NHS Long Term Plan Implementation Framework

We welcome the numerous mentions throughout the document of the need for the NHS to work with partners, in particular local government. The NHS view of what constitutes a locally driven plan, however, is more centrally driven than the local government perspective.


Key messages

  • We welcome the numerous mentions throughout the document of the need for the NHS to work with partners, in particular local government. The NHS view of what constitutes a locally driven plan, however, is more centrally driven than the local government perspective. The LTPIF includes a lot of central direction and specification, not just in terms of what systems must prioritise but also how they should achieve objectives. There is some scope for local discretion on the timescale for achieving national expectations and the milestones they can choose to measure progress but we believe that local clinical, political and community leaders need more space and scope to develop implementation plans, and that these should build on existing strategies for improving health and wellbeing, enhancing care and support services and making most effective use of public resources.
  • The LTP objectives will be achieved only when adult social care, public health and local government services more generally are sufficiently and sustainably resourced. The entirety of the health, wellbeing and social care system has to be adequately funded to ensure people get the right care at the right time and in the right place. This will in turn reduce demand on NHS services. We are stilling waiting for the adult social care green paper and the spending review to give the whole health and care system the long-term certainty that is so urgently required. In some parts of the country the need to achieve financial balance within the NHS also remains a challenge that could affect the ability to deliver new objectives.
  • Increasingly, primary care networks (PCNs) will assume an organising role in health systems by commissioning services, employing staff and as the basic building block of primary and multi-disciplinary hubs for community health and care services, which will include adult social care, and community and voluntary sector (CVS) organisations. It is essential, therefore, that councils and other partners are involved in the development of PCNs, in particular in relation to their footprints to ensure that they are meaningful to local people in accessing health and care services, and build on existing local arrangements. Up to now, councils, CCGs and other partners have had little involvement in the development of PCNs. We welcome the assurance that plans for PCNs will need to take account of and be based on existing local plans, and developed in partnership with councils, the CVS and other local partners. As described above, however, there is still a significant amount of national prescription that will limit the scope for local leadership to shape plans according to local need and context. 
  • The focus on the pressing need to address health inequalities and to prioritise investment in prevention are very positive aspects of the LTPIF, which the LGA fully supports.
  • Also welcome is the recognition of the importance of integration and joint working with local government to provide person-centred care and support to promote health, wellbeing and independence. In addition, the LGA applauds the recognition given to the critical role of the community and voluntary sector and others.
  • With regard to workforce, however, there is still inadequate recognition of the need to develop a system-wide workforce plan which spans health and care. Failure to do so will lead to health and care fishing from the same limited pool of professionals, inevitably leading to NHS poaching ASC staff.

Download the full briefing
NHS Long Term Plan Implementation Framework