[Withdrawn] DHSC single departmental plan
Updated 20 August 2019
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Our single departmental plan sets out our objectives and how we will achieve them.
Secretary of State for Department of Health and Social Care
Permanent Secretary
The Department of Health and Social Care (DHSC) supports ministers in leading the nation’s health and social care to help people live more independent, healthier lives for longer. We work closely with our partners in the health and care system, our arm’s length bodies (ALBs), agencies, local authorities, across government, and with both patients and the public, ensuring that we are all working with one focus – the people who use our services.
Our objectives
The department’s overall objective is to support ministers in delivering the government’s health and care priorities including the Long Term Plan for the NHS. In particular, we will:
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Keep people safe, leading global health and international relations including Brexit
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Keep people healthy and independent in their communities, supporting the transformation of NHS primary, community and mental health services, and local authority public health and adult social care
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Support the NHS to deliver high quality, safe and sustainable hospital care and secure the right workforce
-
Support research and innovation to maximise health and economic productivity
-
Ensure accountability of the health and care system to Parliament and the taxpayer, and create an efficient and effective department
-
Create value (reduce costs and grow income) by driving excellence in commercial practice across the health and social care system
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Improve health and social care by giving people the technology they need, led by NHSX
1. Keep people safe, leading global health and international relations including Brexit
Lead ministers
Chris Skidmore MP, Minister of State for Health
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care
Baroness Nicola Blackwood, Parliamentary Under Secretary of State for Innovation
Lead official
Clara Swinson, Director General, Global Health
1.1 Protect people’s health
| How we will achieve this |
|---|
| Ensure readiness to manage emergencies affecting the health sector in accordance with the government’s National Risk Assessment (with NHS England and Public Health England) |
| Manage the risk and likely impact of a major pandemic flu or emerging infectious disease outbreak (contributes to SDG 2 & 3) |
| Deliver the health protection programme, including on screening, blood safety, antimicrobial resistance and environmental health protection (with NHS England, Public Health England, and Department for Environment, Food & Rural Affairs) (contributes to SDG 2) |
| Deliver the Global Health Security programme (with Department for International Development) (contributes to SDG 3) |
| Support Public Health England and NHS England to deliver the national immunisation programme covering 16 diseases |
1.2 Prepare the health and social care system to exit from the European Union
| How we will achieve this |
|---|
| Prepare the health and care system to implement the Withdrawal Agreement with the European Union and the Political Declaration, if ratified (Deal) |
| Prepare the health and care system for the possibility of the UK exiting the European Union without the Withdrawal Agreement being ratified (No-Deal) |
1.3 Prepare for future trade negotiations
| How we will achieve this |
|---|
| Continue to develop and implement a trade policy that protects and promotes the interests of the UK’s health and care sector; and ensure trade considerations are integrated in DHSC policy making |
1.4 Manage reciprocal healthcare for UK nationals
| How we will achieve this |
|---|
| Manage the department’s reciprocal healthcare obligations, payments and receipts as part of the work involved in the UK’s exit from the European Union |
1.5 Maximise the UK’s international influence
| How we will achieve this |
|---|
| Lead government’s international engagement on health matters, for example with the World Health Organisation and its member states, to drive progress on UK priority areas and organisational reform (contributes to SDG 16) |
Our performance
Objective 1.1 – MenACWY vaccine coverage data (England) 86.2% 2017/18
School-based vaccination programme for adolescents aimed at one cohort per year. MenACWY routine Cohort 4, born between 1 September 2003 and 31 August 2004 – School Year 9 in 2017/18 (13 to 14 year olds)
Source: Public Health England Meningococcal ACWY immunisation programme; release schedule: annually
