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The NHS long term plan

BMJ 2019; 364 doi: (Published 07 January 2019) Cite this as: BMJ 2019;364:l84
  1. Hugh Alderwick, assistant director,
  2. Jennifer Dixon, chief executive
  1. Health Foundation, London, UK
  1. Correspondence to: H Alderwick Hugh.Alderwick{at}

Rightly ambitious, but can the NHS deliver?

This week, national NHS bodies published their long term strategy for the NHS in England1—a response to the prime minister’s promise of £20.5bn (€23bn; $26bn) extra funding for the NHS (3.4% real terms growth a year for NHS England to 2023-242).

The plan arrives at a gloomy time for the NHS. More people are waiting longer for treatment. Performance targets are being missed all year round. And the system is short of 100 000 doctors, nurses, and other staff.3 Against this backdrop, the plan plots a pragmatic path for the NHS over the next decade, following that set by the Five Year Forward View in 2014.4

The new plan focuses on what the NHS can deliver, and how. In terms of what, the aim is to shift the NHS model of care further upstream: more preventive care, closer integration of services in the community for people with chronic conditions, better coordination of urgent care to reduce demand on emergency departments, and outpatient visits reduced by a third. Improvements are promised in priority services, …

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