Corporate report

Shared delivery plan: 2015 to 2020

Published 19 February 2016

This corporate report was withdrawn on 14 December 2017

This has been replaced by another version.

Applies to England

£116.4bn Total Departmental Expenditure Limit (DEL) in financial year 2015 to 2016

This includes £111.6 billion resource DEL and £4.8 billion capital DEL.

Source: Spending Review and Autumn Statement 2015

Vision

Nothing could be more central to giving security to people through every stage of their life than the NHS. On the back of a strong economy, the government is investing £10 billion more by 2020, backing the NHS’s own improvement plan, the Five Year Forward View, improving access to a free and high quality health service.

The Department of Health will set the direction and coordinate action across the health and care system, which comprises public health, the NHS and adult social care. We work with our partners to ensure everyone can access the health and care they need, from supporting people to have the best start in life, to staying in good health and, where that might not be possible, supporting people to live as independently as they can.

We are committed to providing for patients and the public the highest quality, most compassionate health and care service in the world, built on the guiding principles of the NHS – that access to health care is based on need and not the ability to pay, and that services are not just comprehensive and available to all, but of high quality.

We will champion the power of patients and the public through greater focus on safety, compassionate care and transparency. People will be able to see a GP and receive the same quality hospital care 7 days a week. While leading the world in improving cancer care, making maternity services safer and confronting dementia, we will transform mental health provision for children and adults.

Across the system, our plan to integrate health and social care services by 2020 will bring about more joined-up care. To reduce the demand on our health and care system and contribute to its long term sustainability, we will take action to improve people’s health – focusing as much on the prevention of poor health as we do on treating illness.

We will continue to pioneer and innovate to ensure the NHS is world-leading in all it does, and makes its important contribution to the growth of the UK economy. We will lead on global challenges, including through our research into new treatments and technologies and how we protect against health threats.

To achieve these ambitions, the health and care system must be a service that is well-led, always learning to improve, and more efficient – reducing waste and making sure public money is spent wisely.

Our ministers and management

Objectives

1. Improving out-of-hospital care

Lead minister: Alistair Burt, Minister for Community and Social Care

Lead officials: Jon Rouse, Director General Social Care, Local Government and Care Partnerships; Simon Stevens, Chief Executive, NHS England; Jim Mackey, Chief Executive, NHS Improvement; and Ian Cumming, Chief Executive, Health Education England

1.1 What we are doing

Greater investment in primary care services and more doctors in general practice will help to improve access 7 days of the week and provide more preventive and person-centred care, particularly for people with long term health conditions.

The government’s plans for locally-led integration of health and social care services will bring about more joined-up care and improve the range of out-of-hospital services. The Better Care Fund has set the foundation, but the government wants to go further and faster to join up care, enabling local areas to design and develop new models of care tailored to meet their populations’ needs. Some parts of the country are already demonstrating new approaches that the government supports – such as Greater Manchester’s devolved model, which enables more radical pooling of health and social care funding. The Spending Review set out the ambition that every part of the country must have an integration plan in 2017, to be implemented by 2020.

Alongside their physical health, people’s mental health and social care needs will be better met. This will be done through improved access to talking therapies for mental health, and by having access to social care that offers independence and improved well-being.

Increased funding for mental health care will also mean more community-based places of safety for those suffering mental health crises. We will enforce the new access and waiting time standards for people experiencing mental ill-health, and continue to develop new standards including for children and young people.

Support for carers will be improved and the specific needs of people with learning disabilities and autism will be addressed. Women will have access to mental health support during and after pregnancy.

We will give people easier and more convenient access to GP services. Patients will be able to get GP appointments at evenings and weekends, provided either by their own GP practice or by a group of GP practices working together. For urgent needs, one call to NHS 111 will allow patients to arrange to see or speak to a GP or another professional 24 hours a day, 7 days a week.

People over 75 will be guaranteed a same-day appointment. Everyone will have a right to a specific named GP who will be responsible for coordinating their care.

By making smarter use of digital technology and innovative ways of working, we will provide more effective and cost efficient health and care services.

