2023/24 NHS priorities and operational planning guidance: what you need to know

TRFT Library & Knowledge Service

Jan 3

NHS Confederation - Dec 22

Overview and analysis of NHS England's operational planning guidance and priorities for the service in 2023/24.

Key points

On 23 December 2022, NHS England (NHSE) released its 2023/24 priorities and operational planning guidance, outlining three priority areas for the service: to recover core productivity; progress the aspirations in the Long Term Plan; and transform the health and care system for the future.
We welcome the step change in the approach to this year's guidance. It is notably shorter with fewer targets and promotes genuine partnership between systems and the centre, with a greater emphasis on outcomes and less prescription on how to achieve them. It is also positive to see more flexible funding for systems to deliver on local priorities and that the focus on productivity sits alongside continued investment.
The planning guidance acknowledges that prevention and the effective management of long-term conditions are key to improving population health and curbing the ever-increasing demand for healthcare services. This is at the core of integrated care systems' (ICSs') mission but will require split-screen thinking to deliver this longer-term change at the same time as addressing immediate operational pressures.
While there is progress still to be made, we believe that this signals a welcome trajectory for a new relationship between the service and the centre in the future, which empowers local leaders. This sentiment also reflects NHSE's new operating framework and the aims of the Hewitt Review, which is welcomed in the planning guidance.
Our members are committed to the central aims in the planning guidance. Longer-term financial planning with fewer 'penny packets' will help them to deliver this. NHS performance is challenged everywhere, but this will be best resolved with local solutions rather than national instructions.
While we need to go further and faster in reducing the backlog of elective care, we are, however, concerned that returning to paying full unit prices reintroduces an element of payment by results, a retrograde step that risks undermining innovation, system working and value for money.
The plan rightly acknowledges the critical contribution of our workforce in delivering the priorities. Restating the commitment to publishing a long-term workforce plan is welcome, but decisions on funding and priorities are also required. The ask of leaders to refresh workforce plans for 2023/24 that can deliver more and different as set out in the guidance, while improving staff experience, requires additional investment and resources to what is a complex challenge.
Finally, given the uncertainties around the impact of the current industrial action, which may last well into next year, we recommend that the objectives set out in this guidance are kept under review.

Further information - 2023/24 NHS priorities and operational planning guidance

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