The NHS Long Term Plan, Explained

On Monday, NHS England kicked off the New Year by publishing in full their long-awaited NHS Long Term Plan. This plan will set the direction of the NHS in England for the next five years, and explains how the service will spend its new £20bn cash injection.

We’ve been working hard, both publicly and behind the scenes, to ensure that this plan promises better care for people with and at risk of diabetes. We’re pleased to report that on diabetes, the plan seems to deliver.

We’ve already heard – and commented – in the press about some of the big initiatives included, including making flash glucose monitoring more widely available and expanding the NHS Diabetes Prevention Programme. The full document also gives much needed assurances that existing funding to transform diabetes care across England will be continued, although we don’t currently know whether this will be at the same levels.

As you will be able to see as you glance down this page, there is a lot going on. Taken together these changes have the potential to make a real difference. But turning the plan into reality will not be easy.

The NHS is still under real strain. It is just one part of the health system alongside public health and social care. A reversal of cuts to public health, resources to get the NHS staff we need, and a way of paying for proper social care are all needed if we are to have a sustainable health system.

The very welcome commitments in diabetes will only come about if there is a healthy NHS to deliver them. To pick one example, we are not going to get consistently good inpatient diabetes care without skilled and motivated staff to actually deliver it.

The Long Term Plan – At a Glance

Below we go into more detail about some of the proposals in the plan, and what they’ll mean for people living with diabetes.

New Commitments from NHS England:

In the run-up to the announcement of the plan there were new commitments from NHS England. They include:

  • Ensuring that everyone who could benefit from flash glucose monitoring (in line with clinical guidance) will have access to it, as well as offering continuous glucose monitoring to all pregnant women with Type 1 diabetes.
  • Testing a programme of 800 calorie a day diets for people with obesity and Type 2 diabetes. This expands on the Diabetes UK DiRECT trial, which at the end of its first year showed that these diets – with the right support – can help some people to achieve remission.
  • Doubling the size of the NHS Diabetes Prevention Programme over the next five years, including digital approaches, reaching more people at high risk of developing Type 2 diabetes.

Transforming Treatment and Care:

The published plan has confirmed that existing national work to transform treatment and care for people with diabetes will continue. This is very good news for people with diabetes, as this work is about rolling out tried and tested approaches in key areas of care. Specifically:

  • Expanding provision of structured education and digital self-management support tools for people who are newly diagnosed with Type 1 or 2 diabetes.
  • Ensuring that in future all hospitals provide access to multidisciplinary foot care teams and diabetes inpatient specialist nursing teams.
  • Continuing to invest in supporting delivery in primary care, enabling people to achieve their recommended treatment targets and drive down variation across England.

Supporting people living with long term conditions:

There are also parts of the plan that will have a real impact for people with diabetes alongside other long-term conditions. They include:

  • Rolling out clinical networks to ensure improvement of care for children with long-term conditions including diabetes. While there is already a network in paediatric diabetes, we hope that national recognition will further highlight its importance, and ensure there are the resources available to reduce the great variation between services for children with diabetes across England.
  • Continuing to expand the availability of Improving Access to Psychological Therapies (IAPT) services for adults with common mental health problems, with a focus on people with long-term conditions like diabetes.
  • Offering targeted support and access to weight management services in primary care for people with a diagnosis of Type 2 diabetes and a BMI above 30.
  • Ramping up support for people to manage their own health, by rolling out the NHS personalised care model to reach 2.5 million people by 2023/24. This includes better access to social prescribing and personal health budgets for those who could benefit.

Prevention:

The document also has a much-needed focus on prevention of health problems, including Type 2 diabetes. Highlights include:

  • By 2022/23, NHS England plans to treat 1,000 more children every year for severe complications of obesity, including Type 2 diabetes. These dedicated services could have a big impact for the increasing numbers of children and young people being diagnosed with Type 2.
  • The NHS have committed to take action to improve how healthy their premises are, updating hospital food standards to push NHS providers further in providing healthy food for staff and patients.
  • They also plan to make improvements to clinical training to ensure that frontline staff feel equipped to talk to people about nutrition and achieving a healthy weight.

The next phase of the plan will involve local areas putting together their own plans for how they will implement the commitments in the plan.

We’ll be working with the rest of the diabetes community to influence these local plans and turn the commitments in the plan into reality.

Read our response to the NHS Long Term Plan.

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