We will:

• ensure by 2020 everyone should be able to see a GP 7 days a week from 8am to 8pm
• restore the right to a specific, named GP
• guarantee same-day GP appointments for all over 75s who need them
• invest more in primary care to help prevent health problems before they start
• continue to integrate the health and social care systems, joining up services between homes, clinics and hospitals, including through new approaches like the pooling of around £6 billion of health and social care funding in Greater Manchester and the £5.3 billion Better Care Fund
• increase funding for mental health care
• provide significant support for mental health
• ensure there are therapists in every part of the country providing treatment for those who need it, with a commitment to increase access to psychological therapies from 15% to 25% of those who might benefit by 2020
• expand intensive home treatment and psychiatric liaison services as part of our commitment to improving 24/7 access to mental health support
• ensure proper provision of health and community based places of safety for people suffering mental health crises
• ensure that women have access to mental health support, during and after pregnancy, while strengthening the health visitor programme for new mothers
• enforce the new access and waiting time targets for people experiencing mental ill-health, including children and young people
• increase support for full-time unpaid carers
• cap charges for residential social care from April 2020
• guarantee that people will not have to sell their home to fund social care
• allow deferred payment agreements, so no one has to sell their home
• limit individual liabilities from April 2020, protecting people from unlimited costs if they develop very serious care needs

1.2 How we are doing

For the specific set of priorities in this plan we will report on the following headline metrics:

Emergency bed days per 1,000 of population: 43.6

Improved care in out-of-hospital settings is expected to lead to reduced need for emergency admissions to hospital, and to shorter stays for those who are admitted, and hence a fall in the number of emergency bed days per head of population (age/need standardised). This figure is for September 2015 and we would expect the number to fall over time.

Source: Hospital Episode Statistics and GP registered lists data

Proportion of people with a learning disability on the GP register receiving an annual health check 44%

Health checks for people with learning disabilities in primary care settings help to identify previously unrecognised health problems, some of them associated with life-threatening illnesses. This figure is for 2013 to 2014 and we would expect later years to show a higher figure.

Source: Public Health England - The Uptake of Learning Disabilities Health Checks, 2013 to 2014

Mental health access (6 weeks) 80%

of patients start treatment within 6 weeks under the Improving Access to Psychological Therapies programme. Under our access standards, 75% of patients are expected to start treatment within 6 weeks. Data for July 2015. We aim to keep levels above our 75% standard.

Source: Health and Social Care Information Centre

Mental health access (18 weeks) 96%

of patients start treatment within 18 weeks under the Improving Access to Psychological Therapies programme. Under our access standards, 95% of patients are expected to start treatment within 18 weeks. Data for July 2015. We aim to keep levels above our 95% standard.

Source: Health and Social Care Information Centre

We use the outcomes frameworks for public health, NHS and social care to measure the wide range of ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

2. Creating the safest, highest quality healthcare services

Lead minister: Ben Gummer, Minister for Care Quality

Lead officials: Charlie Massey, Director General Strategy and External Relations; David Behan, Chief Executive, Care Quality Commission (CQC); Sir Mike Richards, Chief Inspector of Hospitals, CQC; Sir Bruce Keogh, NHS Medical Director, NHS England; Sir Andrew Dillon, Chief Executive, NICE; and Jim Mackey, Chief Executive, NHS Improvement

2.1 What we are doing

Everyone deserves care that is safe, compassionate and effective, at all times and regardless of their condition. Our ambition is that English hospitals and GP surgeries are among the safest in the world. We will work to provide a service in which people’s experience of their care is as important as their individual clinical needs, which will be borne out by the higher proportion of people who rate their standard of care as ‘excellent’ or ‘very good’ on the Family and Friends Test.

By supporting the NHS to have the confidence to put things right when they go wrong, and by being accountable for and learning from mistakes and incidents, we will build a better service for those who work in it and for those who use it.

Learning on this scale, and working in partnership with other healthcare systems around the world, will help us meet the population’s changing needs. This focus on safety should contribute to a reduction in avoidable deaths and harm including reducing unacceptable variations in the quality of maternity care. By ensuring the Care Quality Commission rates hospitals, care homes and GP surgeries we will continue to root out poor care and to promote excellence. Patients who need urgent and emergency hospital care should have access to the same high quality services, regardless of the day they fall ill or are admitted to hospital. All patients will receive the same high quality of assessment, diagnosis, treatment and review any day of the week.

