NHS Ten-Year Plan Consultation

Published:
Consultations & Briefings
In the news
  Login / Join us

We contacted BABCP members in November 2024 to gather feedback on the current NHS Change consultation. Thank you to the 92 members who gave us their views on the areas covered in the consultation. These responses helped us greatly in making our response to the consultation within the required 500 word limit, ahead of the organisational submission deadline of 2 December. You can read our responses to each question below, in the blue boxes marked ‘BABCP response’.

All members of the public can still provide feedback to the ongoing wider consultation as individuals, and we would encourage everyone to take part if you have not already done so. You can find out more here.

The consultation and our responses

Priorities

The government has promised to put in place a 10-Year Health Plan to fix the NHS in England. We want to hear what your priorities are for this plan as interested organisations.

What does your organisation want to see included in the 10 Year Health Plan and why?

BABCP response:

Our key priorities over the next 10 years for the NHS would include:

  • Increase protection for patients and the public by ensuring interventions delivered only by qualified and registered/accredited practitioners – particularly in psychological therapies
  • Only evidence-based interventions e.g.CBT – implementing NICE guidance – psychological therapies emphasis on equity of access for minoritised populations; dose, intensity, frequency and modality
  • Prioritise staff wellbeing -in resources available, caseload size and complexity, clinical supervision and leadership
  • Public health education–understanding of evidence-based mental health care, accessible prevention/early intervention.
  • Equity of esteem, rapid access, across age groups and individual differences -– tackling barriers for people with protected characteristics; financial hardship and lack of community and social resources; in different geographical locations with specific differences – particularly intersections of these.

The next questions relate to 3 ‘shifts’ – big changes to the way health and care services work – that doctors, nurses, patient charities, academics and politicians from all parties broadly agree are necessary to improve health and care services in England:

  • Shift 1: moving more care from hospitals to communities
  • Shift 2: making better use of technology in health and care
  • Shift 3: focusing on preventing sickness, not just treating it

In answering the following questions on the 3 shifts, we’d welcome references to specific examples or case studies. Please also indicate how you would prioritise these and at what level you would recommend addressing this at, i.e. a central approach or local approach.

Shift 1: Hospital to Community

This means delivering more tests, scans, treatments and therapies nearer to where people live. This could help people lead healthier and more independent lives, reducing the likelihood of serious illness and long hospital stays. This would allow hospitals to focus on the most serious illnesses and emergencies.

More health services would be provided at places like GP clinics, pharmacies, local health centres, and in people’s homes. This may involve adapting or extending clinics, surgeries and other facilities in our neighbourhoods, so that they can provide things that are mostly delivered in hospitals at the moment. Examples might include:

  • urgent treatment for minor emergencies
  • diagnostic scans and tests
  • ongoing treatments and therapies.

BABCP response:

  • Address long term lack of staff and funding; retain good staff, recruit and train according to evidence base and need.
  • Addressing gaps in social care, pathways of care, communications between teams in the community. Community support to reduce stigma, resources in the community for successful transition between hospital and community. Access to evidence-based treatment (not repeated assessments/referrals).
  • Address infrastructure – safe and accessible space, appropriate buildings to deliver therapies.
  • Public education – when tests/investigations are not indicated will reduce unnecessary interventions – education on services that are available and what works.

Reference: Nuffield Trust – Focus on people with mental ill health and hospital use

Shift 2: Analogue to Digital

Improving how we use technology across health and care could have a big impact on our health and care services in the future.

Examples might include better computer systems so patients only have to tell their story once; video appointments; AI scanners that can identify disease more quickly and accurately; and more advanced robotics enabling ever more effective surgery.

What does your organisation see as the biggest challenges and enablers to making better use of technology in health and care? 

BABCP response:

  • Ensure equity, for excluded people – such as unable to use technologies (ability, education, age) reduces choices for willing patients who need support, hardware, data etc. to access digital services. Co-creation with representatives of general population helps ensure equitable access. – Concern that otherwise may exclude or create more barriers for vulnerable groups. Need for widespread education for using digital technologies, equipment, genuine IT support and continued updating.
  • Ensure appropriate and adequate training, and good change management to build staff confidence. Skilled project management and commissioning of new technologies, building in ‘future proofing’ as developments happen. Challenges in system usability infrastructure and integration between different services/ platforms -time-consuming, difficult to use, or inequitable for people with disabilities.
  • More choice and efficiency with online and digital tools for appointments, monitoring health/symptoms, (with appropriate support); ensuring all can access it. Evidence supports using computer-assisted CBT, digital apps monitoring progress and accessing appointments remotely – but may be pressure to reduce choice if ‘cheaper’ options in the short term. Implementation should be firmly based on offering evidence-based choices and transparency about outcomes.
  • Trust and Privacy Concerns: top priority is data security and patient confidentiality- must meet ethical, legal standards. Taking ‘fail safe’ steps to ensure this with increased reliance on technology.

