Website of the Department of Health
Please note that this website has a UK government access keys system.
Publications policy and guidance
The NHS Plan: a plan for investment, a plan for reform
- Preface
- Foreword by the Prime Minister
- Executive summary
- Introduction by the Secretary of State
- 1 Our vision: a health service designed around the patient
- 2 The NHS now
- 3 Options for funding healthcare
- 4 Investing in NHS facilities
- 5 Investing in NHS staff
- 6 Changed systems for the NHS
- 7 Changes between health and social services
- 8 Changes for NHS doctors
- 9 Changes for nurses, midwives, therapists and other NHS staff
- 10 Changes for patients
- 11 Changes in the relationship between the NHS and the private sector
- 12 Cutting waiting for treatment
- 13 Improving health and reducing inequality
- 15 Dignity, security and independence in old age
- 16 The reform programme
- Annex 1 The public's concerns about the NHS today
- Annex 2 Modernisation action team members
- Annex 3 Department of Health Public Service Agreement
- 14 The clinical priorities
You are here:
- Home >>
- Publications >>
- Publications
16 The reform programme
Introduction
16.1 Expanding and reforming the NHS takes time. Change of this nature and on this scale does not happen overnight. This is not an excuse. It is a simple fact of life. It takes time to train and recruit the extra doctors, nurses and other staff the NHS needs, just as it takes time to build and equip modern NHS facilities. The resources are now in place. Delivery of the programme set out in this NHS Plan will provide the reforms the health service needs.
16.2 The process of modernisation is already underway. The internal market has gone and we have already started to build modern, responsive NHS services. The pace of improvement will now accelerate. Some improvements can be achieved quickly, others will take time.
16.3 The reform programme up to 2003/04 will be based on the settlement announced in the Budget on 21 March. We have been disciplined in determining how much progress we can make, and in the phasing of the proposals. This is an ambitious plan but a deliverable plan.
'Must do' targets
16.4 A key message arising from the consultation with the NHS in formulating this Plan was that it needs a small focused set of targets to drive change. Too many targets simply overwhelm the service.
16.5 This NHS Plan provides the clear, focused targets the Service has asked for. A small core of targets form the Department of Health's Public Service Agreement with the Treasury.
16.6 The targets are:
For the NHS
For the NHS
- reduce the maximum wait for an outpatient appointment to 3 months and the maximum wait for inpatient treatment to 6 months by the end of 2005
- patients will receive treatment at a time that suits them in accordance with their clinical need: two thirds of all outpatient appointments and inpatient elective admissions will be pre-booked by 2003/04 on the way to 100% pre-booking by 2005
- guaranteed access to a primary care professional within 24 hours and to a primary care doctor within 48 hours by 2004
- to secure year-on-year improvements in patient satisfaction including standards of cleanliness and food as measured by independently audited surveys
- reduce substantially the mortality rates from major killers by 2010; from heart disease by at least 40% in people under 75; from cancer by at least 20% in people under 75; and from suicide and undetermined injury by at least 20%. Key to the delivery of this target will be implementing the National Service Frameworks for Coronary Heart Disease, and Mental Health and the National Cancer Plan
- our objective is to narrow the health gap in childhood and throughout life between socio-economic groups and between the most deprived areas and the rest of the country. Specific national targets will be developed with stakeholders and experts early in 2001
- the cost of care commissioned from trusts which perform well against indicators of fair access, quality and responsiveness, will become the benchmark for the NHS. Everyone will be expected to reach the level of the best over the next five years, with agreed milestones for 2003/04.
For the NHS in partnership with social services
For the NHS in partnership with social services
- provide high quality pre-admission and rehabilitation care to older people to help them live as independently as possible by reducing preventable hospitalisation and ensuring year-on-year reductions in delays in moving people over 75 on from hospital. We expect at least 130,000 people to benefit and we will monitor progress in the Performance Assessment Framework
- increase the participation of problem drug users in drug treatment programmes by 55% by 2004, and 100% by 2008.
For social services
For social services
Improve the life chances for children in care by:
- improving the level of education, training and employment outcomes for care leavers aged 19, so that levels for this group are at least 75% of those achieved by all young people in the same area by March 2004
- increasing the percentage of children in care who achieve at least five grade A* to C GCSEs to 15% by 2004
- giving them the care and guidance needed to narrow the gap by 2004 between the proportion of children in care and their peers who are cautioned or convicted
- maximising the contribution adoption can make to providing permanent families for children; a specific target will be set in the light of the Prime Ministers review of adoption services.
The next steps
16.7 Implementation of this NHS Plan begins immediately:
- during August 2000, new resources to increase the number of heart operations will be allocated to the NHS
- by September 2000, the Modernisation Board will be in place
- by autumn 2000, the new NHS Chief Executive will be appointed
- in the autumn, the Modernisation Board will agree and publish a detailed implementation programme for the NHS Plan
- in the autumn, we will for the first time provide health authorities with three year allocations, rather than annualised allocations allowing the NHS the financial stability needed at a time of service modernisation.
Conclusion
16.8 This NHS Plan is ambitious and radical. It is based on investment and reform. Investment to expand staff and services in the NHS. Reform to get the best value from this extra investment in the NHS. It represents a fundamental package of reforms to address the systemic weaknesses inherent in the NHS since its creation in 1948.
16.9 The NHS Plan has been developed with the help of leading doctors and nurses, therapists and other NHS staff, top NHS managers, patient and citizens' representatives. They have signed up to the principles on which it is based. The Government believes the Plan provides the basis for a national effort to reform the National Health Service.
16.10 Over the weeks and months ahead, the joint effort and service-wide co-operation, which marked the production of the NHS Plan, will be harnessed to deliver it. This scale of investment will be felt at every level of the NHS. Reform will require change at every level. Change will be led by key modernisers from within the service itself.
16.11 There is overwhelming support across the country and across the Service to see the NHS improved and reformed. Now, the necessary resources are in place. The reform programme is set out. It will take time to deliver but our vision of an NHS designed around the patient will become a reality.
Access keys
