RCEM response to NHS Long Term Plan

7 January 2019

Responding to the publication of the NHS Long Term Plan, Vice President of the Royal College of Emergency Medicine, Dr Chris Moulton said: “On face value, the NHS long-term plan is ambitious, optimistic and considered. Within it there are many fine aims which, if delivered, will improve care for some patients.


“However, we fear that there are incompatibilities with expectation and reality; particularly when considering the gap between what is being promised and what is being provided.

“As others have rightly pointed out, the viability of this plan will not only be conditional on tackling workforce shortages – and ensuring that those staff that we have do not leave the NHS – but also on adequate funding for both public health and social care. 

“The plan leans towards prevention rather than treatment, yet there has been no halt to the cuts in public health funding and this settlement does not include any increase. 

“Embedding social care teams in the emergency department may well be a good idea, but social care has been in a dire state for a long time and the green paper on it has been delayed for many years.  

“Aiming to relieve pressure on hospitals by shifting towards care in the community is commendable, and patients naturally want to be treated as close to home as possible. But if this change is to work then this care must be available, like emergency care, 24/7. This will need serious commitment on the part of other specialities and agencies.

“While the College welcomes moves to relieve pressure on emergency departments, it is disappointing to find that despite the proposed measures to do this, it has still not resulted in a firm commitment to restoring hospital four-hour performance to 95% - a sensible target that is very much achievable given the right resourcing and desire to do so. 

“We also fear that the Clinical Standards Review that the document alludes to but provides scant details of, may not be driven by patient interests alone. Targets ensure patient safety, drive improvement and provide a level of transparency around system performance that is essential for good decision making. 

“While experience shows that diversion strategies do not work as desired, most of the aims within the plan are laudable, if perhaps too readily promised. Unfortunately, it appears to be the case that while many patients will benefit, this may be to the detriment of others – those attending A&E will continue to suffer from delays and overcrowding.”