We will close the quality gap identified in the Five Year Forward View and reduce health inequalities for physical and mental health. We will deliver the new strategy recommended by NHS England’s cancer taskforce, working with the NHS, charities and patient groups, and continue to invest in the Cancer Drugs Fund.

We will make sure that choice, compassion, dignity and respect remain at the heart of everything the NHS does, with a particular focus on ensuring that everyone has the best possible end of life care. We will support those who commission services to better combine health and social care services for the terminally ill. This will include taking better account of individual needs in decisions about end of life care, so that more people can die in a place of their choice – including at home.

We will:

• ensure English hospitals and GP surgeries are among the safest in the world
• roll out 7-day services in hospital to 100% of the population (4 priority clinical standards in all relevant specialities, with progress made on the other 6 standards) so patients receive the same standards of care, 7 days a week
• continue to eliminate mixed-sex wards and hospital infections
• ensure the NHS is accountable when mistakes are made
• implement the recommendations of the independent review into the Stafford Hospital scandal
• ensure the Care Quality Commission rates all hospitals, care homes and GP surgeries
• continue to back expert chief inspectors to promote excellence and root out poor care
• continue to ensure that we have enough doctors, nurses and other staff to meet patients’ needs and consider how to best recognise and reward high performance
• improve standards in all areas of care
• maintain and increase the number of people recommending services in the Friends and Family Test
• implement the NHS’s own plan, the Five Year Forward View, to improve health care even further
• continue to invest in the Cancer Drugs Fund
• deliver the new strategy recommended by NHS England’s cancer taskforce, working with the NHS, charities and patient groups
• ensure hospitals are properly staffed so the quality of care is the same every day of the week
• support commissioners to combine better health and social care services for terminally ill

2.2 How we are doing

NHS staff survey measure: ‘my organisation acts on concerns raised by patients and service users’ 73.2%

Percentage of people who feel ‘my organisation acts on concerns raised by patients and service users’ (NHS Staff Survey 2014). Staff perceptions are a useful indicator of the extent to which organisations do act on concerns raised by patients. The percentage of staff who feel their organisation does act is increasing. We would expect to maintain or improve on this percentage.

Overall patient experience score (OPES) based on the Care Quality Commission adult inpatient survey 76.6 out of 100

Patient surveys capture objective views of patients on specific aspects of their care. For each service area, it is possible to combine patient responses into a single overall patient experience score out of 100. This figure represents results derived from the adult inpatients survey. We would expect to maintain or improve this level of patient experience.

Based on 2014 to 2015 Care Quality Commission adult inpatient survey.

One year survival for all cancers 68.2%

The percentage of people surviving 1 year after a diagnosis of cancer is a key outcome indicator. There is a steadily increasing trend in 1-year survival rates for all cancers. Figure for the year 2011. We would expect later figures to show a continued increasing trend.

Source: Office for National Statistics

Number of trusts in special measures 15

The number of trusts in special measures will vary over time. If trusts enter special measures, the number will increase. As issues are resolved and trusts leave special measures, the number will fall. Figure as at 30 November 2015. We would expect this number to fall over time.

Percentage of organisations rated as outstanding on safety and percentage rated as good on safety by Care Quality Commission

	Percentage of acute trusts (%)
Inadequate	17
Requires improvement	70
Good	13
Outstanding	0

	Percentage of mental health trusts (%)
Inadequate	9
Requires improvement	86
Good	5
Outstanding	0

We would expect the percentage of organisations rated as good or outstanding to increase over time.

Source: Care Quality Commission. Data up to December 2015

Reporting of patient safety incidents 471,000 reports

This indicator is a measure of transparency of reporting, rather than a direct measure of safety. Reported incidents form a relatively low proportion of the overall true figure. We encourage incident reporting and would expect to see an increase in the number of incidents reported to the National Reporting and Learning Service. This figure relates to the quarter April to June 2015. We would expect this number to increase in later quarters, as reporting of incidents improves.

