Unit 1.2.2 Planning in the NHS and key documents

Question 1

The NHS is founded on a common set of principles and values that bind together the communities and people it serves - patients and public - and the staff who work for it. What does the Constitution do?

Answer 1

Establishes the principles and values of the NHS in England.

it sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.

Question 2

Who produced the Constitution?

Answer 2

The DHSC

Question 3

How often does the Constitution need to be reviewed and with the involvement of who?

Answer 3

The Constitution will be renewed every 10 years, with the involvement of the public, patients and staff.

Question 4

What is the constitution accompanied by?

Answer 4

The handbook to the NHS Constitution

Question 5

How often should the handbook to the NHS Constitution be renewed?

Answer 5

At least every 3 years.

Question 6

What does the handbook to the NHS Constitution set out?

Answer 6

Current guidance on the rights, pledges, duties and responsibilities established by the Constitution.

Question 7

Everyone who uses the NHS should understand what legal rights they have - for this reason, where are the important legal rights summarised and where are they explained in more details?

Answer 7

Important legal rights are summarised in the Constitution and explained in more details in the Handbook to the NHS Constitution.

Question 8

What does the Constitution also contain, that the NHS is committed to achieve and that goes above and beyond legal rights?

Answer 8

Pledges.

Question 9

With regard to access to medicines, what does the Constitution state that patients and the public have the following rights to? (3 points)

Answer 9

• Right to drugs and treatments that have been recommenced by NICE for use in the NHS if are clinically appropriate for you.
• The right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence. if the local NHS decides not to fund a drug or treatment you and your doctor feel would be right for you, they will explain the decision to you.
• You have the right to receive the vaccinations that the Joint Committee on Vaccination and Immunisation recommends that you should receive under an NHS provided national immunisation programme.

Question 10

What does the governments mandate to NHS England set out?

Answer 10

The governments objectives and budget for the public body and helps to ensure that the NHS is accountable to Parliament and the public.

Question 11

What does NHS England oversee the commissioning of?

Answer 11

Health services in England, it has an important role in setting direction for the health and care system as a whole.

Question 12

What reaffirms the governments commitment to an NHS that provides the best care and support to today’s patients and also safeguards the service for future generations.

Answer 12

The Mandate.

Question 13

When has the mandate been set since?

Answer 13

2016

Question 14

How often is the mandate reviewed (PQ)?

Answer 14

Yearly - building on the multi-year approach taken to setting the mandate since 2016.

Question 15

When does the mandate continue to set objectives and goals to?

Answer 15

2020, as well as some specific things that NHS England should be seeking to deliver in the financial year 2018 to 2019.

Question 16

What do the financial directions accompanying this mandate set out?

Answer 16

Certain additional expenditure controls to which NHS England must adhere. These stem from budgetary controls that HM Treasury applies to the DHSC.

Question 17

NHS Objectives and goals 2018/2019:
Objective: Through better commissioning, improve local and national health outcomes, particularly by addressing poor outcomes and inequalities.

Answer 17

Goals:
CCG and STP Performance:
- CCG: consistent improvement in performance of CCGs against new CCG assessment framework.

• STPs: With NHS Improvement, support local areas to ensure delivery of agreed plans within each STP area, including progress against metrics.

Question 18

NHS Objectives and goals 2018/2019:

Objective: To help create the safest highest quality health and care service.

Answer 18

Goals:
Improving service quality and achieveing seven dat services - including:

• Roll out of seven day services in hospital to 100% of the population.
• Significantly increase the number of trusts rated good or outstanding.
• Measurable improvement in antimicrobial prescribing, resistance rates and healthcare associated infection rates.

Patient Experience - including:
- Improve the percentage of NHS Staff who report that patient and service user feedback is used to make informed improvement decisions.

• Significantly improve patient choice, including maternity, end of life, elective care and for people with long term condition.

Cancer:
- Deliver recommendations of the Independent Cancer Taskforce.

Question 19

NHS Objectives and goals 2018/2019:

Objective: To balance the NHS budget and improve efficiency and productivity.

Answer 19

Goals: Balancing the NHS budget - including:
- Ensure overall financial balance in the NHS, while continuing to improve overall quality.

