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1. Introduction
2. Letter from the Prime Minister
3. Letter from the NHS Chief Executive

INTRODUCTION

The April 2002 Budget provides for an average 7.5 per cent real growth in the NHS in England over each of the next five years.

As a result, the total NHS budget in the UK will climb from £65.4 billion in 2002-2003 to £105.6bn in 2007-2008.

In Delivering The NHS Plan - next steps on investment, next steps on reform, published the day after the Budget, health secretary Alan Milburn outlined further steps in reform to ensure the extra money is used effectively. The document covers:

• what the public can expect to see in improved services as the Plan is implemented
• how these improvements will be secured.

Key points include:

• 35,000 more nurses, 15,000 more doctors, 30,000 extra therapists and scientists
• 40 new hospitals and 500 primary care centres
• A new and independent Commission for Healthcare Audit and Inspection and Commission for Social Care Inspection (CSCI)
• 10,000 more general and acute beds
• Primary care trusts will be free to buy care from the most appropriate provider - be they public, private or voluntary
• The hospital payment system will switch to payment by results using a regional tariff system
• Patients will be given information on alternative providers and can choose to switch to hospitals that have shorter waits - including private hospitals and hospitals overseas
• New PFI mechanisms
• Legislation to make local authorities responsible for the costs of delayed discharges along with incentives to use the extra investment to fund home care services for older people.

Alan Milburn set out some of the implications for nursing in his speech to the Royal College of Nursing Annual Congress on 24 April. For details, go to
www.doh.gov.uk/speeches/apr2002milburnrcn.htm

Prime Minister Tony Blair and NHS Chief Executive Nigel Crisp both wrote to chief executives on 18 April. Copies of their letters follow.

For more information, go to: www.doh.gov.uk/deliveringthenhsplan

LETTER FROM THE PRIME MINISTER

I wanted to write to you after the Budget to thank you and your staff for your hard work over the past year and to speak about the opportunities and the challenges for the National Health Service.

I want to thank you because I know the tremendous work that is going on across the country in our health service. Too often the focus, particularly in the national media, is on the things that go wrong in the NHS rather than its real achievements, world-class services and the thousands of lives saved every day by the skills and dedication of your staff.

I also know that there is a tremendous amount of change now underway in the NHS. Like most change, it isn't easy. So I wanted to say how grateful I am for the way you and your staff have met the extra demands upon you.

Over the last few months, Alan Milburn and I have met many of you. We have both been impressed by your deep commitment to the NHS, your absolute determination to improve the standards of care you provide to your community and your efforts to overcome the many challenges you face in achieving this.

The biggest challenge the NHS has faced, as you have made very clear to us, is its level of funding which has for decades been well below that of other European health systems. Last week's Budget which set out our long-term plans to close this gap.

The challenge now, for both Government and NHS staff alike, is to ensure this sustained extra investment delivers the improvements in care and service and to ensure we reshape a modern health service around the needs of patients. I know from our meetings you will be determined to get value for money from every pound you get.

This will also need Government to give you and your front-line staff the responsibility and freedom to bring about these improvements at a local level. Just as I hoped we have shown we have listened to you over the resources the NHS needs so I hope in the coming months we will show you we have listened about your calls for more local decision-making so that you can do your job better.

I promise as well that we will keep listening to you so our decisions reflect your experience and the needs and priorities of the community you serve. Thank you and your staff again for all you have done in the past - and all I know you will do in the future as we implement the 10 year Plan.

TONY BLAIR

LETTER FROM THE NHS CHIEF EXECUTIVE

The budget settlement is both an enormous vote of confidence in the NHS and Social Services and a huge challenge.

Your achievements over the last year showed that we can deliver and begin to make improvements for patients and the public. We must build on this year on year.

Progress was made through sheer hard work but it was also partly due to reforming the system and changing the way we organise and deliver services. In rising to the challenges for the future we need to concentrate even more on finding better ways of doing things - making progress through redesigning services, involving the public, giving patients choice and helping staff to achieve their potential.

It often feels as if progress is made despite the system. Today's announcements offer the NHS a whole range of the reforms we have been asking for - longer term planning and stability, new incentives with payment for delivery, new ways of strengthening the partnership with Social Services, decentralisation and new local freedoms to innovate and improve. They will enable us to continue the changes we need to make to implement the NHS Plan. They are far reaching and radical.

These are real challenges and we must be realistic in facing up to them. It will take time and hard work. There will be tough decisions to make sure we get the best out of the new money. We can't do everything at once and there will be raised expectations. There will be mistakes. Above all we should remember that providing health care in any circumstances will remain a difficult and demanding - if rewarding - job.

But the extra funding and the reforms give us the tools we need to deliver for our patients and the public. As they become available we must use them wisely. In the mean time, we should remember that we already have a great deal of freedom to innovate, redesign and reform. Let's make sure that we use our existing resources and freedoms to the full and keep up the momentum for improvement.

Delivering the NHS Plan - next steps on investment, next steps on reform

We will be sending you a hard copy of the document together with a letter from the Prime Minister tomorrow. In the meantime, copies of 'Delivering the NHS Plan - next steps on investment, next steps on reform' are now available at www.doh.gov.uk/deliveringthenhsplan. Please share the messages from the Prime Minister's letter and the document with your staff. The Executive Summary contains the following very simple chart which helps explain the changes.

Over the next few weeks we will be working up the details of the new arrangements with Strategic Health Authorities and the involvement of others within the NHS and Local Authorities. I shall be asking Directors of Health and Social Care and StHA Chief Executives to arrange meetings to involve as many people as possible in participating in this.

NIGEL CRISP

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copyright: © | published: July, 2002