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

3. Maintaining and improving performance against core standards while achieving financial balance

Lead minister: Lord David Prior, Minister for NHS Productivity

Lead officials: David Williams, Director General, NHS Group, Finance and Commercial; Simon Stevens, Chief Executive, NHS England; and Jim Mackey, Chief Executive, NHS Improvement

3.1 What we are doing

Demand on the NHS is growing every year, and the service continues to provide high standards of care while also pushing for improvement where it is needed. The Spending Review set out the government’s commitment to providing real terms growth in our £116.4 billion budget so that the service can continue to perform well over the next 5 years.

The NHS will have the capacity to deal with rises in demand during the winter months, while maintaining standards in treating diseases such as cancer and to continue to play its part in any national emergency. NHS England, with NHS Improvement, will ensure the NHS balances its budget, including commissioners and providers living within their budgets.

At the same time, we will address the longer term issues that lead to increased demand in emergency care: changing services so they meet the needs of today’s patients, with stronger coordination of health and social care and access to the services that patients need 7 days a week; reducing unwarranted variations in performance such as waiting times for operations or emergency care; and supporting the public and patients to take the right steps to look after their own health.

We will:

• increase NHS funding in real terms every year (by a minimum of £8 billion over the next 5 years)
• support the Sustainability and Transformation Fund
• implement the Carter programme

3.2 How we are doing

Patients with incomplete referral to treatment pathways waiting less than 18 weeks 92.5%

Consultant-led referral to treatment waiting times measure from patient referral for non-emergency treatment (usually by a GP) until the start of first definitive treatment. The operational standard is that at least 92% of patients on incomplete non-emergency pathways (that is, yet to start treatment) should have been waiting no more than 18 weeks from referral. Figure for September 2015. We would expect to maintain performance above our 92% standard.

Source: NHS England Referral to Treatment times

Percentage of patients spending less than 4 hours in accident and emergency from arrival to admission, transfer or discharge 93.5%

Our operational standards say that 95% of patients attending an A&E department should wait less than 4 hours from arrival until they are admitted, transferred or discharged. Figure for September 2015. We would aim to maintain performance above our 95% standard.

Source: NHS England A&E waiting time statistics

Percentage of patients who began first treatment within 62 days of an urgent GP referral for cancer 81.5%

Early treatment for cancer is an important factor in improving outcomes. Our operational standards say that 85% of patients with an urgent GP referral should begin first treatment within 62 days. Figure for September 2015. We would aim to maintain performance above our 85% standard.

Source: NHS England

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

4. Improving efficiency and productivity of the health and care system

Lead minister: Lord David Prior, Minister for NHS Productivity

Lead officials: David Williams, Director General, NHS Group, Finance and Commercial; Simon Stevens, Chief Executive, NHS England; Jim Mackey, Chief Executive, NHS Improvement; and Sir Andrew Dillon, Chief Executive, NICE

4.1 What we are doing

We will spend taxpayers’ money more efficiently and reduce waste – to help make sure that every pound possible is spent on patient care.

We will reinvest the efficiency savings identified in the NHS’s Five Year Forward View, into frontline health services by 2020 to 2021. The savings will be achieved by reducing running costs, paying the right price for equipment, reducing avoidable hospital admissions and improving the quality of care. The recommendations in the Carter Review are already helping hospitals to improve staff management practices to ensure staff spend more time with patients and less time on paperwork.

We will ensure there is good financial management across the NHS including, for example, recovering the cost of healthcare - up to £500 million by the end of 2017 to 2018 - from overseas visitors and migrants who use its services. We will focus on encouraging the best and most productive ways of working throughout the NHS, including a greater focus on safety, which has been shown to save money.

We will continue to deal with immediate financial challenges and planning for longer-term efficiencies, supported by £10 billion of additional government investment in the NHS and coupled with wider actions to eliminate trust deficits like reducing spend on agency staff.

More efficient use of resources across the NHS, public health and social care will create the financial stability needed to meet the demands of today’s and tomorrow’s patients, with services that are more responsive and accessible, and that help people to stay in good health for longer.

