John Lister assesses the published drafts of the plans for implementing the Five Year Forward View published by NHS England in 2014. They envisage a major switch of treatment from hospitals to non-hospital settings, and a reduction in the need for healthcare through measures to prevent illness and through helping people to take more care of their own health. NHS services are expected to become more accessible and effective while at the same time costing less, and thus closing the growing funding gap between what the government is committed to spend and what the NHS, as currently organised, needs.
The assessment finds that the plans rest on implausible assumptions and lack credible implementation measures. It concludes that the scale of the planned reduction in hospital services implies rationing and risks the collapse of some services.