Shift 3: Sickness to Prevention

Spotting illness earlier and tackling the causes of ill health could help people stay healthy and independent for longer, and take pressure off health and care services.

What does your organisation see as the biggest challenges and enablers to spotting illnesses earlier and tackling the causes of ill health?

BABCP response:

Ideas for change

We’re inviting everyone to share their ideas on what needs to change across the health and care system. These could be:

  • Ideas about how the NHS could change to deliver high quality care more effectively.
  • Ideas about how other parts of the health and care system and other organisations in society could change to promote better health and/or improve the way health and care services work together.
  • Ideas about how individuals and communities could do things differently in the future to improve people’s health.

Quick to do, that is in the next year or so 

BABCP response:

  • Review outcome measurement in psychological therapies/ mental health in general, – offering genuine choice of evidence-based interventions – funding services not only based on measures of ‘reaching recovery’ but equally based on satisfaction, moving in the patient’s valued direction and quality of life.
  • Require rapid access to actual interventions, -which will reduce cost and increase benefit – Appropriate, culturally humble and trauma-informed- services with minimal different assessments before interventions –
  • Funding community-based care services so that people can afford to work in care services
  • Offering mindfulness as part of personal development in schools, promoting drinking fresh water during the day at school and ensuring that everyone coming to school has free or (genuinely) affordable healthy foods.
  • A ban on advertising gambling
  • Bans on advertising foods which are not nutritious or healthy 

In the middle, that is in the next 2 to 5 years 

BABCP response:

  • For evidence-based therapies such as CBT, review to ensure services are commissioned in line with evidence, so that people accessing those services are offered genuine choice of evidence based options with appropriate modality, mode of delivery dose and frequency
  • All long term conditions services should include access to skilled and competent therapists providing evidence-based interventions.
  • Learning from research on better outcomes, deliver coherent pathways of care co-created with patients and frontline clinicians
  • Investment in mental health research where outcomes are poorer, investment in action on what is known but not yet implemented-
  • Challenging popular media themes on taxation and investment in public health/social care being a ‘bad thing’ – promoting narratives on values supporting society-wide longer-term benefits [including for mental and general health of people with higher income]
  • Implementing best practice

Related resources:

https://babcp.com/BAME-Positive-Practice-Guide

https://babcp.com/Therapists/LGBTQ-Positive-Practice-Guide

https://babcp.com/Therapists/Older-Adults-Positive-Practice-Guide

https://babcp.com/Therapists/Good-Practice-Guide-for-working-with-children

https://babcp.com/Therapists/Perinatal-Positive-Practice-Guide

https://babcp.com/Therapists/Armed-Forces-Veterans-Positive-Practice-Guide

  • Reviewing progress on retention – and implementing further what works to support and retain staff

Related resource:

Nuffield Trust – Closing the gap: Key areas for action on the health and care workforce

Long term change, that will take more than 5 years 

BABCP response:

  • Embedding mental health awareness in every area of society- early years education to older adult care, actions aimed to enhance wellbeing across the population –

Education and opportunity to take care of one’s mental health built into school curricula, social care and the workplace –

Meeting the need for people delivering health and care services, by training and providing career pathways, reasonable income and support – continuing to act on research about retaining the right people

Introducing a Universal basic income –or other means of a guaranteed ‘safety net’ – evidence this has population-scale benefits- Reduces stigma, enhances well-being; protective for mental health and self-respect. Need for more research, – change the way that the current health-related benefits system pushes people into long term ill health related to exclusion, poverty, disability, discrimination, lack of ‘connectedness and belonging’ or due to having to ‘prove’ they are very ill in order to receive disability-related benefits.

Related resource: 

World Economic Forum – Sweden is a top performer on well-being. here’s why 

  • Long term protected investment in careers in health and care, training, manageable work/life balance, reasonable caseloads and valued, connected support services are embedded