2. Keep people healthy and independent in their communities, supporting the transformation of NHS primary, community and mental health services, and local authority public health and adult social care
Lead ministers
Chris Skidmore MP, Minister of State for Health
Caroline Dinenage MP, Minister of State for Care
Nadine Dorries MP, Parliamentary Under Secretary of State for Mental Health, Suicide Prevention and Patient Safety
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care
Baroness Nicola Blackwood, Parliamentary Under Secretary of State for Innovation
Lead official
Jonathan Marron, Director General, Prevention, Community and Social Care
2.1 Enable an affordable, high quality and sustainable adult social care system that meets people’s needs, whilst supporting health and care to join up services around people
| How we will achieve this |
|---|
| Enable a high quality and sustainable social care sector today, working with partners |
| Develop the government strategy for adult social care which addresses sustainability, quality and fairness over the medium term, including the development of the green paper on adult social care reform |
| Support the NHS Long Term Plan’s transformation aims around more personalised care, more healthcare delivered in the community and better integrated services across health and social care, including reviewing the future of the Better Care Fund |
| Lead the Ageing Society Grand Challenge by supporting cross-government policy collaboration and stimulate investment in products and services which support healthy ageing and economic growth, whatever the Brexit outcome (contributes to SDG 8) |
2.2 Improve people’s health; strengthen the public health system and reduce inequalities
| How we will achieve this |
|---|
| Deliver programmes of work to promote healthy behaviours, including on tobacco, alcohol, drugs, sexual health and physical activity ensuring that the programmes are consistent with the prevention objectives in the NHS Long Term Plan (contributes to SDG 3) |
| In support of wider government objectives, deliver programmes of work for vulnerable groups, including victims of crime and violence, child sexual abuse/exploitation, female genital mutilation, rough sleeping; and lead work to reduce health inequalities, including contributing to the Race Disparity Audit (contributes to SDG 3, 10 & 16) |
| Implementation of 2 major delivery programmes: a new Medical Examiner system and organ donation consent legislation |
| Lead a programme of work on childhood obesity – delivering the commitments in chapters 1 and 2 of the childhood obesity plan and developing future chapters including as part of the Prevention Green Paper |
| Deliver the Public Health Regulation workstream of the department’s Brexit preparation programme |
2.3 Improve health and care through better use of primary care and the voluntary sector
| How we will achieve this |
|---|
| Strengthen the primary care workforce and access to primary care, including working towards the 5,000 extra doctors in general practice target |
| Set the strategic framework for general practice and support its implementation to enable the delivery of the NHS Long Term Plan |
2.4 Improve the lives and outcomes for people with mental health needs, dementia and disabilities
| How we will achieve this |
|---|
| Improve mental health services and their links to other public services to ensure delivery of key commitments on mental health, in particular the Five Year Forward View for Mental Health, NHS Long Term Plan, reform of mental health legislation, and Health Education England’s Mental Health Workforce Plan (contributes to SDG 3) |
| Develop policy and strategy to prevent onset of mental ill health and intervene early, including for children, young people and at-risk groups, and reduce health inequality (contributes to SDG 3 & 10) |
| Implement the Dementia 2020 challenge (contributes to SDG 3) |
| Improve the quality of life and reduce health inequalities for autistic and disabled adults; including through building the right community support to reduce the need for, and improve the experience of, inpatient care for those with the most complex needs (contributes to SDG 3 & 10) |
2.5 Develop community pharmacy to provide a more efficient service whilst maintaining patient access and improving quality
| How we will achieve this |
|---|
| Develop and deliver community pharmacy contractual framework reforms for 2019/20 and beyond |
| Set Drug Tariff reimbursement prices and reform the arrangements to achieve better value for the NHS |
2.6 Deliver continued efficiencies in the medicines budget whilst ensuring patients have access to appropriate, safe and cost-effective medicines
| How we will achieve this |
|---|
