Published by the Department for Health and Social Care today, the strategy outlines concrete action already taken across government to embed lessons from Covid-19: 

• PPE stockpiles will continue to be replenished with a variety of products and sizes.
• Departmental pandemic response plans will be reviewed to ensure government services and critical national infrastructure can be maintained effectively in a pandemic. 
• An ‘All Pandemic Hazards Bill’ will be drafted to ensure the government has legislative options ready to review and introduce as necessary in response to a range of pathogens. This will sit alongside a suite of prepared options for community protection measures to support swift decision-making and prioritisation to keep people safe. 
• UKHSA will build a new set of services to manage large scale testing, contact tracing and other scaled public health response measures’.
• Chemicals and equipment stockpiles needed for testing will be built up further to protect against supply risks that could develop in the early stages of a pandemic. 
• Data requirements to support decision-making will be reviewed to ensure information needed in a pandemic response is available, transparent, and can be shared quickly between organisations and with the public.

Improve people’s health and care outcomes, reduce health inequalities and help them stay well at home

This will be done by:

• focusing on prevention and proactive care management, including using data to effectively manage risk and prevent escalation
• strengthening primary and community services
• working better with specialists traditionally based in hospitals, public health, adult and children’s social care, VCSEs and other partners.

Organise services around the person with more convenient, personalised and joined-up care

Orientate services around a person’s needs, rather than organisational convenience. A strong digital approach will be critical to this. This includes:

• improving access to care (by phone, online or in person)
• moving more outpatient care from hospitals into neighbourhoods
• improving continuity of care for those with longer-term needs
• more effectively co-ordinating services for those with the most complex needs, for example, those at end of life.

Reduce pressure on more acute services - including hospitals and care homes

This will be done by:

• using effective neighbourhood working to decrease avoidable hospital admissions or attendances and facilitate timely discharge
• reducing the de-conditioning that happens to many people when they spend time in hospital
• reducing avoidable care home admissions
• ensuring acute services are focused on those who need them most.

Cut waste and duplication

This will be done by:

• integrating services across health, local government and wider partners
• making full use of digital opportunities
• ensuring the NHS is more sustainable.

The government wishes to express its gratitude to all of those who contributed to this consultation, and their patience while the analysis and response was finalised.

It is clear from the majority of responses that there is a need for better transparency regarding payments made between industry and:

• registered healthcare professionals
• healthcare provider organisations
• organisations connected to the provision of healthcare

The government fully supports this sentiment, recognising the importance in enabling patients to make informed decisions about their own care and improving the transparency of industry payments.

In response to this consultation, the government will develop and publish clear guidance in relation to disclosing payments made by the medicines and medical devices industries to the healthcare sector. This guidance will set out best practice for industry to follow, which will advise on:

• which payments should be reported
• the format of the reporting
• the frequency of the reporting

The government will monitor the uptake of this forthcoming guidance.

While the government acknowledges that a number of stakeholders favoured a legislative approach to payment disclosures, this guidance-based approach will allow patients to benefit from industry reporting more quickly, without further delays that could have followed the introduction of legislation and the establishment of a government reporting and compliance system. This positive step towards transparency will add clarity to the relationship between industry and healthcare professionals, assisting patients in making informed decisions about their care.

Over the coming months, officials will work with stakeholders to develop a robust set of guidelines, with careful consideration given to the range of valuable suggestions provided by respondents to the consultation. This will ensure that the guidance is comprehensive and captures all relevant payments to healthcare-related professionals.

To date, no formal government guidance has been available for industry to follow and against which patients can hold the sector to account. This step will provide certainty for industry and stakeholders, as well as a clear path to improve transparency and improve public safety.

This decision is also aligned with the government’s commitment to reduce regulatory burden on industry. It will provide industry with the space to show leadership and a commitment to transparency, while minimising regulatory requirements that could be especially detrimental to small and micro businesses.

• Preventing infection in older adults can significantly improve overall health and quality of life.
• Controlling specific infections has proven highly successful in preventing certain cancers.
• Infections in pregnancy and the neonatal period still present significant risks.
• Easily underestimated but potentially very harmful diseases are increasing due to gradually declining coverage of routine vaccinations in children and young adults over the last decade.
• The burden and range of infections imported into the UK has increased over the last decade.
• Antimicrobial resistance (AMR) continues to be a major risk.
• The periodic occurrence of significant new epidemics and pandemics as a natural consequence of emerging and evolving infections is predictable, even if the timing of their onset and infection is not.

