Approach and methods

In this report, we provide a narrative overview of the main developments following the publication of the NHS Long Term Plan in 2019 to June 2021. We then offer an assessment of the progress made against the main commitments in the plan.

The plan contains a large number of pledges and promises in its 136 pages (estimated to contain more than 100 commitments and 500 general ambitions). To assess progress, we focus on the indicators specified in NHS England’s implementation framework, published in June 2019 (shown in full at Annex A), and which also feature on NHS England’s website as ‘Long Term Plan Headline Metrics’.

Finally, we offer some analysis of what this means for the timing and ordering of what the NHS aimed to do in the long term plan, over 2 very different years ago.


Our analysis is based on publicly available data and documents. For the narrative of events, we used our COVID-19 policy tracker, covering events in 2020, supplemented by searches of government and other websites for developments since. We used a mix of data to assess progress. Where there are specific datasets referred to in the long term plan, we used these to assess how far national commitments had been delivered. Where new measures were promised but are yet to be developed, we used other national datasets on the same topic (for example, findings from the NHS staff survey on wellbeing in lieu of a new wellbeing metric).

Where data were missing, we accessed NHS England press releases, board papers, annual or other reports, and submissions to parliamentary committees or questions. For additional context, we also looked at reports produced by professional organisations and patient charities, in addition to relevant publications by official bodies, including the National Audit Office, Healthwatch and the Care Quality Commission.

Our assessment only provides a limited picture. We focus on the ‘headline metrics’ in the plan, which do not include commitments and general ambitions to improve care for major conditions including stroke, cardiovascular and respiratory disease, and other areas. Gaps in data make it difficult to assess progress in some of the priority areas. And new data on progress against different aspects of the long term plan are always emerging; the main analyses were based on data collected between February and May 2021, and as a result may have omitted more recent data. Nonetheless, the report attempts to give a comprehensive overview of COVID-19’s impact on the long term plan so far.

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