NHS planning guidance offers welcome reduction in targets but ambitions will be 'unbelievably stretching'

Responding to the publication of the NHS operational planning guidance Matthew Taylor, chief executive of the NHS Confederation, said: 

“NHS leaders will welcome the reduction in national targets and clearer priorities that are set out in the planning guidance, so it is clear that the government and NHS England have been listening to our members. But we should be under no illusion – this is going to be one of the most challenging financial settlements of recent years and these ambitions will be unbelievably stretching for the NHS.

"Leaders recognise the need to live within our means, and, as more staff have joined the NHS, they are making solid progress to reduce need for agency staff to plug vital rota gaps and ensure safe staffing levels. They will continue to work with agencies, the BMA and other unions to take forward that work.

“While a reduction in national targets has been long called for, the combination of the tight financial envelope, 4% efficiency targets and high expectations on boosting productivity are likely to leave our members having to make difficult choices over what services to cut to make ends meet and hit targets. 

“Although NHS productivity is already improving, we know more progress is needed. The government and NHS England will need to support health leaders when they make tough and unpopular decisions over service provision, over services being cut or scaled back. We would also like the centre to use this opportunity to focus on how it can best support the NHS to deliver rather than on how it instructs the service. It can and should play a more enabling role that sees more power and autonomy delegated to local leaders.

“Fewer targets and a slimmed-down set of priorities are a welcome step towards allowing local leaders to act with more autonomy. But it is also vital that we monitor the data for any unintended consequences to make sure areas that are not targeted do not become deprioritised.

“While we understand the guidance is focused on recovery, putting the NHS on sustainable footing will require more radical reform and delivery of the government’s three shifts. This should not be a zero-sum game. Moving care out of hospitals into the community, improving digital technology and providing more preventative interventions will also help the NHS now, not just in the future. The NHS needs to drive up performance in the short-term but without long-term reforms the health service will not be able to meet rising demand in the future.

“The 10 Year Health Plan will need to work out how to do recovery and reform at the same time. We look forward to working with the government on how our members can achieve both these vital ambitions.”