| Manage the strategy and operational delivery of the 2019 Voluntary Scheme for Branded Medicines Pricing and Access and the statutory medicines pricing scheme |
| Lead mitigation and management of medicines supply disruptions, including delivery of the agreed contingency plans to manage the supply of medicines whatever the Brexit scenario |
| Ensure that effective regulation of medicines and medical devices continues whatever the Brexit scenario |
Our performance
Objective 2.2 – Prevalence of adult smoking in England
| Year | Smoking prevalence |
|---|---|
| 2017 | 14.9% |
| 2016 | 15.5% |
| 2015 | 16.9% |
| 2014 | 17.8% |
Source: Public Health England – Public Health Outcomes Framework; release schedule: annually
Objective 2.2 – Prevalence of childhood obesity
| Year | Reception year | Year 6 |
|---|---|---|
| 2017/18 | 9.5% | 20.1% |
| 2016/17 | 9.6% | 20.0% |
| 2015/16 | 9.3% | 19.8% |
| 2014/15 | 9.1% | 19.1% |
| 2013/14 | 9.5% | 19.1% |
| 2012/13 | 9.3% | 18.9% |
Prevalence of child obesity by school year and year of measurement
Source: National Child Measurement Programme - England; release schedule: annually
Objective 2.3 – Proportion of population who benefit from extended access services, England
| Month | Proportion of population |
|---|---|
| February 2019 | 99.8% |
| January 2019 | 99.8% |
| December 2018 | 99.9% |
| November 2018 | 99.5% |
| October 2018 | 98.4% |
| September 2018 | 80.7% |
| August 2018 | 68.2% |
| July 2018 | 64.9% |
Source: NHS England CCG Improvement and Assessment Framework; release schedule: annually
Objective 2.4 – Total NHS spend on mental health (£m) and percentage of clinical commissioning groups meeting Mental Health Investment Standard
| Year | Total NHS Spend (£m) | % of clinical commissioning groups meeting Mental Heath Investment Standard – see note 2 |
|---|---|---|
| 2018/19 (planned) – see note 1 | £12,154.9 | 100% |
| 2017/18 – see note 1 | £11,976.0 | 90% |
| 2016/17 | £11,601.9 | 85% |
| 2015/16 | £10,978.9 | 81% |
Note 1: This does not include additional expenditure allocated during the course of 2018/19
Note 2: To calculate whether the Mental Health Investment Standard will be met based on the planned spend figures for 2018/19, the 2017/18 actual spend figures used must be adjusted to exclude the expenditure against additional allocations made during the year. The Mental Health Investment Standard calculation also does not include planned or actual spend on learning disabilities and dementia, which is included in the total mental health spend presented here. Specialised commissioning spend is not included in the mental health investment standard compliance calculation.
Source: NHS England Mental Health Five Year Forward View Dashboard; release schedule: quarterly
3. Support the NHS to deliver high quality, safe and sustainable hospital care and secure the right workforce
Lead ministers
Chris Skidmore MP, Minister of State for Health
Caroline Dinenage MP, Minister of State for Care
Nadine Dorries MP, Parliamentary Under Secretary of State for Mental Health, Suicide Prevention and Patient Safety
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care
Lead official
Lee McDonough, Director General, Acute Care and Workforce
3.1 Improve health through employment
| How we will achieve this |
|---|
| Deliver on government commitment to see one million more disabled people in work by 2027 over the next 10 years because good work is generally good for our health (with Department for Work and Pensions) (contributes to SDG 3 & 10) |
3.2 Assure the quality, safety and effectiveness of NHS hospitals
| How we will achieve this |
|---|
| Ensure services across the health and care system are of the highest quality and patients are safe in the NHS’s care through ongoing system regulation and oversight, embedding programmes that promote a culture of learning and continuous improvement, and the delivery of a new national patient safety strategy for the NHS |
| Oversee delivery of NHS litigation cost savings and complete implementation of the general practice indemnity scheme |
3.3 Support service improvements in cancer care, maternity and to armed forces veterans
| How we will achieve this |
|---|
| Work with system partners to improve services across the health and care system, including supporting NHS England to deliver commitments in the Cancer Strategy and in the NHS Long Term Plan and ensuring health services for veterans are tailored to their needs (with NHS England and Ministry of Defence) (contributes to SDG 3) |
| Oversee the delivery of the Secretary of State’s ambition to reduce rate of stillbirths, neonatal deaths, maternal deaths and brain injuries in babies soon after birth by 20% by 2020 and 50% by 2025 and to reduce pre-term births from 8% to 6% by 2025 (contributes to SDG 3) |
