This Mid-Term Review document provides an update on the progress we are making in implementing our Programme for Government. For a definitive account, this document should be considered alongside the quarterly reports that are published on progress against the commitments in departmental business plans.
NHS and Social Care
The NHS is one of our great national institutions. We believe that healthcare should be free at the point of delivery on the basis of need, not ability to pay. The NHS we inherited was overly centralised, insufficiently responsive to patients and ill-equipped to handle both the demands of an ageing population and the rising costs of treatment. That is why, as well as protecting the health budget, we have reformed the NHS, giving patients and communities more choice and a stronger voice. This combination of investment and reform is starting to deliver significant improvements in outcomes and productivity. We have identified four key priorities for health and care: reducing preventable early death; improving the standard of care that people receive; improving the treatment and care of people with dementia, mental illness and other long-term conditions; and bringing the technology revolution to the health and care sectors.
We have improved the NHS by:
increasing the health budget in real terms in 2011/12 and for each subsequent year of this Parliament;
starting to devolve commissioning of most health services to GP-led clinical commissioning groups, with at least one practising nurse and a secondary care specialist on each of their governing bodies; and
allowing patients in six trial primary care trusts to register or receive a consultation with a GP practice of their choice.
We have reduced preventable early death by:
meeting the standard that 93 per cent of all patients referred by GPs with a suspicion of cancer should be seen within two weeks and that they should, if diagnosed, begin treatment within two months;
setting up a £600 million Cancer Drugs Fund which, between October 2010 and October 2012, has helped more than 25,000 patients to access the drugs that would previously have been denied to them;
increasing the number of doctors in England by 5,180 and the overall number of clinical staff by 2,642; and
saving £2.7 billion by the end of 2012/13 by cutting administrative staff, reducing expenditure on wasteful IT projects and ploughing the money back into patient care.
We have improved the standard of care, particularly the treatment and care of people with dementia and other long-term conditions, by:
achieving the best ever performance in reducing the number of patients waiting for more than 18 weeks to start consultant-led treatment; reducing MRSA bacteraemia and C. difficile infections to their lowest levels since monitoring began; and reducing breaches of the mixed sex accommodation guidance by 98 per cent since December 2010;
providing funding that has allowed an additional 1.1 million people to access NHS dental services since May 2010;
using the NHS tariff to ensure that hospitals continue to care for patients beyond discharge and so reduce the level of re-admissions within 30 days;
confirming our commitment to ensuring that the Care Quality Commission is a strong and effective regulator, with a new Chief Executive and a new Chair;
setting up the Nursing and Care Quality Forum to advise on best practices in nursing care;
providing an extra £7 billion to adult social care over the current Spending Review period;
establishing the Dilnot Commission to examine the funding of long-term care in England, which reported in July 2011. We have made it clear that we support its principles;
allocating £400 million to the NHS for them to support carers better by providing them, including young carers, with breaks from their caring responsibilities; and
launching the Prime Minister’s challenge on dementia, which will see the diagnosis rate increased, the use of anti-psychotic drugs reduced and funding into dementia research rise from £26.6 million in 2009/10 to £66.3 million in 2014/15.
We have brought the technology revolution to health and care by:
setting out a comprehensive information strategy for health and care within the NHS Commissioning Board Mandate;
allowing people to have online access, by 2015, to their GPs and to the health records held by their GPs; and
enabling 3 million people over the next five years to use ‘telehealth’ and ‘telecare’ to help them manage their own conditions.
We will continue to improve the NHS by:
increasing the health budget in real terms;
abolishing strategic health authorities and primary care trusts from April 2013, saving £1.5 billion annually;
establishing health and well-being boards to bring together local authorities and the NHS to co-ordinate provision of health and social care (we will also transfer £300 million of additional funding from the NHS to social care to develop better integrated health and care services); and
investing up to £300 million over five years in specialised housing for those in need of care.
We will continue to reduce preventable early death by:
introducing a new bowel screening programme to reduce incidence of, and mortality from, bowel cancer, saving 3,000 lives a year; and
making the UK the first country in the world where doctors will have to be revalidated – a process of regular assessments to ensure that their training and expertise are up to date and that they are fit to carry out their duties.
We will continue to improve the standard of care, particularly the treatment and care of people with dementia and other long-term conditions, by:
establishing the Friends and Family Test for all hospitals, to ensure that prospective patients can see exactly how previous patients and staff rate quality of care;
setting an ambition for the NHS to put mental health on a par with physical health, significantly improving access and waiting times for all mental health services, and reducing the incidence and impact of post-natal depression through earlier diagnosis and better intervention and support;
establishing Healthwatch as a consumer advocate with new powers;
investing £56 million over four years in children and young people with mental health problems to help transform care in light of the scandalous abuse at Winterbourne View hospital;
implementing a strategy aimed at building a culture of compassionate care for nursing, midwifery and care staff;
consulting on further measures to protect people who rely on care services where the provider fails in England;
introducing a national minimum eligibility threshold to make access to care more consistent across England;
introducing a Universal Deferred Payments scheme so that nobody will need to sell their home to pay for the costs of residential care in England;
legislating to give people with eligible needs for care an entitlement to a personal budget and a care and support plan in England;
working with the Alzheimer’s Society, recruiting 1 million people to become Dementia Friends to improve awareness of dementia and support for those with dementia; and
gradually increasing the availability of personal health budgets to increase patient choice and control.
We will continue to bring the technology revolution to health and care by:
providing £100 million for NHS nurses and midwives to spend on new technology to free up time for patient care and make essential patient details instantly available on the ward. Those organisations that receive positive feedback from patients in the Friends and Family Test will not have to repay any of the loan; and
establishing the new 111 service, to provide immediate over-the-phone access to health services.
Despite the rhetoric on the need to reform the rules on charging for social care we have yet again been left without any detail of how this will be done. People with dementia and other conditions are being hit with huge bills for inadequate care or care that arrives too late. They deserve to know an end to this injustice is in sight.
Our political parties must provide clarity on how the financial burden on people who need care will be reduced both now and in the future. We also need to hear how the gaping and expanding funding hole in social care is to be plugged. Only then can we guarantee that people will receive the care they need, at the right time and at the right price.
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Another excellent session from Support Solutions - excellent value for money and excellent training
D.A - St Vincent's Housing Association