• Ensure that commissioners discharge their duties in a way which supports all parts of the system to live within their control totals across the STP footprint and in aggregate.
• Achieve year in year improvements in the NHS efficiency and productivity (3% each year)

Question 20

NHS Objectives and goals 2018/2019:

Objective: To lead a step change in the NHS in preventing ill-health and supporting people to live healthier lives.

Answer 20

Goals:
Obesity, Diabetes and Prevention - Including:
- Measurable reduction in child obesity
- 100,000 people supported to reduce their risk of diabetes through the NHS Diabetes prevention Programme.
- Reduction of preventable illness and associated hospital admissions through the implementation of tangible, preventative interventions in the NHS.

Dementia:
- Deliver the actions as outlined in the Challenge on Dementia 2020 Implementation Plan.

Question 21

NHS Objectives and goals 2018/2019:

Objective: To maintain and improve performance against cote standards:

Answer 21

Goals:
A&E Ambulances and Referral to treatment (RTT) - including
- 95% of people attending A&E seen within 4 hours.
- Meet ambulance response time standards for most urgent calls and the A&E standard.
- Ensure the NHS plays its part in significantly reducing delayed transfers of care by developing and applying new incentives.

Question 22

NHS Objectives and goals 2018/2019:

Objective: To improve out of hospital care:

Answer 22

Goals:
New models of care and General Practice:
- Implementation of the measures to support general practice set out in the General Practice Forward View, including:
- improved access to primary care ensuring 100% of the population has access to weekend/evening routine GP apps.
- 5,000 extra doctors in General Practice.
- Measurable reduction in age standardised emergency admission rates and inpatient bed-day rates; more significant reductions through the new care model programme covering at least 50% of the population.

Health and social care integration:
- Achieve better integration of health and social care in every area of the country with significant improvements in performance against relevant indicators within the CCG improvement and assessment framework, including new models of care.

Mental health, learning disabilities and autism - including:

• To implement the Mental Health 5 Year Forward view recommendations
• At least 70,000 more children and young people o access evidence based treatment.

Question 23

NHS Objectives and goals 2018/2019:
Objective: To support research innovation and growth and to support the Governments implementation of EU Exit in regards to health and care.

Answer 23

Goals:
Research and growth - including:
- Support the DHSC and the Health Research Authority in their ambition to improve the UKs international ranking for health research.

Technology - including: - 95% of GP patients to be offered e-consultation and other digital services.

Health and work - including:
- Contribute to the Governments goal to increase integrated working between health services and work related interventions including through increasing the use of Fit for Work.

EU Exit:
- With the Department of Health and Social Care and its other Arms Length Bodies, help support local areas to implement the outcome of negotiations with the European Union to help ensure that services continue to operate effectively

Question 24

Within the Governments Mandate, Jeremy Hunt, former Secretary of State for Health made a statement, what was his major concerns?

Answer 24

Increased demand on the healthcare system - seeing more people than at any point in history - nearly half a million being treated within 18 weeks of referral compared to 5 years go.

providing timely access is a key part to NHS promises.
Despite more people being seen, a number of hospitals are struggling to meet these core performance standards overall.

Question 25

Within the Governments Mandate, Jeremy Hunt, former Secretary of State for Health made a statement, what did he say the NHS will receive?

Answer 25

The NHS will receive an additional £2.8 billion between 2017-2018 and 2019-2020 taking NHS funding to over half a trillion pounds from 2015 - 2020 - but with these increases comes a clear responsibility for the NHS to minimise waste and make best use of its resources.

Question 26

When was the NHS Five Year Forward View first published?

Answer 26

October 2014

Question 27

What does the NHS 5 Year Forward View set out a new shared vision for?

Answer 27

A new shared vision for the future of the NHS based around the new models of care.

Question 28

The NHS Five Year Forward View has been developed by the partnership organisations that deliver and oversee which health and care services?

Answer 28

Care Quality Commission, Public Health England and NHS Improvement (previously Monitor and National Trust Development Authority)

Question 29

Patient groups, clinicians and independent experts have also provided their advice to create what?

Answer 29

A collective view of how the health service needs to change over the next 5 years if it is to close the widening gaps in the health of the population, quality of care and the funding of services.

