The Department’s remit formally expanded from the “Department of Health” to the “Department of Health and Social Care” in January 2018. Our health and social care services continue to meet the challenges of rising demand and ever more complex need. In 2018-19, there were 24.8 million A&E attendances, 4.3 million more than were seen in 2009-10 and 1.7 million more within four hours. 1.8 million requests for adult social care support from 1.3 million new clients were received in 2017-18. This is down to the commitment, compassion and professionalism of the 1.3 million people who work in the NHS and the 1.6 million people working in adult social care services across the country. As at June 2019 there were over 17,300 more doctors and over 8,000 more nurses and health visitors since June 2010, with plans to recruit even more.
Since 2017, the Department has achieved a significant amount—continuing to drive forwards its strategic priorities to help people live more independent, healthier lives for longer. In July 2019, the Department reached an important milestone: the 100th anniversary since the Ministry of Health was established. It has also been working to ensure the health and social care system is as prepared as possible for EU exit.
A stronger NHS, driven forward by the ambitions set out in the NHS long term plan and significant funding commitments that support it. In July 2018 we celebrated the 70th anniversary of the NHS. Accompanying this significant milestone, the Government announced the single biggest cash increase made in the NHS’s history—an extra £33.9 billion a year by 2023-24 (compared with 2018-19). This backs the NHS’s clinically led long term plan (LTP), which sets out a bold and innovative vision, safeguarding our nation’s health for generations to come.
A healthier nation, with prevention at the heart of our strategy to tackle the causes of poor health and ongoing efforts to ensure we play a leading role in confronting global health challenges.
Prevention remains a high priority for the Department. Important progress has been made across a number of areas, including: the tobacco control plan published in 2018; extending the HPV vaccine to boys; a new £6 million scheme to improve outcomes for children with alcohol dependent parents; exceeding the NHS diabetes prevention programme commitment a year early; being one of the first countries in the world to achieve the UN’s “90/90/90” goals on HIV prevention; creating the first Minister for Suicide Prevention alongside the cross-Government suicide prevention workplan; and introducing the soft drinks industry levy in April 2018, which has been hugely successful—the average sugar content of drinks subject to the levy decreased by 28.8% between 2015 and 2018.
The Prevention Green Paper published in July 2019 signalled a new approach for the health and social care system. This included chapter 3 of the childhood obesity strategy and driving forward policies in chapter 2, such as ending the sale of energy drinks to children and exploring what additional opportunities leaving the European Union presents for front of pack food labelling in England.
The Government have continued to protect and promote the health of the nation, including through: consulting on proposals to reduce ill-health related to job loss; fully establishing the Northern Ireland abortion scheme in 2019; announcing a new network of eight walk-in FGM clinics; new legislation on organ donation; and leading the healthcare response to emergency incidents, such as the Novichok poisoning in Salisbury.
We continue to play a leading role in global health security, through our work with the G7, G20, World Health Assembly and the UN. The Government have published a 20-year vision and a 5-year national action plan for how the UK will contribute to containing and controlling antimicrobial resistance by 2040.
A transformation in care, to make sure we are supporting the most vulnerable in our community with joined-up, compassionate and modern services.
We have been supporting primary and community services through: investment which will grow faster than the overall NHS budget; a new 5-year contract for GPs; expanding evening and weekend GP appointments; rolling out the NHS comprehensive model of personalised care; improving diagnosis of dementia with record recent monthly figures; a new clinical negligence scheme for general practice; and we now have record numbers of GPs entering training, with 3,415 acceptances in 2018, we expect that trend to continue this year.
The Government and the NHS are continuing to make progress towards parity of esteem for mental health, including: spending on mental health rising to £12.5 billion in 2018-19; NHS LTP committing to spending a further £2.3 billion a year by 2023-24 to transform mental health services, and support 380,000 more adults and 345,000 children and young people (aged 0-25); publishing the 2017 Green Paper on children and young people’s mental health and creating the first wave of schools and college-based mental health support teams; modernising the Mental Health Act 1983; hosting a global ministerial mental health summit to put mental health on an equal footing with physical health; and contributing to the Government’s first strategy to tackle loneliness in England in October 2018. Overall, waiting time standards and the IAPT recovery rate continues to improve and we are consistently exceeding the targets: 52.1% of patients who finished a course of psychological therapy recovered in 2018-19 (up from 50.8% in 2017-18), this is the second reporting year in a row when the recovery rate has surpassed the Government target that 50% of eligible referrals to IAPT services should move to recovery; and 89.4% of people were seen within six weeks for their first course of treatment, against a target of 75% (an increase from 89.1% in 2017-18).
