NHS Long Term Plan: babies, children and young people focus

The new plan will save up to half a million lives with focuses including maternity and neonatal services, cancer, stroke, learning disability and mental health.

  The NHS Long Term Plan was published this week. It will save almost half a million more lives with practical action on major killer conditions and investment in world class, cutting edge treatments. The plan states that NHS funding will increase, averaging 3.4% a year over the next five years, compared with 2% over the past five years. There will be “a new guarantee that investment in primary, community and mental health care will grow faster than the growing overall NHS budget. This will fund a £4.5 billion new service model for the 21st century across England, where health bodies come together to provide better, joined up care in partnership with local government”. Areas covered in the plan include maternity and neonatal services, cancer, stroke, learning disability and mental health. Charities and associations have responded to announcements made.

Maternity and neonatal services

A new NHS maternity package for England was announced on 30 December and the plan reiterates investment in this area. Measures in the maternity package include initiatives to improve safety, quality and continuity of care, which aims to halve stillbirths, maternal and infant deaths and serious brain injuries in newborn babies by 2025. The NHS say the Long Term Plan will accelerate action to achieve such reduction. A list of initiatives include:
  • every trust in England with a maternity and neonatal service being part of the National Maternal and Neonatal Health Safety Collaborative;
  • implementing continuity of carer so that, by March 2021, most women receive continuity of the person caring for them during pregnancy, during birth and postnatally;
  • the NHS continuing to improve how it learns lessons when things go wrong and minimise the chances of them happening again.
Commenting on the plan, Sean O’ Sullivan Head of Health and Social Policy at the Royal College of Midwives (RCM) said: “While the RCM supports this part of the NHS long term plan, the implementation of the entire plan, just like the recently announced new maternity package, cannot be done on a shoestring – successful implementation of any such plans  will need real investment in the recruitment and retention of midwives, in the training of more specialist midwives.”

Children with cancer to be offered whole genome sequencing

The Brain Tumour Charity said it is encouraging that all children with cancer will be offered whole genome sequencing. It said: “This will allow for more comprehensive diagnoses as well as access to targeted treatments. It also has the potential to reduce the use of medications which may be harmful. Targeted treatments will mean fewer young patients need high doses of chemotherapy and radiotherapy and therefore limit the number who experience lifelong health problems.” It continued: “We are already paying for biomarker testing for UK children with medulloblastoma; based on their results they could now be eligible to enrol on the latest European clinical trial, PNET5. This commitment will mean that more children should be able to access tailored treatments, improve their quality of survival and access clinical trials. It is really positive.” The Brain Tumour Charity’s statement was part of a full response given in a series of blogs: Inside the NHS long term plan: Part 1; What’s missing from the NHS England’s long term plan? Part 2; and Implementation of the NHS Long Term Plan, Part 3.

Stroke

Childhood stroke was not addressed specifically but The Stroke Association is positive stroke is established as a national priority. The plan aims to help provide the best stroke care in Europe with over 100,000 more people each year accessing new, better services. Juliet Bouverie, Chief Executive at The Stroke Association said: “Stroke is a devastating condition requiring action across the NHS. The Long-Term Plan cements it as the national priority that it needs to be. “We are delighted to be working with NHS England and others across health and social care to roll it out. This will ensure that more strokes are prevented and all stroke patients get the best treatment and support that they so desperately need. We know this plan can and will ensure that more lives are saved and more people spared from serious disability.”

Learning disability and autism

The plan states: “Across the NHS, we will do more to ensure that all people with a learning disability, autism, or both can live happier, healthier, longer lives.” The plan says that timely support will be provided to children and young people and their families. It continues: “We will do more to keep people well with proactive care in the community. We will ensure that reasonable adjustments are made so that wider NHS services can support, listen to, and help improve the health and wellbeing of people with learning disabilities and autism, and their families. “Over the next five years, we will invest to ensure that children with learning disabilities have their needs met by eyesight, hearing and dental services, are included in reviews as part of general screening services and are supported by easily accessible, ongoing care. “For people with the most complex needs, we will continue to improve access to care in the community, so that more people can live in or near to their own homes and families. “Finally, we will accelerate the LeDeR initiative to identify common themes and learning points and provide targeted support to local areas.”

Mental health services

Children and young people’s mental health services are also a focus (as are adult mental health services). The plan states this is the biggest ever investment in mental health services rising to at least £2.3 billion a year by 2023/24. The plan states it will give mental health help to 345,000 more children and young people through the expansion of community based services, including in schools.

Looking forward

Other priority conditions include ‘out-of-hospital’ care, cancer, cardiovascular disease, diabetes and respiratory disease. Using the latest technology is a focus with ‘digitally-enabled care’ going mainstream across the NHS (such as digital GP consultations). NHS England has also published a blog on how the Long Term Plan for the NHS will impact on carers. Ian Dalton, chief executive of NHS Improvement, spoke of the strides the NHS has made over the last seven decades and the need to build on these achievements. Summing up the plan he said: “This means breaking down organisational barriers to take a more holistic approach to how care is delivered and paid for, embracing new and existing forms of technology, recruiting and retaining the right number of staff, and shifting the focus away from hospitals to prevention and care in the community. “Developed by those working within the NHS, the long term plan sets out an exciting roadmap for how we will do this together for the benefit of patients.”
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