3.4 Secure the staff needed to deliver affordable high quality health and social care
| How we will achieve this |
|---|
| Ensure the health and social care system workforce is prepared for all Brexit scenarios |
| Help ensure the successful development and implementation of the NHS People Plan, which reflects the changes needed in supply, culture and leadership in order to deliver the ambitions of the NHS Long Term Plan (contributes to SDG 3) |
| Ensure we have a social care workforce of the right size with the right skills in order to deliver our ambitions for social care |
| Ensure the NHS has appropriate pay, pensions and terms and conditions to attract and support the staff required to deliver the ambitions of the NHS Long Term Plan |
3.5 Improve hospital access and flow, and the delivery of NHS performance standards, including considering NHS proposals for improvements to existing access standards in the best interests of patients
| How we will achieve this |
|---|
| Assure priority delivery across all the core performance standards and the delivery of improvements to services, as set out in the Accountability Framework 2019-20 |
| As set out in the NHS Long Term Plan and Interim Clinical Review of Standards, consider proposals on improvements to existing access standards ensuring they take account of engagement with staff, patients and the public, and that proposals are evidence based, affordable and deliverable |
| Ensure continued effective implementation of the Ambulance Response Programme, including the blue light radio network |
3.6 Maximise the resources available for patient care through efficient use of provider funding
| How we will achieve this |
|---|
| Ensure recovery of income from overseas visitors and migrants not entitled to NHS-funded care, and operate the injury cost recovery scheme |
| Ensure reduction in unnecessary spend on costly staffing agencies, through supporting the development of in-house temporary staff arrangements, helping to put the NHS back onto a sustainable financial path as set out in the NHS Long Term Plan |
| Deliver on the NHS Long Term Plan to achieve savings to the NHS through operational productivity improvements and reducing unwarranted variation, to total £5.8 billion of recurrent savings by the end of 2021 |
Our performance
Objective 3.5 – Patients spending less than 4 hours in accident and emergency from arrival to admission, transfer or discharge
| Month and year | Patient attendance |
|---|---|
| April 2019 | 85.1% |
| March 2019 | 86.6% |
| February 2019 | 84.2% |
| January 2019 | 84.4% |
| December 2018 | 86.4% |
| November 2018 | 87.6% |
| October 2018 | 89.0% |
| September 2018 | 88.9% |
| August 2018 | 89.7% |
| July 2018 | 89.3% |
| June 2018 | 90.8% |
| May 2018 | 90.4% |
Source: NHS England A&E Attendance and Emergency Admissions; release schedule: monthly
Objective 3.5 – Incomplete referral to treatment pathways waiting less than 18 weeks
| Month and year | Referral to treatment pathways |
|---|---|
| March 2019 | 86.7% |
| February 2019 | 87.0% |
| January 2019 | 86.7% |
| December 2018 | 86.6% |
| November 2018 | 87.3% |
| October 2018 | 87.1% |
| September 2018 | 86.7% |
| August 2018 | 87.3% |
| July 2018 | 87.8% |
| June 2018 | 87.8% |
| May 2018 | 88.1% |
Source: NHS England Referral to Treatment Times; release schedule: monthly
Objective 3.5 – Mean response rate for Red 1 incidents by ambulances 7 minutes 1 second April 2019
Source: NHS Ambulance Quality Indicators; release schedule: monthly
4. Support research and innovation to maximise health and economic productivity
Lead minister
Baroness Nicola Blackwood, Parliamentary Under Secretary of State for Innovation
Lead official
Professor Chris Whitty, Chief Scientific Adviser
4.1 Improve the health and wealth of the nation through health research and science policy
| How we will achieve this |
|---|
| Provide leadership, direction and strategic oversight of the NHS, public health and social care research system, ensuring they are prepared for any Brexit scenario |
| Lead on rare diseases policy and science advice to inform developments aimed at ensuring the UK remains the world-leader in genomics building on the 100,000 Genomes Project |
4.2 Provide the evidence to enable a safer, more efficient and effective health and care system
| How we will achieve this |
|---|
| Prioritise and commission research through the National Institute for Health Research to meet the needs of patients and the public in England (contributes to SDG 9) |
| Support global health research that will deliver benefits to those in low and middle income countries (contributes to SDG 17) |
