This Framework follows the release of the NHS Long Term Plan in January 2019 and is intended to guide the creation of five-year strategic plans by Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs).
These local-level plans should be complete by November 2019, ready to be incorporated into a national implementation plan. This national-level plan will set out initial performance trajectories and programme milestones to deliver the Long Term Plan commitments, while also taking the Government Spending Review into account. The Government Spending Review is currently due to be published later in 2019.
The full Framework can be found online on the NHS Long Term Plan website. Here we have summarised the key parts of the Framework relevant for our members and for child health. This includes an outline of who should be involved in the creation of the five-year local-level plans, according to the Framework. The stipulations made by the Framework regarding services for children and young people are then outlined. The broad funding pledges made by the Framework for service expansion and new initiatives are also discussed, along with the support offered to ICSs and STPs for use when developing their five-year plans.
Maternity and neonatal services
Local maternity systems are expected to outline how they will ensure that every child in their care receives the best start in life. LMS plans should be integrated into broader local system plans and the national Maternity Transformation Programme and Children and Young People’s Transformation Programme will work together in supporting systems.
Additional funding will be released to support the expansion of various local maternity system and neonatal services, in addition to funds for the initiatives such as the Saving Babies’ Lives Care Bundle and the UNICEF Baby Friendly Initiative.
The production of local plans to improve outcomes for children and young people
Regarding services for children and young people, the Framework states that local plans to improve outcomes for this group should be co-produced with the input of children, young people and parents/carers.
Named clinical and management leaders should also work alongside leaders from the NHS, local Government, education and others in the field of child health to produce the plans. The national Children and Young People’s Transformation Programme support to systems can be found in the system support offer which has been published alongside the framework.
Priority areas to improve outcomes for children and young people
The Implementation Framework refers to a number of priority areas that STPs and ICSs should discuss in their plans. For example, the Framework explicitly states that plans must outline how the performance of childhood screening and immunisation programmes will be improved.
There is a focus on integrated care to enable joint working and integration between: physical and mental health services; primary, community and acute services; and paediatric and adult services. A clear alignment between mental health and social care is also stipulated to strengthen specialist, crisis care and community teams for children and young people with learning disabilities and autism.
The local plans must also set out how care for children with long term conditions will be improved, along with outcomes for children and young people with cancer. Plans should also address how children and young people’s cancer networks will be strengthened with the aim of improving access to high-quality treatment services.
Finally, the expansion of Children and Young People’s mental health services (CAMHS) must be outlined in local plans, along with services and initiatives to treat and manage childhood obesity.
The Implementation Framework states that additional funding will be available from 2021-22 to 2022-23 to support the integration and improvement of children and young people’s services. This will be followed by additional funding in 2023-24.
The Framework also notes that funding for CAMHS services will grow faster than NHS funding and total mental health spending. Local-level plans must set out how this investment will be used to deliver the commitments in the Long Term Plan and the Five Year Forward View for mental health, such as supporting an additional 345,000 children and young people to access NHS-funded mental health services.
Furthermore, targeted funding will be available to develop keyworkers for children and young people with the most complex needs and their families/carers from 2020-21, with additional funding allocations made in 2023-24.
Also in 2020-21, funding will be made available for the roll of out the Stopping Over Medication of People with a learning disability or autism and Supporting Treatment and Appropriate Medication in Paediatrics (STOMP-STAMP) programmes as part of new primary care network (PCN) arrangements.
Targeted funding will also be available from 2021-22 to increase service capacity for the treatment of obese children and health complications related to their obesity.
The Implementation Framework also pledges extra funding to children’s hospices and children’s palliative and end of life care services, and to test the model of ophthalmology, hearing and dental services to children in residential schools from 2021-22.
Support for ICSs and STPs
The Long Term Plan Implementation Framework system support offer has been published alongside the Implementation Framework, outlining the national and regional systems that can support STPs and ICSs in the development of their five-year plans.