We will:

• implement the NHS’s own plan, the Five Year Forward View, to improve health care even further
• recover up to £500 million from migrants who use the NHS by the middle of the Parliament

4.2 How we are doing

NHS income from outside the group £9.1bn

The departmental group includes Department of Health itself, arm’s length bodies including Public Health England and NHS England, NHS providers, non-departmental public bodies, NHS charities and other group bodies. The income into this group of organisations from external sources could come, for example, from sales of goods and services or income from overseas patients (data for 2014 to 2015 financial year). We would expect figures for later years to show an increasing trend.

Source: Department of Health Accounts

Annual growth in cost-weighted activity 3.1%

The government’s mandate to NHS England for 2016 to 2017 says that 2020 goals include year-on-year gains in NHS efficiency and productivity (2 to 3% each year), including from reducing growth in activity.

The NHS is a complex system that produces many different types of activity. A cost-weighted activity index is a means of measuring the overall quantum of activity, counting up the amount of activity carried out by reference to the average cost of each type of activity.

This figure is for the 2014 to 2015 financial year, compared to the 2013 to 2014 financial year, and is sourced from a wide range of activity data from NHS England and the Health and Social Care Information Centre.

We would expect this rate of growth to decline in future years.

Agency expenditure growth 30.5%

In 2014 to 2015, agency expenditure growth was around 30% per annum. The government’s mandate to NHS England includes a 2016 to 2017 financial year deliverable to reduce agency spend by £0.8 billion on a path to further reductions over the Parliament.

We would expect agency expenditure to fall in future years.

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

5. Preventing ill health and supporting people to live healthier lives

Lead minister: Jane Ellison, Minister for Public Health

Lead officials: Dame Sally Davies, Chief Medical Officer; Felicity Harvey, Director General, Public and International Health; Jon Rouse, Director General, Local Government and Care Partnerships; Simon Stevens, Chief Executive, NHS England; Duncan Selbie, Chief Executive, Public Health England; and Ian Hudson, Chief Executive, Medicines and Healthcare Products Regulatory Agency (MHRA)

5.1 What we are doing

We will create a healthier society by supporting people to make lifestyle changes to improve their physical and mental health and prevent avoidable disease – such as giving up smoking, drinking alcohol within the UK Chief Medical Officers’ new guidelines, eating healthily, reducing drug use, helping more people recover from drug and/or alcohol dependence and being physically active. This will not only improve people’s health, it will improve all aspects of people’s lives – from education to employment and the wider contribution they are able to make to their community and to society. Across all our work to create a healthier society, we will take particular account of the need to reduce health inequalities.

We will review how best to support those suffering from long-term, but treatable, conditions (such as drug and alcohol addiction or obesity) to enable them to stay in employment or to get back into work.

We have already invested in an expansion of the health visitor programme, and have made it obligatory for local authorities to give every child 5 universal health visitor reviews. These reviews assess a child’s development from pre-birth to the age of 2 and a half.

We will reduce rising levels of obesity – particularly among children – and make sure that health and care services work with individuals, communities and industry to deal with this issue in radical and innovative ways, as well as continuing to promote the need for industry to provide clear food information, supporting consumers to make the healthier choice the easier choice.

We will work to improve treatment and care for people with diabetes by making sure they are supported to better manage their condition, and to avoid associated complications. We will also do more to reach the 5 million people at high risk of developing Type 2 diabetes via the NHS Diabetes Prevention Programme. Alongside this we will reduce variation in treatment and care for people with diabetes.

The Prime Minister’s 2020 Dementia Challenge and the launch of the UK’s first Dementia Research Institute will mean we continue to have a leading role in the global fight against dementia, with a focus on raising awareness, improving care for people living with the disease, reducing risk and on seeking a cure.

Our ongoing work to address global threats to public health, such as infectious diseases and drug resistance, will also be taken forward both nationally and internationally.

We will:

• review how best to support those suffering from long-term, but treatable, conditions (such as drug and alcohol addiction or obesity) back into work. People who might benefit from treatment should get the medical help they need and if they refuse treatment we will review whether their benefits should be reduced
• reduce childhood obesity
• continue to promote clear food information
• implement a national, evidence-based diabetes prevention programme
• deliver the Prime Minister’s 2020 Dementia Challenge
• continue to combat antibiotic resistance, taking forward the findings of the independent review

5.2 How we are doing

Prevalence of childhood obesity

	Prevalence of childhood obesity (%)
Boys (aged 4/5)	9.5
Girls (aged 4/5)	8.7
Boys (aged 10/11)	20.7
Girls (aged 10/11)	17.4

Measured through the National Child Measurement Programme (2014/15)

We aim to reduce levels of obesity, particularly among children. The National Child Measurement Programme measures the prevalence of obesity for children at 2 key ages: aged 4/5 (school reception) and aged 10/11 (school year 6). Figures are presented separately for boys and girls. We would expect these percentages to fall in future years.