4.3 Optimise the business environment for life sciences and healthcare to enable economic growth from the life sciences industries and support the NHS to increase patients’ access and uptake of cost-effective innovations
| How we will achieve this |
|---|
| Implement the vision of the Life Sciences Industrial Strategy and deliver the Life Sciences Sector Deal programmes |
| Accelerate access to and uptake of innovative technologies in the NHS, as a key part of the Life Sciences Industrial Strategy and through the Accelerated Access Collaborative (contributes to SDG 17) |
Our performance
Objective 4.1 – The number of participants recruited via the Clinical Research Network to studies supported by the National Institute for Health Research
| Year | Number of participants |
|---|---|
| 2018/19 | 870,250 |
| 2017/18 | 725,333 |
| 2016/17 | 665,000 |
Source: National Institute for Health Research; release schedule: annually
5. Ensure accountability of the health and care system to Parliament and the taxpayer; and create an efficient and effective department
Lead ministers
Chris Skidmore MP, Minister of State for Health
Caroline Dinenage MP, Minister of State for Care
Jo Churchill MP, Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care
Lead official
David Williams, Director General, Finance and Group Operations
5.1 Set the strategic direction of the health and care system, support ministers and provide effective internal governance and accountability
| How we will achieve this |
|---|
| Help ensure the successful implementation of the NHS Long Term Plan, maximising the value from the additional funding of £33.9 billion by 2023/24 |
| Support ministers to set the strategy for the health and care system through strategic policy advice and delivering the 2019 Spending Review |
| Provide assurance to the Board that departmental performance, risk, high value business case investments, programme and project management are being managed effectively across the health system |
| Work to ensure that public appointments made by DHSC contribute to realising the ambition that by 2022, 50% of all public appointees are female and 14% of all public appointments made are from ethnic minorities |
5.2 Ensure the health and social care system lives within its means, now and in the future; and is accountable to ministers, Parliament and taxpayers for efficient and effective delivery
| How we will achieve this |
|---|
| Deliver financial balance in DHSC and its arm’s length bodies, holding NHS England and NHS Improvement to account for delivering financial balance of the NHS |
| Provide strategic medium and long term financial planning, including financial policy changes to support implementation of the long-term plan and to ensure the NHS capital regime supports the most efficient investment and maintenance of capital assets |
| Provide full transparency and Parliamentary accountability through publication of our annual report and accounts |
| Maintain an effective counter fraud response through continued policy and capability development – progress measured against a cumulative £300 million fraud reduction target by 2020/21 (from 2017/18 baseline) |
5.3 Develop our leaders, capability and skills to create an inclusive and great place to work
| How we will achieve this |
|---|
| Embed an inclusive culture where everyone has the opportunity to achieve their potential and which aligns with our values – fair and inclusive; respectful and confident; open and engaged |
| Promote the department as a great place to work, recognised as an exemplar on learning and development and where health and wellbeing is prioritised |
5.4 Make the department a great and efficient place to work and support transformation of the NHS estate
| How we will achieve this |
|---|
| Set the strategy for, maintain, improve and transform operational service delivery through workplaces, technology and smarter working that support the department in delivering its objectives as efficiently as possible |
| Improve NHS estates capability to support planning and delivery of estate transformation, including targeting the disposal of surplus NHS land sufficient for 26,000 homes by 2020 |
5.5 Inform and engage the public, media and stakeholders on health and social care
| How we will achieve this |
|---|
| Design and deliver insight-led, impactful campaigns and engagement programmes to support departmental objectives including campaigns on: Social Care Green Paper, Prevention Green Paper and Autism |
Our performance
Objective 5.3 – People survey engagement score
| Year | Engagement score |
|---|---|
| 2018 | 63% |
| 2017 | 62% |
| 2016 | 45% |
Source: Civil Service People Survey; release schedule: annually
Objective 5.3 – Representation of female staff, ethnic minority staff and disabled staff
| Year | Female | Ethnic minority | Disabled |
|---|---|---|---|
| 2018 | 64.5% | 23.4% | 5.9% |
