3. The Five Year Forward View: identifies the challenges facing the NHS sets out plans for how to overcome them describes a future for the NHS where current problems are alleviated and patient care is given seamlessly across a range of organisations. Its goal is to achieve an NHS that: continues to be tax-funded is free at the point of use is fully equipped to meet the evolving needs of its patients, now and in the future. Although not easy, it’s achievable, but only with support and action from: politicians the public the NHS and its staff.

5. There are three areas that each have a significant and widening gap between current NHS resources and the demands on the service: health and wellbeing care and quality funding and efficiency. The future of the NHS depends on closing these gaps, which means fundamental change is needed.

7. Closing this gap focuses on preventing illness. Much of the pressure on the NHS is caused by avoidable illnesses, such as heart disease and diabetes. Supporting people to improve their own health and wellbeing would help avoid unnecessary hospital admissions.

8. How will this be done? NHS England will work with Public Health England to take action on the UK’s main causes of major health problems: obesity, smoking and alcohol. Incentivising and supporting healthier behaviour The NHS will support national action to include clear information and product labelling, as well as targeted personal support and wider changes to product marketing and pricing. Local democratic leadership on public health Through local health and wellbeing boards, the NHS will support initiatives to improve the health of local communities. Enable greater local decision-making on public health policy.

9. Targeted prevention Establish a programme of services to help target preventable illnesses related to obesity, smoking and alcohol. Supporting people to get and stay in employment A government-backed Fit for Work scheme will support people to stay in work, which in turn improves mental and physical health by preserving livelihoods. NHS England will test an opportunity to improve access to NHS services for at-risk individuals. Workplace health NHS England and NHS Employers will develop incentives that ensure the NHS supports its own staff to stay healthy, and serve as health ambassadors in local communities.

11. People are living for longer and with more long-term conditions, meaning people need a wider range of care over a longer period of time. The traditional divide between primary care, community services and hospitals needs to be removed. Care must be joined up and provided seamlessly across a range of healthcare organisations. New technologies and ways of working will be needed to improve the quality of care and patient experience.

12. How will this be done? Several new models of delivering care have been identified. First and foremost is the need for a new way of delivering general practice (GP) services. Primary care has been underfunded compared to hospitals but demand remains high. More funding is needed to encourage people to become, and remain, GPs, while training more community nurses and other primary care staff. In addition, there are seven other proposed models of delivering care and several trusts have been selected to develop them. These are known as vanguards.

13. How will this be done? If the new models are successful in these vanguards, they will be rolled out to other areas where similar improvements are needed. There will be investment in new options for the workforce, as well as training and development to make sure staff are fully equipped to support the changes. The NHS will also be supported to better share innovative ways of working and technologies that are already happening, and to undertake research to develop new ones.

15. There will be a gap between patient needs and NHS resources of nearly £30 billion a year by 2020/21. To sustain a high-quality NHS that meets the changing needs of patients both now and in the future, the NHS needs to use its money more efficiently. This gap must be closed through taking action on demand, efficiency and funding.

16. How will this be done? Preventing and managing demand Preventing ill health will reduce demand for services and the measures to address the health and wellbeing gap will have a positive effect on this. Redesigning more productive services Different ways of working and harnessing innovation and technology will ensure the NHS works more efficiently and cost-effectively. Maximising the value of the NHS budget Understanding spending patterns across the NHS will help to see where changes could be made and reduce variations. Transparency will help to understand if money is being spent well. NHS England will develop a common measure of the good use of resources in the NHS.

18. The NHS workforce is crucial to achieving the Five Year Forward View’s goals. No new care models or strategies can be achieved in the NHS without the support of its workforce. NHS England will work with Health Education England and NHS Employers to ensure a non-discriminatory environment where staff are healthy, engaged, sufficiently trained, productive and supported to raise concerns where necessary.

20. Add any information here to outline to staff what your trust’s involvement is, ensuring that your workforce understands that the Five Year Forward View is something that affects and involves everyone working in the NHS. Potential challenges and solutions. What more can we do to support the Five Year Forward View?

21. The Five Year Forward View The Five Year Forward View: One year on www.nhsconfed.org/1yearon Health and wellbeing gap Protecting staff and preventing ill health www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/ health-work-and-wellbeing/protecting-staff-and-preventing-ill-health Reducing sickness absence www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/ health-work-and-wellbeing/action-on-absence Staff engagement www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/staff-engagement Exemplary work in HWB and engagement www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/ health-work-and-wellbeing/copy-of-leading-the-way/nhs-exemplar-trust-meeting Supporting health and wellbeing boards www.nhsconfed.org/hwb

22. Care and quality gap Workforce supply www.nhsemployers.org/your-workforce/plan/workforce-supply Staff engagement www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/staff-engagement Exemplary work in HWB and engagement www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/ health-work-and-wellbeing/copy-of-leading-the-way/nhs-exemplar-trust-meeting Workforce Race Equality Standard www.nhsemployers.org/your-workforce/plan/building-a-diverse-workforce/ need-to-know/workforce-race-equality-standard Rip off the sticking plaster now: Enabling the local implementation of sustainable urgent and emergency care models in 2015/16 www.nhsconfed.org/resources/2015/04/rip-off-sticking-plaster-now

23. Care and quality gap The art of the possible: What role for community services in reshaping care www.nhsconfed.org/resources/2015/07/ the-art-of-the-possible-what-role-for-community-health-services-in-reshaping-care Cracking the innovation nut www.nhsconfed.org/resources/2015/06/ cracking-the-innovation-nut-diffusing-healthcare-innovation-at-pace-and-scale Not more of the same: Ensuring we have the right workforce for future models of care www.nhsconfed.org/resources/2014/10/not-more-of-the-same Altogether now: Making integration happen www.nhsconfed.org/resources/2014/07/all-together-now

24. Funding and efficiency gap Lord Carter’s interim report on productivity www.nhsconfed.org/news/2015/06/hospitals-could-save-5bn-a-year What the NHS needs from the Spending Review www.nhsconfed.org/resources/2015/10/ what-the-nhs-needs-from-the-spending-review-a-guide-for-parliamentarians Reducing agency spend www.nhsemployers.org/your-workforce/plan/agency-workers/reducing-agency-spend Decisions of value www.nhsconfed.org/value www.nhsconfed.org/value NHS finances: A service at boiling point? www.nhsconfed.org/resources/2014/07/nhs-finances-a-service-at-boiling-point Cracking the innovation nut www.nhsconfed.org/resources/2015/06/ cracking-the-innovation-nut-diffusing-healthcare-innovation-at-pace-and-scale