Slope indices of inequality in life expectancy at birth based on national deprivation deciles within England

(Data for this metric presented under Objective 7)

Slope indices of inequality in healthy life expectancy at birth based on national deprivation deciles within England

(Data for this metric presented under Objective 7)

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

6. Supporting research, innovation and growth

Lead ministers: George Freeman, Minister for Life Sciences; Alistair Burt, Minister for Community and Social Care

Lead officials: Dame Sally Davies, Chief Medical Officer; Professor Chris Whitty, Chief Scientific Adviser; Will Cavendish, Director General Innovation, Growth and Technology; Sir Andrew Dillon, Chief Executive, NICE; Ian Hudson, Chief Executive, MHRA; Duncan Selbie, Chief Executive, Public Health England; and Simon Stevens, Chief Executive, NHS England

6.1 What we are doing

We will build on Britain’s status as a world leader in clinical research and the life sciences to better understand how we diagnose and treat diseases and revolutionise our approach to treatment to improve health. We will also give the sector the support it needs to bring ideas to life and help the UK economy grow, improving health outcomes, and maximising participation in the workforce, including by supporting those with long-term disabilities or treatable conditions back into work.

We will continue to explore the best use of data in the NHS to develop new approaches to patient care and treatment. The 100,000 Genomes Project will radically change the way we treat diseases such as cancer, enabling drugs and treatment to become more personalised and gene-specific. We are identifying ways to get new drugs, devices and diagnostics to NHS patients more quickly and cost-effectively by implementing the findings of the Accelerated Access Review into innovative medicines and medical technologies. More than 84,000 people have already benefited from access to drugs made available through the Cancer Drugs Fund.

We will continue to fund and carry out research via the Policy Research Programme and National Institute of Health Research (NIHR), and encourage further investment by the life sciences industries through the NIHR research system and our Life Sciences Strategy.

We will encourage a culture of innovation and exploration to ensure the NHS is among the best in the world in meeting the healthcare challenges of the 21st century.

We will:

• support a long-term economic plan by fostering research, innovation and jobs in the life science industry
• support modern industrial approaches, such as the Life Sciences strategy, to help people compete and win in the intense global race for high value, high knowledge jobs
• increase the use of cost-effective new medicines and technologies, and encourage large-scale trials of innovative technologies and health services
• speed up access to new medicines by implementing the findings of Accelerated Access Review
• continue to support research to improve the diagnosis and treatment of rare diseases and cancers, including through decoding 100,000 whole genomes
• prioritise funding for dementia research

6.2 How we are doing

Publications from National Institute for Health Research funding that provide evidence to support government and NHS priorities for health and care 3,791

Number of publications in Quarter 2 of financial year 2015 to 2016. NIHR funded research provides evidence and data to support our aims and priorities for the NHS, for example by identifying more efficient ways of delivering the same outcomes. We would expect this number to be higher in future years.

Source: National Institute for Health Research

Industry income in health life sciences from contract and collaborative studies through the National Institute for Health Research £130.0m

Income from contract and collaborative studies has grown steadily to around £130 million in 2014 to 2015. We would expect this figure to increase in future years.

Source: National Institute for Health Research

Number of studies from contract and collaborative studies through the NIHR infrastructure 3,008

The number of such studies has also grown to 3,008 in financial year 2014 to 2015. We would expect this number to be higher in future years.

Source: National Institute for Health Research

Life science exports £28.8bn

The current value of exports in the life science sector is £28.8 billion (2014). We would expect this figure to increase in future years.

Source: Office for National Statistics (ONS) and Ernst & Young (EY) analysis for the Office for Life Sciences (OLS)

Growth in foreign direct investment in life sciences 8.4%

In 2014 the annual growth rate in the amount of foreign direct investment arising in the health life sciences sector was 8.4%. We would expect this figure to increase in future years.

