The NHS long-term plan offers a chance to put learning and skills at the heart of improving health and wellbeing and carries key lessons for our sector.
The plan sets out how the NHS in England intends to spend the extra £20 billion the government has promised it by 2023, as well as its plans for the next ten years.
I think there are three reasons why this matters for the learning and skills sector.
It shows the value of a long-term plan
The 70th birthday of the NHS provided a helpful hook for thinking about the longer-term future of the NHS. It gave an opportunity to look at the long-term impacts of an ageing population and other societal changes including advances in technology, outside of the confines and limits of a three-year spending review cycle that controls spending on an annual basis.
The same thing was true in the early 2000s when the Labour government commissioned the Wanless Review to look at long-term health needs, making the case for new ways to deliver and funded by a rise in national insurance contributions.
It’s pretty easy to make the same case for a long-term plan for learning and skills, as Commons Education Select Committee chair Robert Halfon has persuasively argued. Indeed many of the components of the argument would be the same: longer working lives and an ageing population combined with advances in technology and changes in the labour market all mean we need to learn more throughout our lives. And taking a longer view gives a greater ability to plan and invest – change takes time.
So why not set out a vision for learning, skills and employment in 2030 and a path to get there, backed by long-term investment?
Learning, skills and employment can improve health and wellbeing
I was pleased to see the plan for the NHS recognise that health isn’t just about health services.
This could be seen in the recognition of the need to support people to make healthy choices and the commitment to greater use of social prescribing – GPs referring patients, where appropriate, to learning and other community activity.
At the Learning and Work Institute, we set out the evidence that learning and work can improve health and wellbeing last year. We also called for a step change in social prescribing. It’s good news these were part of the NHS plan.
There’s still much further to go to make learning, skills and employment the golden thread running through public policy and to translate strategy into action and investment on the ground.
It sets out a view of the provider base needed for the future and the limits of markets
One of the most interesting things for me in the NHS plan was a call to repeal parts of the Health and Social Care Act 2012 in order to exempt the NHS from part of the public procurement regulations and to make other legislative changes.
The starting point is a vision for an integrated care system, recognising that people’s health and care needs are often complex.
The view of the NHS is that integrating health support is more likely to be effective than competition underpinned by a split between producers and providers. So the request is not about wanting to exclude private providers.
Rather, they reflect a view that the best way to deliver care is in an integrated way and that in practice the application of these rules has limited the ability of the NHS to do this.
'A clear step forward'
A quote from the plan is instructive: “The Acts of Parliament that currently govern the NHS give considerable weight to individual institutions working autonomously when the success of our plan depends mainly on collective endeavour. Local NHS bodies need to be able to work together to redesign care around patients, not services or institutions, and the same is also true for the national bodies.”
There are some important lessons for the learning and skills sector here. I’ve argued previously that we need a vision for the system and then a commissioning and funding approach that finds the best way to deliver that. At present, we don’t have that vision so the various commissioning and procurement decisions risk taking us on a random walk to an unknown destination.
This is not necessarily to say that public procurement regulations should not apply to the learning and skills sector. Rather that we need to start from a vision of the system that would best meet the needs of individuals and employers, and then work from there.
Learning and skills are vital to the future of our economy and society. Taking a long-term view would be a clear step forward.
Stephen Evans is the chief executive of the Learning and Work Institute