Website of the Department of Health

This is a Plan for investment in the NHS with sustained increases in funding. This is a Plan for reform with far reaching changes across the NHS. The purpose and vision of this NHS Plan is to give the people of Britain a health service fit for the 21st century: a health service designed around the patient. The NHS has delivered major improvements in health but it falls short of the standards patients expect and staff want to provide.

Public consultation for the Plan showed that the public wanted to see:

In part the NHS is failing to deliver because over the years it has been underfunded. In particular there have been too few doctors and nurses and other key staff to carry out all the treatments required. But there have been other underlying problems as well. The NHS is a 1940s system operating in a 21st century world. It has:

These systematic problems, which date from 1948 when the NHS was formed, are tackled by this Plan. It has examined other forms of funding healthcare - and found them wanting. The systems used by other countries do not provide a route to better healthcare. The principles of the NHS are sound but its practices need to change.

The March 2000 Budget settlement means that the NHS will grow by one half in cash terms and by one third in real terms in just five years. This will fund extra investment in NHS facilities...

...and investment in staff:

But investment has to be accompanied by reform. The NHS has to be redesigned around the needs of the patient. Local hospitals cannot be run from Whitehall. There will be a new relationship between the Department of Health and the NHS to enshrine the trust that patients have in frontline staff. The principles of subsidiarity will apply. A new system of earned autonomy will devolve power from the centre to the local health service as modernisation takes hold.

The Department of Health will set national standards, matched by regular inspection of all local health bodies by the Commission for Health Improvement. A more streamlined centre will merge the posts of Permanent Secretary and Chief Executive creating one post which will be appointed in the autumn.

The National Institute for Clinical Excellence will ensure that cost effective drugs like those for cancer are not dependent on where you live. A Modernisation Agency will be set up to spread best practice.

Local NHS organisations that perform well for patients will get more freedom to run their own affairs. There will also be a £500 million performance fund. But the Government will intervene more rapidly in those parts of the NHS that fail their patients.

For the first time social services and the NHS will come together with new agreements to pool resources. There will be new Care Trusts to commision health and social care in a single organisation. This will help prevent patients - particularly old people - falling in the cracks between the two services or being left in hospital when they could be safely in their own home.

For the first time there will be modern contracts for both GPs and hospital doctors. NHS doctors work hard for the NHS. But the contracts under which they work are outdated. There will be a big extension of quality-based contracts for GPs in general, and for single-handed practices in particular. The number of consultants entitled to additional discretionary payments will rise from half to two-thirds but in return they will be expected to increase their productivity while working for the NHS. Newly qualified consultants will not be able to do private work for perhaps seven years.

For the first time nurses and other staff not just in some places, but everywhere will have greater opportunity to extend their roles. By 2004 over half of them will be able to prescribe medicines. £280 million is being set aside over the next three years to develop the skills of staff. All support staff will have an Individual Learning Account worth £150 per year. The number of nurse consultants will increase to 1,000 and a new role of consultant therapist will be introduced. A new Leadership Centre will be set up to develop a new generation of managerial and clinical leaders, including modern matrons with authority to get the basics right on the ward.

For the first time patients will have a real say in the NHS. They will have new powers and more influence over the way the NHS works:

For the first time there will be a concordat with private providers of healthcare to enable the NHS to make better use of facilities in private hospitals - where this provides value for money and maintains standards of patient care. NHS care will remain free at the point of delivery - whoever provides it.

These far reaching reforms to the service will result in direct improvements for patients.

Patients will see waiting times for treatment cut as extra staff are recruited:

The treatment of cancer, heart disease and mental health services - the conditions that kill and affect most people will improve with:

Older people use the NHS more than any other group. This Plan will provide them with both better and new services:

The NHS Plan will bring health improvements across the board for patients but for the first time there will also be a national inequalities target. To help achieve this we will:

The NHS Plan will require investment and reform to make it work. But the funding is there to support change and it is backed by the key organisations in the NHS. There is a new national alliance behind a reformed, patient-centred NHS. These are the most fundamental and far reaching reforms the NHS has seen since 1948.