Source: Financial Times Foreign Direct Investment markets data

Number of whole genomes sequenced 6,597

The latest figures relate to 1 February 2016. This figure is expected to increase in future years.

Source: Genomics England

Employment rate for disabled people 45.7%

Our aim is to halve the employment gap for disabled people. This figure tells us that around 46% of disabled people were in employment in the quarter July to September 2015. This proportion has been relatively stable in recent years. We would expect the figure to increase gradually in the future years.

Source: Office for National Statistics Labour Force Survey

Read the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

7. Enabling people and communities to make decisions about their own health and care

Lead minister: Ben Gummer, Minister for Care Quality

Lead officials: Charlie Massey, Director General Strategy and External Relations; Jon Rouse, Director General, Local Government and Care Partnerships; Simon Stevens, Chief Executive, NHS England; and Duncan Selbie, Chief Executive, Public Health England

7.1 What we are doing

We will create opportunities for people and communities to play important roles in supporting each other to live healthy, active lives. We will increase partnership working between the voluntary and statutory sectors and work to reduce health inequalities.

We will ask people to share their views and opinions on their health and care so they can influence the design of new services and improve their existing ones by working in partnership.

All patients will be involved in decisions about their own health and care, including greater use of personal care budgets, supported by health professionals who treat them as individuals with unique needs and aspirations.

Giving patients access to health care information such as patient records will help inform people’s choices (including in end of life care) and, in turn, feedback on patient experience will help improve quality and performance across the health and care system.

We will use innovative digital technologies to give people easier access to services, enabling them to provide faster, more responsive feedback on their care and to take more control over their own health and wellbeing.

We will:

• ensure family doctor appointments and repeat prescriptions are routinely available online
• boost transparency even further, ensuring you can access full information about the safety record of your hospital and other NHS or independent providers, and give patients greater choice over where they receive care
• give patients access to their electronic health records, while retaining their right to opt-out of their records being shared electronically

7.2 How we are doing

Overall patient experience score (OPES) based on the Care Quality Commission adult inpatient survey.

(Data for this metric presented under Objective 2)

Slope indices of inequality in life expectancy at birth based on national deprivation deciles within England

	Years of life
Males	9.1
Females	6.9

Range of years of life expectancy at birth across the social gradient for males and females. Data for the period 2011 to 2013.

Slope indices of inequality in healthy life expectancy at birth based on national deprivation deciles within England

	Years of life
Males	19.2
Females	19.5

Range of years of health life expectancy at birth across the social gradient for males and females. Data for the period 2011 to 2013.

Life expectancy at birth, and the number of years of healthy life expectancy at birth, are indicators of overall health outcomes. The slope index of inequality is a measure of the level of inequality in these health outcomes between more and less deprived areas. The slope index represents the range in years of life expectancy and healthy life expectancy across the social gradient, from most to least deprived, taking account of health inequalities across the whole range of deprivation within England. We present the slope index separately for men and women. There has been little change in inequalities in life expectancy and healthy life expectancy by area deprivation over recent years, although for male life expectancy there has been a slight narrowing in inequalities since the mid-2000s. We would expect these figures to fall in future years.

Source: Public Health Outcomes Framework indicator 0.2

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

8. Building and developing the workforce

Lead minister: Ben Gummer, Minister for Care Quality

Lead officials: Charlie Massey, Director General, Strategy and External Relations; Simon Stevens, Chief Executive, NHS England; Ian Cumming, Chief Executive, Health Education England; and Jim Mackey Chief Executive, NHS Improvement

8.1 What we are doing

We will make sure the health and care system workforce has the right skills and the right number of staff in the most appropriate settings to provide consistently safe and high quality care.

To improve people’s access to services in their local communities at their convenience – and to support professionals providing care – we will expand the primary care workforce, including 5,000 more doctors in general practice by 2020.

We will invest in recruitment and improve retention of NHS staff, enable the provision of more training places for doctors and nurses and develop new and different roles. This will be essential to help us introduce more 7-day services and greater integration between acute, community and social care services. Through a culture of continuous learning, transparency and support, staff will be helped and encouraged to make changes and to come up with new and innovative ways to provide services.

