7.1. This Long Term Plan is built on the work and insight of leaders, clinicians, patients, the public and other experts from across the NHS, the voluntary sector and beyond. To support delivery, we will develop a new operating model, based on the principles of co-design and collaboration, working with leaders from across the NHS and with our partners.
7.2. It provides the framework for local planning for the next five years and beyond. Existing commitments in the Five Year Forward View and national strategies for cancer, mental health, learning disability, general practice and maternity will all continue to be implemented in 2019/20 and 2020/21 as originally planned. And as set out in Chapter Six, 2019/20 will be a transition year, with every NHS trust, foundation trust and CCG expected to agree single year organisational operating plans and contribute to a single year local health system-level plan.
7.3. The Government’s Spending Review will set out details of the NHS capital budget and funding for education and training, as well as the local government settlement to cover public health and adult social care services. In spring, the national implementation framework and the Clinical Review of Standards will be published with testing and evaluating of any new and revised standards occurring prior to implementation from October 2019. To support local planning, local health systems will receive five-year indicative financial allocations for 2019/20 to 2023/24 and be asked to produce local plans for implementing the commitments set out in the Long Term Plan in 2019. They will be expected to engage with their local communities and delivery partners in developing plans, which will be based on a comprehensive assessment of population need. We expect that they will build on their existing plans and set out proposals for how they will deliver the outcomes set out in the Long Term Plan. They will also take account of the different starting points and phasing of progress in different parts of the country. We will however require all NHS organisations delivering health services to adopt interventions proven to deliver benefits for patients and staff. This will particularly apply where we need to deliver improvements consistently and as one NHS to secure these benefits. We will set out a single list of essential interventions, including effective e-rostering and e-job planning and processes for standardising and aggregating procurement demand for products and services to make the most of the NHS pound. Local health systems will also have access to expert advice and support through the regions including clinically focused transformation programmes and access to technical expertise such as on rostering, mobile working, procurement, estates, and corporate services. Local implementation plans will then be brought together in a detailed national implementation programme in the autumn.
7.4. Our approach to delivering the Long Term Plan will balance national direction with local autonomy to secure the best outcomes for patients. Local implementation will be led by the clinicians and leaders who are directly accountable for patient care and making efficient use of public money. This will ensure local health systems have the ability and accountability for shaping how the Plan is implemented.
7.5. ICSs will be central to the delivery of the Long Term Plan and by April 2021 we want ICSs covering all of the country. As local systems are in different states of readiness, we will support each developing system to produce and implement a clear development plan and timetable. This will include an intensive support programme for the most challenged systems with peer support from more developed systems.
7.6. Delivering the Long Term Plan will rely on local health systems having the capability to implement change effectively. Systematic methods of Quality Improvement (QI) provide an evidence-based approach for improving every aspect of how the NHS operates. Through developing their improvement capabilities, including QI skills and data analytics, systems will move further and faster to adopt new innovations and service models and implement best practices that can improve quality and efficiency and reduce unwarranted variations in performance. A programme to build improvement capability is established in around 80% of the trusts rated ‘outstanding’ by the CQC. We will, in partnership with the Health Foundation, support an increase in the number of ICSs building improvement capability to implement new ideas and practices.