NHS Shared Planning Guidance

NHS Shared Planning Guidance 2016/17 - 2020/21
NHS England, NHS Improvement, CQC, PHE, HEE and NICE, 22 December 2015
(For commentaries see bottom of page)

• The key NHS organisations supporting the Five Year Forward View have published ‘Delivering the Forward View: NHS Shared Planning Guidance 2016/17 – 2020/21’ which sets out the steps to help local organisations deliver a sustainable, transformed health service and improve the quality of care, wellbeing and NHS finances.
• As part of the planning process, all NHS organisations are asked to produce two separate but interconnected plans - a local Sustainability and Transformation Plan (STP) and a plan by organisation for 2016/17.
• Technical guidance for commissioners and providers published January 2016.

The nine ‘must dos’ for 2016/17 for every local system: Extract from guidance p8/9

1. Develop a high quality and agreed Sustainability and Transformation Plan (STP), and subsequently achieve what you determine are your most locally critical milestones for accelerating progress in 2016/17 towards achieving the triple aim as set out in the Forward View.
2. Return the system to aggregate financial balance. This includes secondary care providers delivering efficiency savings through actively engaging with the Lord Carter provider productivity work programme and complying with the maximum total agency spend and hourly rates set out by NHS Improvement. CCGs will additionally be expected to deliver savings by tackling unwarranted variation in demand through implementing the RightCare programme in every locality
3. Develop and implement a local plan to address the sustainability and quality of general practice, including workforce and workload issues.
4. Get back on track with access standards for A&E and ambulance waits, ensuring more than 95 percent of patients wait no more than four hours in A&E, and that all ambulance trusts respond to 75 percent of Category A calls within eight minutes; including through making progress in implementing the urgent and emergency care review and associated ambulance standard pilots
5. Improvement against and maintenance of the NHS Constitution standards that more than 92 percent of patients on non-emergency pathways wait no more than 18 weeks from referral to treatment, including offering patient choice.
6. Deliver the NHS Constitution 62 day cancer waiting standard, including by securing adequate diagnostic capacity; continue to deliver the constitutional two week and 31 day cancer standards and make progress in improving one-year survival rates by delivering a year-on-year improvement in the proportion of cancers diagnosed at stage one and stage two; and reducing the proportion of cancers diagnosed following an emergency admission
7. Achieve and maintain the two new mental health access standards: more than 50 percent of people experiencing a first episode of psychosis will commence treatment with a NICE approved care package within two weeks of referral; 75 percent of people with common mental health conditions referred to the Improved Access to Psychological Therapies (IAPT) programme will be treated within six weeks of referral, with 95 percent treated within 18 weeks. Continue to meet a dementia diagnosis rate of at least two-thirds of the estimated number of people with dementia.
8. Deliver actions set out in local plans to transform care for people with learning disabilities, including implementing enhanced community provision, reducing inpatient capacity, and rolling out care and treatment reviews in line with published policy.
9.  Develop and implement an affordable plan to make improvements in quality particularly for organisations in special measures. In addition, providers are required to participate in the annual publication of avoidable mortality rates by individual trusts.

Time table:

22 December 2015	Publish planning guidance
By 22 December 2015	Publish 2016/17 indicative prices
Early January 2016	Issue commissioner allocations, and technical annexes to planning guidance
January 2016	Launch consultation on standard contract, announce CQUIN and Quality Premium
By 29 January 2016	Issue further process guidance on STPs January 2016 Localities to submit proposals for STP footprints and volunteers for mental health and small DGHs trials
8 February 2016	First submission of full draft 16/17 Operational Plans
anuary/February 2016	National Tariff S118 consultation J
March 2016	Publish National Tariff
By 31 March 2016	Boards of providers and commissioners approve budgets and final plans
31 March 2016	National deadline for signing of contracts
11 April 2016	Submission of final 16/17 Operational Plans, aligned with contracts
End June 2016	Submission of full STPs
End July 2016	Assessment and Review of STPs

Place based planning/commissioning

• The Guidance describes the move away from organisational separation and autonomy which have dominated NHS practice to date, towards place based planning ie planning by individual institutions will increasingly be supplemented with planning by place for local populations. (para7)
• This is dependent upon system leadership, as well as open, engaging, and iterative process that harnesses the energies of clinicians, patients, carers, citizens, and local community partners including the independent and voluntary sectors, and local government through health and wellbeing boards. (para9)
• A truly place-based STP must cover all areas of CCG and NHS England commissioned activity including: (i) specialised services, where the planning will be led from the 10 collaborative commissioning hubs; and (ii) primary medical care, and do so from a local CCG perspective, irrespective of delegation arrangements. The STP must also cover better integration with local authority services, including, but not limited to, prevention and social care, reflecting local agreed health and wellbeing strategies. (para10)

See also

Wellards commentary on the implications of place based commissioning.
Technical Guidance
Kings Fund briefing
National Voices briefing