Question 30

The first argument made in the forward view is that the future health of millions of children, the sustainability of the NHS and the economic prosperity of Britain depends on…?

Answer 30

A radical upgrade in prevention and public health.

Question 31

The second argument made in the forward view is when people do need health services, patients will gain far greater what of their own care?

Answer 31

Control.

Question 32

The third argument made in the forward view is that the NHS will take decisive steps to break down the barriers in how care is provided between what?

Answer 32

Between family doctors and hospitals, between physical and mental health, between health and social care - the future will see far more care delivered locally but with some services in specialist centres organised to support people with multiple health condition’s not just single diseases.

Question 33

The Five Year Forward View also states that England is too diverse for what type of care model to apply everywhere?

Answer 33

‘one size fits all’ care model.

To meet the changing needs of patients, to capitalise on the opportunities presented by new technologies and treatments and to unleash system efficiencies more widely, we intend to support and stimulate the creation of a number of major new care models that can be deployed in different combinations locally across England.

Question 34

What major innovation was proposed in the 5 year forward view?

Answer 34

To improve integration between different care providers in the NHS, between the NHS and Social care.

Question 35

The Five Year Forward View proposed how many new models of care with invitations to apply for pilot sites?

Answer 35

Seven new models of care.

Question 36

How many Pilot sites were chosen across 5 of the proposed new models within the 5 Year Forward View? What are these sites called?

Answer 36

50 sites. Called Vanguard Site.

Question 37

What is the name for the care provider chosen to develop new care models in accordance with thee 5 year forward view

Answer 37

Vanguard Sites. - each vanguard site will take the lead on the development of new care models which will act as the blueprints for the NHS moving forward and the inspiration to the rest of the health and care system.

Question 38

What were the five year forward view proposed care models designed to break down?

Answer 38

The traditional divides between primary, secondary and community care, mental health and possibly social care.

Question 39

Efficiency and productive investment:
The Five Year Forward View stated that: “It has previously been calculated that a combination of growing demand, no further annual efficiencies and flat real terms funding could produce a mismatch between resources and patient needs of nearly ? by 2020/2021. So to sustain a high quality, comprehensive NHS, Government has backed the plan pledging £8 billion with the remainder being achieved through action on three front.”

Answer 39

Nearly £30 billion per year

Question 40

Was was the ‘Next steps on the NHS 5 Year Forward View’ published?

Answer 40

March 2017

Question 41

What does the ‘Next steps on the NHS 5 Year Forward View’ document review?

Answer 41

The progress made since the launch of the NHS 5YFV in October 2014 and sets out a series of practical and realistic steps for the NHS to deliver a better, more joined up and more responsive NHS in England.

Question 42

The document identified the key areas of improvement for the remaining 2 years of the 5YFV? What are these (3 points)

Answer 42

• Improving A&E services
• Strengthening access to high quality GP services.
• Improvements in cancer services (inc performance against waiting times standards) and mental health.

Question 43

The document identified the key areas of improvement for the remaining 2 years of the 5YFV? In order to deliver these goals, the plan highlighted the need to do what?

Answer 43

The need to accelerate service redesign locally through better integration of GP, community health, mental health and hospital services as well as more joined up working with home care and care homes.

Question 44

What are early results from parts of the country vanguard areas seeing with regards to emergency hospitalisation and time spent in hospital compared to the rest of the country?

Answer 44

Slower growth in emergency hospitalisations and less time spent in hospital compared to the rest of the country.

Question 45

What document was published by NHS England, following the publication of the 5YFV, to direct and support local organisations in the delivery of the national targets?

Answer 45

Delivering the Forward View: NHS Planning Guidance 2016/17 - 2020/21

Question 46

What does the Delivering the forward view: NHS Planning guidance, provide for the subsequent documents (5YFV) as NHS England recognises the need to provide what in order to deliver against the target set within the 5YFV?

Answer 46

provides the core priories for the subsequent documents as NHS England recognises the need to provide focus and stability in order to deliver against the target set within the 5YFV.

Question 47

The core content of Delivering the Forward View: NHS Planning Guidance 2016/17 listed 3 gaps, 3 tasks and 2 documents, what were these?