| 2017 | 64.0% | 22.6% | 5.2% |
| 2016 | 63.0% | 22.0% | 4.6% |
Source: Civil Service Diversity and Inclusion Dashboard; release schedule: quarterly
Percentage of reduction of greenhouse gas emissions against the 2009/10 baseline
| Year | % reduction |
|---|---|
| 2016/17 | 46% |
| 2017/18 | 53% |
Source: Greening Government Commitments annual reports; release schedule: annually
6. Create value (reduce costs and grow income) by driving excellence in commercial practice across the health and social care system
Lead ministers
Chris Skidmore MP, Minister of State for Health
Baroness Nicola Blackwood, Parliamentary Under Secretary of State for Innovation
Lead official
Steve Oldfield, Chief Commercial Officer
6.1 Support, challenge and assure the health and social care system to deliver improved commercial outcomes
| How we will achieve this |
|---|
| Drive improvement in quality of commercial management by leading the Health Commercial Function and supporting, challenging and assuring the health and social care system, focusing particularly on building commercial capability and capacity |
| Support, challenge and assure the DHSC-owned companies and hold them to account, including sponsorship of NHS Business Services Authority and Healthcare UK |
6.2 Ensure the successful implementation of the Future Operating model
| How we will achieve this |
|---|
| All the components of the new operating model, including the category towers and enablers, will be live by end 2019/20 |
| The Procurement Transformation Programme will support the planned transition and operational stabilisation activity for NHS Supply Chain successfully before the programme is brought to a close |
Our performance
Objective 6.1 – Procurement savings achieved by March 2020 7%
Source: Department of Health and Social Care; release schedule: annually
Objective 6.1 – Percentage of procurement spend that is allocated to small and medium sized enterprises
| Year | Percentage of total spend |
|---|---|
| 2017/18 | 22.0% |
| 2016/17 | 21.8% |
| 2015/16 | 22.7% |
Source: Central Government Spend with SMEs; release schedule: annually
7. Improve health and social care by giving people the technology they need, led by NHSX
Lead minister
Baroness Nicola Blackwood, Parliamentary Under Secretary of State for Innovation
Lead official
Matthew Gould, Chief Executive Officer of NHSX
7.1 Improve health and social care by giving people the technology they need
| How we will achieve this |
|---|
| Ensure that citizens have access to the information and services they need, including through delivery of the NHS Long Term Plan |
| Ensure that patient information can be securely accessed wherever it is needed for safer, better care |
| Reduce the time clinicians spend inputting and accessing patient information |
Our performance
Objective 7.1 – Uptake of the NHS App 3,192 users December 2018
Number of users registered on the app during the pilot
Source: NHS Digital NHS App pilot research findings; release schedule: annually
Public Value Framework
To support the delivery of our objectives, we will be improving our performance against the Public Value Framework in the following areas: implementing planning and monitoring progress, capacity to evaluate impact, public and taxpayer legitimacy and workforce capacity.
Our equality objectives
We have set objectives to help us advance equality and contribute to SDG 5. These are:
- We aim to build an inclusive culture within the department which values and respects diversity, where everyone can achieve their potential. As an employer we are also committed to the Civil Service ambition to become the UK’s most inclusive employer.
- Improve the lives and outcomes for people with mental health needs, dementia and disabilities.
- Enable an affordable, high quality and sustainable adult social care system that meets people’s needs, whilst supporting health and care to join up services around people.
- Improve people’s health; strengthen the public health system and reduce inequalities.
- Improve health through employment.
- Tackle the gender pay gap in the health service workforces.
Our finances
Resource Departmental Expenditure Limit (DEL) (including depreciation): £133.6 billion
Capital DEL: £5.9 billion
Resource Annually Managed Expenditure (RAME): £11.4 billion
Capital Annually Managed Expenditure (CAME) £15 million
Net Cash Requirement (NCR) £118.5 billion
Control totals included in this document are in line with those presented in the Main Supply Estimates 2019/20 published by HM Treasury on 9 May 2019.
Source: Main Supply Estimates 2019/20
Our people
As at 31 December 2018, DHSC had 1,530 full-time equivalent employees, not including its agencies.
Source: ONS public sector employment data; release schedule: quarterly