ---but unless the NHS CEO keeps to his word regarding finance and less change in between agenda.s -- in the mean time letting dead wood leave NHS and move only positive forward thinking people in to lead the change s/user s and carers on interview panels ?---my fear is we have been here before in the meantime the MH health system HAVE PRICED OUT any good s/user and carer involvement --------------
by high ticket and travel costs at conferences --over this period dead wood people have gone along to qualify as been there and herd it again conferences and workshops designed by people with little knowledge of day to day care needs within our NHS-----NHS Cheshire seem to have now clicked onto the wonderful report made by DAME KATE BARKER 2014 KINGSFUND with excellent results ---JESSIE CUNNETT is on the right lines WITH depts working together and making the user journey simple and quicker
I know as a s/user and past carer --with also the advantage of working closely in the service as a director

Pearl Baker

Independent Mental Health Advocate and Advisor/Carer,
Comment date
06 February 2016
I totally agree with the above, however with the introduction of 'Devolution' I cannot see this improving anytime soon. If we can't get the 'basics' right there is absolutely no chance. 'Integration' is a word banded about, but means very little to most organisations. CCGs Primary Care and LA have got to 'step up to the mark' including the acknowledgement that CARERS do and CAN play an important part in contributing their knowledge to those Agencies who have a 'duty' to deliver.

As a Carer I would like to know what proportion was used from 'The Better Care Fund' to improve the lives of those suffering from a LTC Mental Illness, my request for this information from my local CCGs was we do NOT have this information on file? probably that is why they are failing to deliver anywhere near an 'integrated' service to my client group.

Carers, Patients need Information, It's not there? This is why it takes forever to get answers to questions, you are sent on a 'Merry Go Round' and you can't get off.

I have no idea how 'patient centred' health & social care provider 'fits' into an NHS that is at 'breaking' point.

Jessie Cunnett

Patient and Public Involvement Ltd
Comment date
05 February 2016
Place based models of engagement of patients, carers and the public are essential too. We have been working on collaborative models of engagement for a number of years with some success http://www.ecstaffs.co.uk/ http://www.escv.org.uk/ https://wessexvoices.wordpress.com/ Each of these models are about putting people at the centre. It makes sense to engage people in their health and care lives, not in isloated commissioning or service offerings. We can develop trusted relationships with local people who can play an integral role at a range of levels across diverse services that interact and interelate. Place based approaches mean not 'doing to', but 'doing with' people, for it is they who make up the places. To achieve this, commissioners and providers will have to be prepared to share and not be protective of what they have created so far. It doesn't make sense for people to have to engage with 10 different organisations but it does make sense for 10 organisations to engage with one community of place.

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