Panoramic view:
NHS customer priorities for 2022 and beyond

The arrival of the NHS operational planning guidance is a big moment in the health service calendar, firing the starting gun on annual planning by marking out national priorities. As such, it’s a useful primer for understanding the core issues that will exercise NHS leadership over the coming year.

In recent times, COVID has complicated the timetable. During 2021, NHS England split the year into two halves, publishing light-touch guidance in March and September in recognition of uncertainties. As well as responding to the pandemic itself, both documents focused on the NHS ramping up activity to address ballooning elective care backlogs.

This year the guidance returns to its standard annual cycle and is more expansive, though still shorter than normal. There is also an enormous caveat on the first page, which states – perhaps optimistically – that all objectives are ‘based on a scenario where COVID-19 returns to a low level and we are able to make significant progress in the first part of next year.’

With a number of Trusts declaring critical incidents recently, there is uncertainty over how much the NHS will deliver – nonetheless, the goals set out provide a glimpse of what the service’s post-pandemic priorities look like. So, what does the document tell us about the NHS’s direction of travel?

Core priorities

The central thrust of the planning guidance is built around a set of ten priorities that mesh the need to maintain an effective response to the pandemic with action to address the elective care backlog, while at the same time supporting a workforce battered by COVID-19.

The NHS has already committed both funds and extra organisational capabilities to address the backlog challenge. This includes:

• • A £2.3 billion package of additional elective recovery funding to be distributed via Integrated Care Systems
• • A £1.5 billion capital funding boost for new surgical hubs, extra bed capacity and the expansion of elective hub sites and day-case units
• • A short-term deal struck by NHS England with a number of independent health companies allowing Trusts to use private hospital facilities and staff.

Transforming care

While much of the guidance is inevitably about addressing backlog pressures, there is also a significant focus on shaping the NHS’s future, particularly through the use of technology and new ways of working. These include:

1. Virtual wards

A significant expansion in the use of virtual wards to deliver care remotely for patients with COVID and other acute respiratory infections, as well as urinary tract infections, COPD and complex presentations. These are set to be rolled out by provider collaboratives and will build on the 53 virtual wards already providing capacity for over 2,500 patients nationally.

2. Urgent community response

The ​long term plan (LTP) set a goal of having faster access to community health crisis response teams and the guidance also wants to achieve an 8am to 8pm service delivered seven days a week nationwide. The guidance pledges to ‘improve capacity in post urgent community response services to support flow and patient outcomes including avoiding deterioration into crisis again or unnecessary admission.’

3. Anticipatory care

The guidance also follows the LTP’s commitment to improve ‘anticipatory care’: proactive care in the community for multi-morbid and frail individuals who would benefit most from integrated care to manage their conditions more effectively. ICSs are being asked to design, plan for and commission anticipatory care solutions.

4. Supporting care homes

The planning guidance recaps on a long-standing pledge to improve how care homes are supported. Primary Care Networks are expected to provide improved on-site and virtual care, delivered by GPs, community and practice nurses, through the Enhanced Health in Care Homes framework. This is part of the new GP contract, funded as a Directed Enhanced Service.

5. Community Diagnostic Centres

Systems have been asked to increase diagnostic activity to a minimum of 120% of pre-pandemic levels across 2022/23 and community settings are key to this, with the lynchpin being the roll out of new Community Diagnostic Centres (CDCs). Systems will get dedicated revenue funding to maintain these, as well as capital support for infrastructure and equipment.

Brand planning

What should industry take from all of this? Firstly, it’s important to heed that these are conditional plans, and there is likely to be variation across systems and locations when it comes to the capacity to deliver aspects of these reforms in the face of ongoing operational or pandemic challenges. Understanding where different localities are in the journey is an essential starting point.

Secondly, the guidance is very explicit about the importance of ‘doing things differently’. The time is therefore ripe for transformed pathways, innovations and use of technology. For example, the remote monitoring of certain conditions – via virtual wards – is being primed to become a mainstream way of offering services across several disease pathways.

Pharma should be looking at how its offer can galvanise these ambitions: the NHS may be open to partnership working, whether in the form of co-produced patient education programmes to support drug adherence or workforce training.

Thirdly, changes to the profile of pharma’s customer base are also likely to accelerate. Any radical expansion of community health will mean a new cast list of stakeholders and influencers. CDCs are likely to become important stakeholders and industry should check their remit and staffing locally, as they may become gatekeepers for certain pathways.

Similarly, with Primary Care Networks playing a central role in diagnostic recovery, we can expect community pharmacy to become more influential, for example in the delivery of care processes such as blood pressure measurement, as well as care packages for people after they are discharged from hospital. Pharma should be renewing their stakeholder maps and CRM approaches accordingly.

Finally, the guidance underlines the desire for systems to view their role in a wider frame than ever before. Under the terms of the Health and Care Bill, all ICSs will be required to produce a one-year operating plan to be finalised in April and a five-year system plan to ‘improve outcomes in population health, tackle inequalities, enhance productivity and value for money and support broader social and economic development’. Both will be key documents for pharma to review.

Time will tell whether these transformational aspects are achieved over the coming months but the intent to make rapid progress in delivering new models of care is clear. Industry must be alive to this and respond with its own ambitious agenda.

Wilmington Healthcare provides market leading data, insight and intelligence across the healthcare community. To find out more about how we can support your NHS partnerships, go to wilmingtonhealthcare.com