NHS leaders will today unveil a five-year path of evolution for the National Health Service that strives to fill the gaping hole in finances and create a new and more equitable care landscape better able to cope with surging demand on services.

First and foremost, the NHS will need a cash injection of at least £8 billion a year from the government if it is to have any hope of maintaining quality services, even taking into account the £22 billion a year that could be saved by re-jigging services as laid out in the plan.

Allowing GP practices to align under single organisations offering a broader range of services, creating new groups providing both GP and hospital services together with mental health, community and social care, and providing urgent care networks that work seven days a week, are just some of a stream of suggestions for potential new models of care - to be decided on locally - put forward in the report to improve the patient journey.

Produced by NHS England, Public Heath England, Monitor, the NHS Trust Development Authority, Care Quality Commission and Health Education England, with advice from patient groups, clinicians and independent experts, the Five Year Forward View lays out four key areas in which action must be taken to plug the growing health and care divide and address 21st century challenges.

Prevention is key

Top of the list, is the need for a much greater emphasis on the prevention of ill health, because “the future health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health”. As such, the report backs “hard-hitting” action on obesity, alcohol and other major health risks.

It also advocates handing patients more control of their own care, and says the NHS must change to meet demands of an ageing population with long-term conditions, breaking down boundaries between family doctors and hospitals, between physical and mental health and between health and social care for a seamless and efficient service.

Lastly, the Five Year Forward View sets out actions necessary to develop and deliver new models of care, including greater alignment between national NHS bodies to provide meaningful local flexibility, and it also proposes more investment in workforce, technology and innovation.

Broadly speaking, the report says action is needed to tackle demand, efficiency and funding, and claims that delivering transformational changes alongside staged funding increases “could feasibly close the £30 billion gap by 2020/21, and secure a far better health service for England”.

“It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure the future that we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so,” commented Simon Stevens, chief executive of NHS England. 


Andy Burnham, Labour’s Shadow Health Secretary, has welcomed the report claiming that it “endorses Labour's plan for the NHS”, which includes better access to primary care, a stronger focus on public health, and full integration of health and social care.

Also welcoming the report, Liberal Democrat Care Minister Norman Lamb also noted that much of Simon Steven’s report is in line with Liberal Democrat policy. “The priority given to mental health is extremely welcome. Recognising and supporting the needs of carers is vital. And getting hospital teams to work more closely with GPs, and GPs to work together to deliver care is an important step in providing care closer to home,” he said.

Nigel Edwards, the chief executive of think-tank the Nuffield Trust, said the report “makes crystal clear that the NHS cannot continue with 'business as usual' if it is to meet the needs of a diverse and ageing population,” and that it “sends a firm signal to MPs of the dangers of any future NHS reorganisation and offers a starting point for politicians considering how to reform the NHS in the future”.

However, outlining the challenges for the Forward View, he also said that “without a sustainable long-term funding plan for the NHS, it is hard to see how these radical changes can happen”. 

“The plan outlines the intention to develop a ‘pump-prime model’ to help services make these changes. But with NHS organisations increasingly going into the red and 2015/16 looking to be a crunch year for the NHS finances, there is a real danger that any money from this will end up papering over the cracks caused by deficits,” he warned.