Winter and funding pressures have been ‘top of mind’ for the NHS since last Autumn, but as Spring approaches what are the challenges facing our healthcare system in the months ahead?

In the November 2017 budget, Chancellor Philip Hammond announced additional NHS revenue funding of £1.6 billion for 2018/19 to increase funding for emergency & urgent care and elective surgery.

In addition, for other core frontline services such as mental health and primary care, the Department of Health & Social Care (DHSC) is making a further £540 million available through the Mandate over the coming financial year.

So as the NHS heads towards its 70th anniversary in July, what can we expect in 2018?



New planning guidance published

New planning guidance published on 2 February by NHS England and NHS Improvement, sets out the expectations for commissioners and providers in updating their operational plans for 2018/19. The guidance – ‘Refreshing NHS Plans for 2018/2019’ – is intended to allow organisations to continue working together through STPs to deliver system-wide plans, with additional freedoms and flexibilities.

Key changes to previous guidance are as follows:

On performance…

  • The old guidance expected the majority of providers to achieve 95 per cent for the four-hour A&E waiting times standard by March 2018, but in the new planning guidance this deadline has now shifted to March 2019.
  • National numbers of patients waiting over 52 weeks should be halved by March 2019.

On funding…

  • Resources available to CCGs will be increased by £1.4 billion, reflecting realistic levels of emergency activity, additional elective activity to tackle waiting lists, universal adherence to the Mental Health Investment Standard and a commitment to reaching standards set for cancer services and primary care.
  • A further £650 million will be added to the Sustainability and Transformation Fund, to create a £2.45 billion Provider Sustainability Fund. 30 per cent of the fund will be linked to A&E performance.
  • There will be no additional winter funding in 2018/19. Systems will need to demonstrate that winter plans are embedded in both system and individual organisation operating plans.

For more information go to:



More evening and weekend GP appointments to become available

Half the country will be able to book a routine GP appointment in the evenings and on weekends by March, and this will ramp up to 100 per cent coverage for early 2019.

Consultation on ACO consultation to be launched

A 12-week consultation on the contracting arrangements for ACOs will be launched by NHS England in March 2018. The consultation will set out how the contract fits within the NHS as a whole and addresses how the existing statutory duties of NHS commissioners and providers would be performed under it. Dudley and Manchester’s proposed local care organisation are the two areas at the forefront of using a contract of this sort.

Young people’s mental health green paper consultation closes

The green paper consultation on how to improve mental health support for children and young people will close on 2 March with views being sought on proposals such as a pilot of a new 4-week waiting time, the creation of a new mental health workforce of community-based support teams, and the appointment of a designated mental health lead in every school and college.

Plans for reducing prescribing of over-the-counter medicines

NHS England’s public consultation on reducing prescribing of over-the-counter medicines for 33 minor, short-term health concerns, will close on 14 March. This is in addition to the NHS England guidance for CCGs on items that should not routinely be prescribed in primary care. Published in December 2017, this guidance is aimed at reducing the routine prescribing of 18 ineffective and low clinical value medicines, such as some dietary supplements, herbal treatments and homeopathy.

New multi-disciplinary cancer diagnostic and assessment centres

By March 2018, 10 new multi-disciplinary Rapid Diagnostic and Assessment Centres will be introduced across England. 



Innovation and Technology payment will become operational

Payments mechanisms or procurement for the Innovation and Technology payment will be operational from April 2018. Announced by Simon Stevens in June 2017 as part of the NHS England’s commitment to the Five Year Forward View, the aim of the NHS Innovation and Technology Payment (ITP) is to create the conditions and cultural change necessary for proven innovations to be adopted faster and more systematically through the NHS.

New bowel cancer screening test for over 4 million people

From April 2018 a new bowel cancer screening test will be introduced, with almost a third of a million more people expecting to complete screening from 2018/19 compared to the old bowel screening test.



Personal data protection rules change on 25 May

Personal data is central to the NHS. Existing laws setting out clear rules around how personal data should be processed will change on 25 May 2018, when the new EU General Data Protection Regulation (GDPR) comes into force.



Social care green paper expected

The government has promised a fresh set of proposals in a green paper for social care in England that will be published by the summer recess.



2018 will see the first cohort going through the NHS Digital Academy’s ‘world class development programme’. The Academy will provide a year long world class digital health training course to Chief Clinical Information Officers, Chief Information Officers and aspiring digital leaders from clinical, and non clinical, backgrounds. They will learn about leadership and change management, health informatics and data analytics, health systems and user-centred design and citizen informatics. An investment of £6m will produce 300 highly skilled technology leaders by 2020/2021.


NEW FACES       

NHS England has made some key new appointments for 2018. Professor Stephen Powis has been appointed as its new National Medical Director and Dr Simon Eccles has been appointed as the new Chief Clinical Information Officer for Health and Care to spearhead NHS use of technology and data to drive improvements in patient care.