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All you need to know about long-term planning

Friday, 11 January 2019

All you need to know about long-term planning

Now that you’ve read the NHS Long Term Plan, it’s time to write your own long-term plan. This practical how-to guide will tell you everything you need to know to write a really credible local plan in line with the national ambition to have long-term plans in place across the whole country by April and an integrated national plan for the long-term planning process by the autumn.

Your plan’s title

It’s entirely up to you what you call your plan, but we strongly recommend something that includes the words “long”, “term” and “plan”. Try to avoid “forward” and “view” to minimise the risk of confusion with previous planning-style documents. 

Long term or long-term?

After extensive consultation with stakeholder groups we took the decision to omit the hyphen from the compound adjective “long-term”. Elsewhere in the plan we have introduced hyphens in verb constructions where they would not normally appear: “work that kicked-off” and “we have not locked-in an assumption” are prime examples – or prime-examples, if you prefer.

These are not errors but illustrations of how local areas will in future be free to determine their own punctuation.

Practical advice

It is essential that your plans contain robust and actionable sounding statements with clearly defined timescales.

Our plan “sets out five, major, practical changes to the NHS service model”.

These are to “boost” out-of-hospital care, “redesign” emergency services, make care “more personalised”, ensure that services are “digitally-enabled” and “focus” on population health. All of these aims are as concrete as they are measurable.

We have committed to make these changes “over the next five years”. We expect to see similarly precise and challenging deadlines in your plans.

Detailed workforce plans

Ensuring the NHS has the workforce it needs remains one of our most pressing problems. The NHS Long Term Plan makes it clear that staff are valued and should not leave. Health Education England is expected to go into even more detail when it publishes its own plan. You should mention workforce and reference HEE at least once in your own plans.

Future perfect

How can you address problems today that will in reality take several years or decades to solve? The answer is to combine the present and future tenses in ways that disrupt today’s outmoded analogue chronological models. Note how in the following example something that will happen in the future has an immediate impact in the present.

“This Long Term Plan therefore sets out a number of specific workforce actions which will be overseen by NHS Improvement that can have a positive impact now.”

Transformative terminology

Some problems are so intractable that they can only be solved with new terminology. The NHS Long Term Plan proposes a robust rhetorical framework that we expect to see used as the basis for your local plans. In the short term these terms will add weight to planning documents. Over time, they may also acquire meaning.

For example, “triple integration” expresses the complexity and ambition of your plans and represents a three-fold increase in the intensity of integration. 

This will be measured by an “integration index”, a single combined measure by which patients will be able to rate the quality, efficiency, safety, health outcomes, value for money, sustainability, person-centricity and joined-upness of their local integrated care system by choosing between a frowning, neutral or smiley face. 

NHS Improvement will deploy an “accelerated turnaround process” (ATP). As a result of the new acronym, the 30 worst performing trusts will finally be able to balance their books.

Be realistic

The NHS plan is nothing if not realistic. Local plans should be written in the same spirit of realism.  

In Chapter Five (“Digitally-enabled care will go mainstream across the NHS”) we identify “costed building blocks and milestones for these developments”. 

It’s vitally important that as you roll out your own plans you keep a careful eye on the cost of the strategic construction materials of the future NHS – and wherever possible shop around for a bargain.

Editor: Julian Patterson