The Government has released the 2023 mandate to NHS England, setting out the Government’s key health priorities for the year ahead. Setting out the mandate in Parliament, Health Secretary Steve Barclay stated that his priority was cutting waiting lists for patients, helping the NHS to support innovation and adopt the right digital health technologies, and adequately supporting the NHS workforce.
He noted that digitally mature trusts outperform those who are less developed and seized the current zeitgeist by hailing the ability of AI to transform outcomes in health. Mr Barclay wants the health service to be ambitious in its adoption of safe yet effective AI techniques which improve efficiency.
Fewer targets have been set out than in previous years, as requested by NHS trusts. The mandate itself is deliberately abbreviated to make it more accessible and allow for clearer focus on the most important health concerns of the public which, as ever, have been identified following consultations with national projects and local Healthwatch networks throughout England.
The mandate will apply from 15 June 2023 until a new mandate is published.
Key objective in the mandate that may be of interest to members are contained below:
Priority 1: cut NHS waiting lists and recover performance
NHS England will need to lead the NHS in recovering services for patients. Delivery should include:
- continuing to deliver the NHS delivery plan for tackling the COVID-19 backlog of elective care. In particular: delivering more planned hospital activity to tackle the elective backlog and build on the success of the delivery of the recovery plan to date. This will include working towards the future ambitions on long waits set out in the plan over the coming years, and will be supported by a focus on increasing outpatient productivity and transforming outpatient pathways to enable the 80% of the patients who are waiting for non-admitted care to be seen more quickly.
- By March 2025, 95% of patients needing a diagnostic test should receive it within 6 weeks. This will be aided by the continued roll out of community diagnostic centres to increase diagnostic capacity
- improving cancer outcomes, including: improving 1 year and 5 year survival for all cancers, and the NHS Long Term Plan ambition that 55,000 more people diagnosed in 2028 will survive for 5 years or more
- increasing early diagnosis and making progress against the NHS Long Term Plan ambition to diagnose 75% of cancers at stages 1 and 2 by 2028
- continuing work to expand diagnostic capacity including through community diagnostic centres, and give priority to people with suspected cancer, so that at least 75% of people referred urgently receive a diagnosis within 28 days
- improving A&E and ambulance performance by delivering the urgent and emergency care recovery plan, including expanding services in the community, with greater use of urgent community response to reduce avoidable admissions and over 10,000 virtual ward beds in place by this autumn
Priority 2: support the workforce through training, retention and modernising the way staff work
Working with DHSC, ICBs and other partners, NHS England should lead implementation of the actions in the NHS Long Term Workforce Plan, which will set out actions to put the NHS workforce on a sustainable footing and ensure that it has the workforce to meet the changing needs of patients over the next 15 years.
Priority 3: deliver recovery through the use of data and technology
It is also crucial that the NHS makes progress in adopting the latest innovation and technology to digitally transform the NHS and help to ensure its long-term sustainability. The system must utilise the power of technology and the skills, leadership and culture that underpins it, to drive a new era of digital transformation.
This will allow the health and care system to thrive long into the future, delivering vast benefits for patients – such as using AI to give better treatment, the latest screening techniques to detect illness sooner and equipment that allows more people to be treated at home. NHS England should continue to prioritise tackling variation, supporting digital transformation in areas where there is greatest challenge.
To support digital transformation, it is vital that staff have the skills and resources to implement and utilise new digital tools effectively to deliver high quality services for patients. Delivery should include:
- By March 2024, all trusts should adopt barcode scanning of high risk medical devices and submission to the national, mandatory Medical Device Outcome Registry (either directly or via a supporting electronic health record (EHR) or inventory management system that can support registry data submission). The registry will be used to improve patient safety and outcomes in procedures that use high risk medical devices. Implementing the national cyber strategy for health and social care and deliver the cyber improvement programme
- developing and delivering the federated data platform and maximising trust and ICB take up of the platforms and national use case tools. Optimising the use of health and social care data to deliver better services and outcomes for patients, maintaining the highest standards of data protection and ensuring cyber resilience to maintain and build public trust in our protection of people’s data
- Increasing the uptake of AI tools to support the NHS workforce in applying best practice.
Continue work to deliver the NHS Long Term Plan to transform services and improve outcomes
Alongside the above objectives, we expect NHS England to continue their wider work to deliver the key NHS Long Term Plan ambitions to transform the NHS for the future, in line with NHS England’s operational planning guidance and its wider duty to promote a comprehensive health service.
As part of this, they should continue to work with the NHS and other partners on improving patient safety, quality of care and health outcomes, including through specific NHS programmes. This includes:
- continuing to shift towards community-based health care, including enabling more people to benefit from proactive and personalised care, strengthen timely access to community services, and streamline direct access and set up local pathways for direct referral
- preventing ill health through the delivery of NHS services, and supporting integrated care systems (ICSs) to tackle inequalities in access to healthcare at a local level; to fulfil their legal duties on health inequalities, including the delivery of 5 strategic priorities for system action on health inequalities; and to embed the Core20PLUS5 approach for adults and children and young people
- working with government to support delivery of the Long Term Plan through developing and delivering a major conditions strategy to tackle the main causes of ill health and ensure care is patient-focused