Chapter 3: Further progress on care quality and outcomes

3.1. For all major conditions, the quality of care and the outcomes for patients are now measurably better than a decade ago. Childbirth is the safest it has ever been, cancer survival is at an all-time high, deaths from cardiovascular disease have halved since 1990, and male suicide is at a 31-year low. But there is good evidence to suggest that over the next decade the NHS should be doing even better. Partly that’s because there’s currently too much variation in service quality between clinical teams and between different parts of the country. Partly we’ll need to improve by tackling previously unmet need – for example in young people’s mental health services. And partly we’ll be able to do better because the worldwide frontier of medical possibility will continue to advance.

3.2. This Long Term Plan therefore sets out clear and costed improvement priorities for the biggest killers and disablers of our population. It largely does so using the latest epidemiological evidence from the Global Burden of Disease [61] (GBD) study for England, supplemented by the views of patients and the public on their priorities for improvement [62]. These confirm that the Plan needs to stick with and make further advances on our current improvement agenda for cancer, mental health, multimorbidity and healthy ageing including dementia, while intensifying the NHS’ focus on children’s health, cardiovascular and respiratory conditions, and learning disability and autism, amongst others. It also affirms the importance of therapies and planned surgical services for conditions that limit independence and affect quality of life.

3.3. The Plan sets out work programmes in these areas, which will be further detailed over the coming years. Some are necessarily framed as 10-year goals given the timelines needed to expand capacity and grow the workforce. So by 2028 the Plan commits to dramatically improving our cancer survival, by increasing the proportion of cancers diagnosed early, from a half to three quarters. Other goals will happen sooner, such as halving maternity-related deaths by 2025. And some are set to happen over the next two years, including significant improvements in mental health and primary care. This chapter sets out the detail, though it does not, of course, describe everything the NHS will do in these and other improvement areas over the coming five and ten years.


61. Steel, N., Ford, J., Newton, J., Davis, A., Vos, T. & Naghavi, M. et al. (2018) Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 392 (10158), 1647-1661. Available from:

62.  Healthwatch. (2018) What matters most – Healthwatch England Annual Report 2017-18. Available from: