The NHS long-term plan

Published January 2019,  the 'NHS Long Term Plan' is the latest iteration of what previously might have described as a ten year plan. 

https://www.longtermplan.nhs.uk/

The main report is 136 pages. There is also a 2 page summary, a 24 page 'easy read' version and a 12 track audio version (total running time: 08:56:52)

The document outlines intentions which are very significant for digital transformation, not least the aspiration to 'develop digitally enabled primary and outpatient care, which will become mainstream across the NHS'.

By  2020/21 (so by 31/03/2021) the NHS app will allow people to see their careplan and 'communications from health professionals'. I have the NHS app installed on my phone. I cannot tell how much of my information is nominally available as I have not experienced any ill-health recently. But I was impressed to see that the NHS App allowed me to see details of my two COVID vaccinations

From 2024, people will be able to use the NHS app to access 'digital primary care services' i.e. to have online appointments. This means to be able to see their GP remotely rather than have to trail into GP surgeries. COVID has already accelerated the availability of telephone appointments. What is new is that in addition to being able to consult their own GP, there will be an option for people to access the 'emerging digital-first providers' instead. This is the game-changer, the disruptive innovation which will transform the NHS and the way people use it. We already have NHS Direct / NHS 111 providing a general telephone triage service supported by online health information. This  new direction will break the role of GPs as gatekeepers to further services.

By 2029 (i.e. by the end of the period covered by the plan) it is envisaged that wearable devices will enable people to stay more at home rather than be moved to NHS locations. Diagnostic services,  such as images and pathology, will be able to be delivered differently, as will Secondary Care Outpatient appointments.

During 2019, new controls will ensure that technology suppliers comply with agreed standards for interoperability. Anybody who has worked in and around NHS patient systems will be familiar with the ease with many suppliers shake off commitments. So it remains to be seen how much impact, how quickly, there will be on supplied systems. Also, the cost is likely to be transferred back to the customer i.e. NHS organisations 

Reminding us that the NHS is a predominantly role-based culture, there is a requirement for the Boards of all NHS organisations to have a Chief Clinical Information Officer (CCIO) or Chief Information Officer (CIO) by 2021/22

These directions are not new, having already been set out in the Wachter Review (2016) and the Future of Healthcare strategy (2018).

Achieving this vision will require significant upgrading and extension of the technical infrastructure. This will require money. It also assumes a higher degree of digital literacy amongst both patients and NHS staff than exists at present. Whether this evolves naturally or has to be nurtured remains to be seen

The plan passes responsibility for working out the details of its implementation to ICSs (Integrated Care Systems) and STPs (Sustainability and Transformation Partnerships)