We will strengthen leadership across the NHS and social care so that the health and care system has the strong, highly skilled workforce it needs to be able to meet the healthcare challenges of the 21st century.

We will:

• ensure hospitals are properly staffed so the quality of care is the same every day of the week
• ensure by 2020 everyone can see a GP at evenings and weekends
• continue to ensure that we have enough doctors, nurses and other staff to meet patients’ needs and consider how to best recognise and reward high performance
• ensure there are therapists in every part of the country providing treatment for those who need it

8.2 How we are doing

See the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services

9. Improving services through the use of digital technology, information and transparency

Lead minister: George Freeman, Minister for Life Sciences

Lead officials: Will Cavendish, Director General Innovation, Growth and Technology; (Vacant) Chief Information and Technology Officer, NHS England; and Andy Williams, Chief Executive, Health and Social Care Information Centre

9.1 What we are doing

We must realise the potential benefits of better use of data and technology to improve the quality, convenience, efficiency and effectiveness of our services in line with public expectations of other sectors.

Better use of technology, information and connected data systems will enable health and care services to become integrated, and free up time for professionals to focus on providing the best possible care. By 2018, clinicians in primary care, urgent and emergency care and other important services will work without the use of paper records and, by 2020, all health and care records will be digital and will be updated in real time.

The My NHS website brings together transparent, comparable information on the quality of health and care services. We will further develop intelligent transparency to improve services, give people more control over their own health and care, support informed choices and provide public accountability.

People will have access to their own electronic health and care records and, from March 2018, will be able to record their own comments and preferences in them. They will be able to book family doctor appointments and order repeat prescriptions online.

Patients will be clear about how their confidentiality is protected and about when they can object to data being used, in line with the recommendations from the National Data Guardian review.

Researchers will be able to use information drawn from the system to develop new medicines, treatments and improvements to the quality and safety of care.

Approved health apps will be available from 2016 to 2017 on NHS.UK, which will also become a single point of access to health services and advice.

We will:

• ensure family doctor appointments and repeat prescriptions are routinely available online
• boost transparency even further, ensuring you can access full information about the safety record of your hospital and other NHS or independent providers, and give patients greater choice over where they receive care
• give patients access to their electronic health records, while retaining their right to opt-out of their records being shared electronically

9.2 How we are doing

See also the outcomes frameworks for public health, NHS and social care which measure the ways in which the health and care system is improving health outcomes for patients, their experience of care, and the quality of services.

10. Delivering efficiently: supporting the system more efficiently

Lead minister: Jane Ellison, Minister for Public Health

Lead official: Tamara Finkelstein, Chief Operating Officer and Director General for Group Operations

10.1 What we are doing

As a department we are committed to working with our agencies and arm’s length bodies to reduce our operating costs over the Parliament, while continuing to improve the efficiency and effectiveness of our services through:

• devising a new operating model and organisation design to make our policy making and the health and care system more flexible
• continuing to develop an integrated technology infrastructure, which can be used by any of our organisations
• reducing accommodation costs through better use of space, relocation and rationalisation
• improving the way information is stored and managed
• creating self-service corporate services that can be shared across organisations

10.2 How we are working collaboratively across government

We will work collaboratively with Cabinet Office, HM Treasury and other government departments to deliver major change in important areas, including:

• rationalising our estate in a joined-up way, looking to develop ‘government hubs’ with other government departments, and ‘health hubs’ across the system, releasing land for housing where possible and participating in the development of the new commercial property model
• achieving savings in our commercial relationships, including through spending on common goods and services, working in partnership with Crown Commercial Services
• continuing to build our commercial capability and working with Crown Commercial Services to contribute towards the government’s commitment to spend 33% of its money with small and medium sized enterprises by 2020
• continuing the implementation of work to reduce prescription fraud by £150 million by 2018. The department will complete a wider review of anti-fraud activity by April 2016 and develop an anti-fraud strategy that will seek to identify and reduce loss through fraud in the health system
• working with Next Generation Shared Services in the Cabinet Office to develop a shared service arrangement: the department will continue to encourage its arm’s length bodies to use a shared services solution, including NHS Shared Business Services