This document includes the following strategic framework for the Men's Health Strategy:

This report highlights a number of issues of concern, including the two areas highlighted below.

Abolition of NHS England

The Committee points to several issues where it believes further clarity is required from the Government in this respect:

• The lack of a clear plan for how DHSC and NHS England will achieve significant headcount reductions, and the costs involved.
• How the reductions fit in with the wider 10 Year Health Plan for the NHS.
• How savings made from reducing NHSE staff costs help frontline services.
• How the institutional knowledge of NHSE would be preserved following its abolition.
• The scale of headcount reductions in the DHSC, and the geographical spread of the planned 50% headcount reductions in NHSE and across local Integrated Care Boards.

Clinical negligence

The Committee has expressed disappointment in this area and stressed the need for significant improvements, stating that:

“Both patients and public money need to be better protected by the Department. Far too many patients still suffer clinical negligence which can cause devasting harm to those affected. It also results in large sums of public money being spent on legal fees and compensation, drawing resources from the wider health service.”

Concerns it highlights include:

• £58.2bn has been set aside to cover the potential cost of clinical negligence events in the latest accounts – the second largest liability across government after nuclear decommissioning.
• 19% of money awarded to claimants in 2023-24 goes to their lawyers (£536m of the total £2.8bn paid that year), on top of the fees payable for the Government Legal Team.

It recommends that within six months, DHSC should set out a plan with clear actions to:

• Reduce tragic incidences of patient harm to as low a level as possible
• Manage the costs of clinical negligence more effectively, including introducing a mechanism to reduce legal fees.
• Improve patient safety across the NHS and in particular in maternity services

The plan has nine strategic outcomes organised under four themes:

1. Reducing the need for, and unintentional exposure to, antimicrobials – this includes activity to prevent infections arising in the first place (through good infection prevention and control, including vaccination), to monitor the emergence and spread of AMR through strengthened surveillance, and to minimise release of antimicrobials and resistance into the environment.
2. Optimising the use of antimicrobials – through ensuring antimicrobials are only used when needed in humans, animals, and the environment.
3. Investing in innovation, supply and access – by supporting and incentivising the development of new vaccines, diagnostics and therapeutics (including alternatives to antimicrobials), making them accessible to those who need them, and ensuring our work on AMR is informed by cutting edge research.
4. Being a good global partner – maintaining the UK’s role as an international leader on AMR and supporting low- and middle-income countries to respond to the threat of AMR through research, good supply chains and access to antibiotics.

Related reading

You can find a number of different resources shared with us by hub members and patient safety advocates providing valuable insights and practical guidance about AMR here.

All independent sector activity undertaken on behalf of the NHS is delivered free at the point of use (and independent sector providers (ISPs) are paid in line with NHS unit prices), upholding the founding principles of the NHS that access should be based on clinical need, not an individual’s ability to pay. ­­­­­­­­­­­­­­

Maximising the use of all NHS assets and available independent sector capacity is a key part of the plan to tackle the elective backlog and, while use of the independent sector is up, this is concentrated in specific specialties.

The Elective Recovery Taskforce was set up in December 2022 to advise and inform the Secretary of State for Health and Social Care and the Prime Minister on how to increase the volume of elective consultations and procedures by both the NHS and the independent sector as far as possible to tackle the backlog.

The taskforce, chaired by Minister Will Quince, brought together leading voices from across the NHS, independent healthcare sector and patient representatives to collaboratively come up with solutions.

The taskforce concluded at the end of March 2023, agreeing to work together to implement action in 4 core areas:

• empower patients to exercise their right to choice
• deliver a post-pandemic recovery
• enable longer-term system sustainability
• deliver this plan and go further

The actions are set out in this implementation plan, with a summary at Annex A. Following the conclusion of the taskforce at the end of March 2023, the focus has turned to delivery and putting these actions into practice, with appointees invited to convene after 6 months to review progress.

The UK Health Security Agency (UKHSA) became fully operational on 1 October 2021, in the midst of the pandemic. There were significant issues in setting up this new organisation and the Department failed to appropriately support UKHSA during this process. This led to a fundamental absence of governance arrangements and controls. Non-executive directors were not appointed until April 2022 and UKHSA’s financial controls and processes were so poor that the organisation could not prepare auditable accounts for the 2021–22 financial year. This resulted in the Comptroller and Auditor General (C&AG) disclaiming his audit opinions. UKHSA faces a significant challenge implementing strong financial controls and processes and the Department must provide sufficient support and oversight to achieve this.

