Prime Minister Theresa May outlined a long-awaited proposed long-term funding plan for the NHS in a key speech delivered at the Royal Free Hospital in London ahead of the 70th anniversary of the NHS.  This would deliver a £20.5 billion annual increase to the NHS budget by 2023.

However, the agenda isn’t just about more money for the NHS. Mrs May says she is prepared to introduce legislation to roll back unpopular reforms to the NHS. This relates to the legislation introduced by the Health and Social Care Act 2012 which created hundreds of clinical commissioning groups (CCGs) responsible for planning and purchasing health services distinct from hospital trusts that provide the care.

This move would potentially smooth the path for plans to integrate health and social care services, due to be unveiled in the autumn, which leaders say are vital to deal with an ageing population with many chronic conditions. It would also benefit the provision of mental health services. Returning to the reforms, Mrs May said: “I think it is a problem that a typical NHS CCG negotiates and monitors over 200 different legal contracts with other different parts of the NHS.”

Building a consensus in parliament

The Prime Minister added that she would “try to build the broadest possible consensus in parliament, so we can truly create an environment in which the NHS can get on and deliver the long-term 10-year plan.” This plan, she said, “must tackle waste, reduce bureaucracy, and eliminate unacceptable variation with all these efficiency savings reinvested back into patient care.” She added that this plan must ensure that every penny is well spent. The Prime Minister also made clear that she wants the NHS to make better use of advances in technology to ensure that ill people can make quicker recoveries.

Over the next few months, the NHS is expected to pull together the 10-year plan on what services and improvements can be expected with the money provided. Simon Stevens, Chief Executive of NHS England, has a pivotal role in this and he supports a move to accountable care organisation (ACO)  bodies that would oversee the health budget for a geographical area. He is also seeking to integrate his organisation with the watchdog NHS Improvement but at present reform is being frustrated by the Health and Social Care Act.

On paying for the changes Mrs May said that some of the £20.5 billion would be covered by cash which the UK will no longer send to Brussels after it leaves the EU. The rest would be raised from taxpayers. She said: “Taxpayers will have to contribute a bit more in a fair and balanced way to support the NHS we all use.”

Chris Dalton, chief executive of NHS Providers, which represents hospitals, said: “The existing legislation continues to be a barrier for more integrated care and causes unnecessary bureaucracy, so we welcome the prime minister’s offer for NHS leaders to develop proposals for how the current legislation can be simplified.”

Making the case for mental health

Sean Duggan, chief executive of the Mental Health Network (MHN), part of the NHS Confederation, said: “We welcome the prime minister’s commitment to the NHS as her number 1 priority and within that the emphasis on improving mental health. She has challenged those who work inside the NHS to come up with ideas about how the long-term plan should look, and we will continue to work with the Department of Health and Social Care through the Mental Health Policy Group, to ensure that MHN member views are fed into the long-term plan.”

Responding to the prime minister’s speech Niall Dickson, chief executive of the NHS Confederation, said: “The prime minister has thrown down the gauntlet and made clear that the NHS and its staff can now help to shape its future. This is hugely welcome. 

“The new money represents a major investment guaranteed over five years and quite rightly government and society will expect the NHS to deliver. But we must set realistic goals and make clear that there will be hard choices ahead. The danger is that we overpromise and under deliver. The biggest challenge will be to make sure we do not just put more money into existing services but instead reform the way services are run.”