The NHS 10-year plan: what we already knowIvy Madziva
A renewed drive to extend survival from cancer by improving early diagnosis of the disease will see the NHS cancer screening programmes overhauled, new investment in diagnostic technology and extra funds for research and innovation. The health service will make it easier for patients offered screening appointments to attend by extending the use of new tests for bowel cancer, mobile lung cancer screening units and rapid diagnostic centres that yield a result on the same day. The age at which people are offered bowel cancer screening will be lowered from 60 to 50.
All this is aimed at increasing the number of people diagnosed with cancer when it is at stage one or two, as that makes it easier to treat and means they have a greater chance of survival. Currently, 52% of the 10 commonest cancers are diagnosed at stages one and two. Ministers want this to be 75% by 2028.
Mental health services – a key personal priority for Theresa May – are set to undergo the biggest overhaul of any area of NHS care, which ministers say is “the largest expansion of mental health services in a generation”. About 2 million more people who suffer from a mental health condition such as anxiety or depression will benefit from at least £2.3bn of extra funding being invested in the sector by 2023-24. An estimated 350,000 more children and young people will be treated, and an extra 380,000 more adults offered access to talking therapies, over the next five years.
New support teams in schools will help identify mental health problems earlier and support those in need. Crisis care, which NHS bosses say is a serious weakness, will be improved by people of all ages being able to ring the NHS 111 helpline and be directed to support around the clock. There will also be a raft of A&E-style waiting time targets to enable people of all ages to access mental healthcare quickly.
NHS England plans to put an extra £4.5bn into out-of-hospital services to help keep patients as healthy as possible at home for as long as possible, and avoid potentially unnecessary spells in already overcrowded hospitals. This major expansion of primary care and community services is central to reducing the burden on hospitals, which are struggling to cope with the rising demand for care created by the ageing and growing population. New “24/7 rapid response teams” made up of doctors, nurses and physiotherapists will give patients urgent care and support in the community as an alternative to hospital.
The NHS will be making much greater efforts to persuade heavy drinkers who end up in hospital to reduce their alcohol intake. It plans to set up alcohol care teams in the 50 hospitals that have the largest number of people who need to be admitted for treatment as a result of drink, in advice sessions lasting 20-40 minutes. Nurses and doctors will adopt a more interventionist approach and will talk to problem drinkers about their habit and how to cut down.
People will receive personalised feedback about how risky their drinking is and advice about how to drink less. Hospitals which already have such a team have found they significantly reduce the number of attendances at A&E, days heavy drinkers spend in a bed, readmissions and ambulance callouts. The NHS hopes rolling out these teams will prevent 50,000 hospital admissions involving 250,000 bed days over the next five years, as alcohol costs it £3.7bn a year.
All smokers who become NHS inpatients will be encouraged to quit. Photograph: Jonathan Brady/PA
In future, NHS staff will encourage all smokers who become a hospital inpatient, or a patient in a mental health or learning disabilities unit, to quit. As with heavy drinkers, nurses and doctors will automatically talk to them about their smoking and suggest they try to kick the habit with the help of stop-smoking services. The initiative will particularly target mothers-to-be who are still smoking despite their pregnancy, and also encourage their partners to give up, in the hope of making it easier for the women to do the same. NHS bosses hope the move will further reduce smoking rates and say they are hopeful of success because most smokers, when asked, want to stop.
Matt Hancock, the health and social care secretary, has promised that by March 2021 the majority of women in England will have one named midwife to guide and support them through their pregnancy, labour and after their baby has been born. Research has shown that pregnant women who experience this continuity of care are less likely to have a miscarriage, lose their baby or have a premature birth. Women from black and ethnic minority backgrounds and poorer families will be given priority when the scheme starts being rolled out from later this year.
The NHS will also expand the number of staff working in neonatal units looking after sick babies, especially specialist neonatal nurses. New parents, both mothers and fathers, will also get extra mental health support. This is all part of the government’s ambition to reduce stillbirths and the deaths of babies and mothers, and to make the NHS the safest healthcare system in the world for maternity care.
From April, tens of thousands of people with type 1 diabetes will be able to get a wearable sensor called a FreeStyle Libre on prescription from their GP to help them manage their condition. At present only a few of the 300,000 people in England who have the disease use the device, which is about the size of a £2 coin and is strapped to the upper arm. It reduces the need for patients to give themselves what the NHS admits are inconvenient and sometimes painful finger-prick blood tests. The sensor helps by relaying the sufferer’s blood glucose level to a smartphone or e-reader. The NHS England chief executive, Simon Stevens, says the sensor is an example of how the health service will increasingly use technology to help patients monitor and manage their conditions. “In the NHS of the future, for many conditions you’re going to get NHS support direct from your smartphone or wearable device, rather than having to trek to regular hospital outpatient appointments”, he says.
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