Answer 47

Three gaps:

1) Health and wellbeing
2) Care and quality
3) Funding and efficiency

Three tasks:

1) Implement the 5YFV
2) Restore and maintain financial balance.
3) Deliver core quality and access stands.

Two documents:
1) A five year

Question 48

The NHS planning guidance 2016/17 also sets out 9 must dos that organisations must address - what are these?

Answer 48

1) Develop a high quality and agreed sustainability and transformation plan STP
2) achieve aggregate financial balance.
3) Develop and implement a local plan to address the sustainability and quality of practice.
4) Get back on track with access standards for A&E and ambulance waits.
5) 18 weeks wait from referral to treatment.
6) Achieve and maintain the 2 new mental health access standards
7) Continue to meet dementia diagnosis rates.
8) Transform care for people with learning disabilities.
9) Develop and implement an affordable plan to make improvements.

Question 49

In 2016 the NHS and local councils came together in 44 areas covering all of England to develop proposals to improve health and care - they formed new partnerships, what were these known as?

Answer 49

Known as sustainability and transformation partnerships (STPs).

Question 50

What are STPs?

Answer 50

A collaboration of NHS and local authorities to build on collaborative work that began under the Delivering the Forward view and the NHS operational and planning guidance to support implementation of the 5 year forward view

Question 51

What partnership was formed to run services in a more coordinated way, to agree system-wide priorities and to plan collectively how to improve residents day-to-day health.

Answer 51

Sustainability and transformation Plans.

Question 52

In some areas, what do STPs evolve to form?

Answer 52

Integrated Care Systems (ICS) - a new type of even closer collaboration.

Question 53

In what system do NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards and improving the health of the population they service?

Answer 53

Integrated Care Systems (ICS)

Question 54

Local services can provide better and more joined up care for patients when different organisation work together in this way. For staff improved collaboration can help make it easier to work with colleagues from other organisations and systems can better understand data about local peoples health, allowing them to provide care that is tailored to individual needs. What allows all this to happen?

Answer 54

Integrated Care Systems (ICS)

By working alongside councils and drawing on expertise of others such as local charities and community groups, the NHS can help people to live healthier lives for longer and to stay out of hospital when they do not need to be there.

Question 55

In return, what do ICS leaders gain greater freedoms in?

Answer 55

Greater freedoms to manage the operational and financial performance of services in their area.

Question 56

What will integrated care systems draw on the experience of?

Answer 56

The 50 vanguard sites which have led the development of new care models across the country.

Question 57

When was the NHS Long Term Plan published?

Answer 57

January 2019.

Question 58

Which plan states “we must keep all that is good about our health service and its place in our national life. But we must tackle head-on pressures out staff face, while making our extra funding go as far as possible.

Answer 58

The NHS Long Term Plan.

Question 59

The plan sets out how the NHS intends to do this stating that they are able to because:

• They now have a secure and improved funding pathways, averaging what % a year over 5 years.
• There is a wide consensus about the changes now needed - confirmed by patients groups, professional bodies and frontline NHS Leaders.
• Work that kicked off after what is now beginning to bear fruit?

Answer 59

• They now have a secure and improved funding pathways, averaging 3.4% a year over 5 years.
• There is a wide consensus about the changes now needed - confirmed by patients groups, professional bodies and front line NHS Leaders.
• Work that kicked off after the NHS Five Year Forward View is now beginning to bear fruit.

Question 60

The NHS Long Term Plan is set out into 7 chapters.

What are these?

Answer 60

1. A new service model for the 21st Century (PCNs)
2. The NHS will take action to strengthen its contribution to prevention and health inequalities.
3. Priorities for care quality and outcomes improvement for the decade ahead.
4. Current workforce pressures will be tackled and staff supported.
5. Wide-ranging and funded programme to upgrade technology and digitally enabled care across NHS.
6. Sets out how the 3.4% five year NHS funding settlement will help put the NHS back onto a sustainable financial path.
7. Next steps in implementing the Long Term Plan.

Question 61

The NHS Long Term Plan has a vision to transform the NHS over the following how many years?

Answer 61

10 years.

Question 62

Within the current legal framework, he NHS and its partners will be moving to create Integrated Care Systems wherewhere by when?

Answer 62

By April 2021.