Tackling cancer remains a priority for this Government. In October 2018, the Prime Minister announced measures with the aim of seeing 75% of all cancers detected at an early stage by 2028 to save 55,000 lives a year. Survival rates are at a record high, increasing year-on-year since 2010. One-year survival rate for adults diagnosed in 2016 is over 70%, an increase of around 10 percentage points over the last two decades. A recent international study showed that the five-year net survival rate for breast cancer increased by 7% between 2000-04 and 2010-2014—among the fastest in western Europe. In 2018-19 the NHS carried out almost 23 million diagnostic tests, eight million more than in 2010 (an increase of 53%); 2 million people were seen by a specialist for suspected cancer, over 1 million more than in 2010 (an increase of 124%); and 310,700 patients started treatment for cancer, around 70,900 more than in 2010 (an increase of around 30%).
The Government have given councils access to up to £3.6 billion more dedicated funding for adult social care in 2018-19. In total, the Government have given councils access to around £10 billion more adult social care funding from 2017-18 to 2019-20. In the recent 2019 spending round we announced councils will have access to a further £1.5 billion for social care—£1 billion through a new grant and £500 million through the adult social care precept. This will support councils to meet rising demand and continue to stabilise the social care system. We ran two new national adult social care recruitment campaigns to raise the image and profile of the sector and encourage people with the right values to apply for current vacancies. In June 2018 we published the cross-Government carers action plan 2018-20.
We announced new landmark arrangements for community pharmacy, which came into force from October 2019. In addition, working with the branded pharmaceutical industry, represented by the ABPI, we agreed the 2019 voluntary scheme for branded medicines pricing and access, which began on 1 January 2019 and will run for five years. The NHS is expected to save around £930 million on its medicines bill for 2019 as a result.
In July 2019 the new NHS patient safety strategy set out NHS actions to continue to improve patient safety. We published the Health Service Safety Investigations Bill, which will establish the world’s first independent body to investigate patient safety concerns and share recommendations to prevent incidents.
A workforce fit for the future, created by recruiting, retaining and developing the people we need to deliver and by making the health and care system a rewarding place to work.
The interim NHS people plan, published in June 2019, set out proposals to grow and support the NHS workforce. As part of the 2019 spending round every nurse, midwife and allied health professional will receive a new £1,000 personal development budget over three years.
In September 2019, we agreed a new contract deal for junior doctors in England, successfully bringing an end to the junior doctors dispute, following a review of the 2016 contract.
In June 2018, we agreed a new multi-year pay and contract reform deal for agenda for change staff which benefits nearly 1 million NHS workers over three years.
Better technology and data, which will harness the full potential of technology to modernise and improve the way we deliver healthcare for the 21st century.
In October 2018, we published the Secretary of State’s technology vision “The future of healthcare: our vision for digital, data and technology in health and care”. In July 2019 NHSX became operational to drive transformation and lead policy, implementation and change—leading the largest digital health and social care transformation programme in the world; and in August 2019 we announced a new artificial intelligence lab, to help solve some of healthcare’s toughest challenges. In total, over £250 million will have been invested nationally to improve the cyber security of the health and social care system between 2016 and 2021.
We have supported and funded the ambitious and world-leading 100,000 genome project, reaching the goal to sequence 100,000 whole genomes in December 2018. We established the genomic medicine service in the NHS—the first of its kind in the world to integrate whole genome sequencing into the healthcare system.
The Department has maintained its focus on investing in infrastructure and research, through the National Institute for Health Research (NIHR). In 2018-19 there have been over 1 million participants in NIHR-supported health and social care research studies. We have maintained spending on dementia research and are on track to meet our commitment of £60 million spent annually to March 2020.
In December 2018, the Government, in collaboration with industry, launched the second life sciences sector deal, backed by a range of organisations from across the sector and £1.2 billion of new investment from industry.