Over the last few years, there have been repeated governance and financial control failings across the Departmental group leading to a number of qualified accounts. This has undermined Parliamentary accountability and resulted in the Departmental group incurring expenditure without Parliamentary approval. The Department has also been unable to lay its accounts before the summer recess, only just managed to do so before the final statutory deadline. It has not yet got a credible plan to return to laying its accounts before the summer recess. The Department must strengthen its governance and financial controls and set out a clear plan to restore timely accountability across the Departmental group. To do this, the Department must work with NHS England and local auditors to restore timely financial reporting across the NHS. 

A. Increase capacity, to help deal with increasing pressures on hospitals which see 19 in 20 beds currently occupied.

• 1. Dedicated funding of £1 billion will pay for additional capacity, including 5,000 new beds as part of the permanent bed base for next winter.
• 2. Over 800 new ambulances, including 100 specialist mental health ambulances, the majority of which will be on the road by next winter.
• 3. ‘Same day’ emergency care services will be in place across every hospital with a major emergency department, so patients avoid unnecessary overnight stays.

B. Grow the workforce, as increasing capacity requires more staff who feel supported.

• 4. More clinicians will be available for 111 online and urgent call services to offer support, advice, diagnosis and, if necessary, referral. From this April a new targeted campaign will be launched to encourage retired clinicians, and those nearing retirement, to work in 111 rather than leaving the NHS altogether.
• 5.  The workforce will grow with more flexible ways of working and increase the number of Emergency Medical Technicians next year to respond to incidents and support paramedics.

C. Speed up discharge from hospitals, to help reduce the numbers of beds occupied by patients ready to be discharged.

• 6. Over the next 2 years, and as part of the up to £14.1 billion extra for health and social care, £1.6 billion will be focused squarely on discharge.
• 7. ‘Care transfer hubs’ in every hospital ahead of next winter will mean faster discharge to the right setting, so that people do not stay in hospital longer than necessary.
• 8. This year, new approaches to step-down care will start to be implemented so, for example, people who need physiotherapy can access care as they are being discharged from hospital before they need to be assessed by their local authority for long-term care needs.
• 9. New discharge information will be published, with new data collected from this April.

D. Expand new services in the community, as up to 20% of emergency admissions can be avoided with the right care in place.

• 10. Ahead of next winter the government will offer more joined-up care for older people living with frailty, including scaling urgent community response, frailty and falls services across the whole country – meaning the right people help you get the care you need, without needing an admission to hospital if it’s not necessary.
• 11. Greater use of ‘virtual wards’, which allow people to be safely monitored from the comfort of their own home, will be achieved by an extra 3,000 beds to provide over 10,000 in total by this autumn, allowing staff to care for up to 50,000 patients a month this way over the longer term.
• 12. Help people access the right care first time, as 111 should be the first port of call and reduce the need for people to go to A&E. By April 2024, urgent mental health support through NHS 111 will be universally available.
• 13. From this April, new data will allow the public to easily see and compare the performance of their local services. It will also tackle unwarranted variation in performance in the most challenged local systems.
• 14. This April, a new clinically-led programme to reduce unwarranted variation will launch, alongside intensive support for those areas struggling the most

• Autism and learning disability
• Grounds for detention and community treatment orders
• Appropriate medical treatment
• The responsible clinician
• Community treatment orders
• Nominated persons
• Detention periods
• Periods for applications and references
• Patients concerned in criminal proceedings or under sentence
• Help and information for patients
• After care

• There is an opportune ‘policy window’ for change in patient safety.
• The burden of unsafe care is clear and evidence-based both locally and globally.
• Momentum towards safer care is building at local, national and international levels.
• Culture is equal to policy and public momentum in order for safety innovations to land, take root and flourish.
• In order for safety opportunities to materialise, they require a concerted effort towards collaboration, innovation and education.

Agreed actions

• Create national learning systems.
• Ensure meaningful collection and responses to patient feedback.
• Develop curricula for patient safety including curricula for investigations.
• Develop local and global portals for sharing ideas and best practice.
• Design systems to prevent harm with aligned priorities.
• Collect data about impact and evaluation.
• Harness existing digital innovations to improve patient safety.

Wilton Park is an Executive Agency of the Foreign and Commonwealth Office.

• infrastructure
• digital services
• innovation
• skills and culture.

Challenges to overcome:

• legacy technology and commercial arrangements
• complex organisational and delivery structures
• a risk-averse culture
• limited resources to invest
• a critical need to build and maintain public trust.

Describes four guiding principles:

• user need
• privacy and security
• interoperability and openness
• inclusion.