Briefing / Multi-year plans: embedding system-level productivity and efficiency

04 October 2022 Sarah Day
1 CPD hour
On 1 July 2022, 42 integrated care boards (ICBs) became statutory organisations responsible for bringing together the NHS locally to improve population health and establish shared strategic priorities. This autumn, it is expected that NHS England will issue planning guidance that will require the ICBs and their systems to develop a longer-term plan, covering the period 2023/24 to 2027/28.

When developing plans over a long period, the first two years will be a detailed operational plan, setting out how organisations and systems are going to meet current pressures and demand within existing constraints such as workforce, finance and estates. The anticipated refresh of the NHS long term plan will set out a number of expectations and targets for activity. The later three-year period will be planned at a more strategic level, setting out aims and aspirations for how services will develop, how the workforce will evolve and how the ICB can leverage system working to transform the local NHS in a positive way. 

The scale of the challenge facing the NHS is vast. The impact of the pandemic on waiting times and the need to recover elective activity and tackle waiting lists can appear to overshadow other aspects of care and recovery. However, ICBs, as part of their wider integrated care system (ICS), have four key aims:

• improving outcomes in population health and healthcare
• tackling inequalities in outcomes, experience and access
• enhancing productivity and value for money
• helping the NHS to support broader social and economic development.

The plans developed by organisations in the coming months must not only tackle the immediate need for recovery but also address the longer-term strategy that will meet the four key aims.

At a time when financial and workforce resources are severely constrained, the golden thread that draws all of this together is the need to find more efficient ways of delivering services together with improvements to productivity. Many of the balanced plans submitted by ICBs to date depend on delivering a significant level of efficiency.

Grant Thornton supported six systems in the Midlands with the elective recovery planning round. This work identified three key areas of focus for ICBs and systems when developing plans for the next five years, both to address elective recovery and to deliver wider system-level improvements to meet the NHS’s strategic objectives. The three areas are:

• the need to develop whole system solutions
• the importance of innovative workforce models
• optimising digital technologies and the use of data.

This briefing draws on the work carried out by Grant Thornton and supplements it with learning from the HFMA’s members.
CPD accredited
CPD accredited logo