NHSE 2023/24 priorities and operational planning guidance

On 23 December, NHS England published its 2023/24 priorities and operational planning guidance, which this year is organised around “three key tasks” for the system.
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The “three key tasks” for the system: 

  1. Recovering core services 
  2. Making progress on delivering ambitions set out in the NHS Long Term Plan 
  3. Transforming the NHS for the future

Service recovery is the “immediate priority” and key theme throughout the guidance, with a focus on improving A&E waiting times, reducing long waits for elective care, and making it easier for people to access primary care services through self-referral routes. Key actions to deliver on this commitment include:

  • Increasing day case rates and theatre utilisation 
  • Moving to self-referral when GP involvement is not clinically necessary, including for audiology, weight management, and physiotherapy services
  • Increasing bed capacity, with a focus on reducing adult general and acute bed occupancy
  • Delivering a safe reduction in outpatient follow up (OPFU)

The guidance highlights several priorities around babies, children and young people, most of which are restatements of commitments made in the NHS Long Term Plan. These are:

  • Expanding access to mental health support, in line with the LTP ambition for 340,000 more children and young people to access NHS funded services than in 2019 
  • Improving support for children and young people with a learning disability/autism - Ensuring 75% of young people aged 14+ on the learning disability register have an annual health check, and reducing the numbers of young people with a learning disability or autism cared for in inpatient settings
  • Improving the quality and safety of maternity and neonatal services, with a commitment for the NHS to publish a single delivery plan for maternity and neonatal services in early 2023. The guidance also set out plans to ensure increased access to perinatal mental health services, extending personalised care approaches,  and ensuring every ICB can implement local equity action plans to reduce inequalities in maternity and neonatal access and outcomes. 

This year’s guidance includes a significantly reduced number of objectives or targets which sit underneath its three core ambitions, from around 130 last year to just 30. While the Chair of the ICS review, Patricia Hewitt said she “warmly welcomed the reduction” in targets and described this as both a step in the right direction and a sign of things to come, it is notable that this has corresponded with a reduction in focus on children, young people and the systems which support them. 

Most of the objectives are focused on how the system works for adults. For example, the targets around prevention and health inequalities focus on hypertension and CVD, and the target for urgent and emergency care is to reduce adult general and acute bed occupancy to 92%, with no equivalent aim for children. There is no mention of children’s community health service recovery, including community paediatrics or speech and language therapy provision, where waiting times remain unacceptably high.

Other key priorities set out in this guidance for 2023/24 are:  

  • Publishing the long-awaited People Plan by Spring this year 
  • Eliminating waits of over 65 weeks for elective care by March 2024
  • Continue to deliver against the strategic priorities for tackling health inequalities set out in the Core20PLUS5 the Core20PLUS5 Children agendas
  • Ensuring the health system has the right digital foundations, building on the strategic plans in Data Saves Lives. Commitments include procuring a Federated Data Platform to help coordinate care, improving data architecture and infrastructure for better population health management, and developing a ‘digital first’ approach for the public
  • Prioritising programmes of work on mental health and better supporting people with a learning disability or autism

Further information:

NHS 2023/24 priorities and operational planning guidance

RCPCH response to DHSC 10-year mental health and wellbeing strategy consultation

RCPCH response to DHSC data saving lives consultation