Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

Additional ICB Strategic Priorities

ICB Strategic Priority: Improve access to health and care services

ICB Challenge:
Care arranged around service needs rather than people; and workforce shortages

Expected outcomes

Governance Groups:
ICB Primary Care Board and ICB Performance Board

What our residents say:
A survey into Joint Forward Plan priorities, carried out in 2023 by the ICB and thematically analysed by Healthwatch Hertfordshire heard from 1,124 respondents, predominantly aged 50+.

  • When asked whether they would be prepared to travel to have non-urgent treatment more quickly, 70% said that they would be prepared to travel to another location in Hertfordshire or west Essex, and 59% said that they would be prepared to travel to a neighbouring area.
  • 77% of respondents agreed that they would be happy to receive initial healthcare advice from a telephone appointment
  • 15% (60) of respondents suggested that the NHS could do more to support people by improving access to services. For example, a large proportion felt that the NHS needs to shorten waiting times, particularly in relation to GP services, secondary care and mental health services.
  • 90% of people surveyed said that they would be happy to see other professionals, such as a physiotherapist, social prescriber or practice nurse if this person had the skills required to help them, rather than wait to see a GP.

Suggestions included:

  • “More appointments face to face available - GP surgeries open longer hours; patients able to see their doctor on day/next day that they are ill - not in 2 weeks’ time”.
  • “Much quicker access to appointments. Specialists should actually read referral notes instead of making incorrect assumptions. Give timely appointments and treat emergencies in an urgent manner.”
  • “Make access to different services quicker and easier so you don't have to keep waiting for a GP for example.”
  • “They need to shorten wait times for both seeing a local GP, dentist or outpatients.”

Year 1 priority actions

  1. Transform services and access for Same Day Emergency Care (SDEC) with a particular focus on Long Term Conditions (LTCs) and anticipatory care, and community alternatives to ED and ambulances
  2. Deliver elective care more efficiently including utilisation of Elective Hubs and Community Diagnostic Centres (CDC).

For further details about key deliverables across the next five years, please refer to pages 71 - 77 of the PDF.

ICB Strategic Priority: Achieve a balanced financial position annually

ICB Challenge: 30% Reduction in ICB Running Costs by the end of 2024-25

Expected outcomes

  • Financial Balance achieved each year. 
  • Efficiency and productivity targets achieved.

Governance Groups:
ICB Finance and Investment Committee

Year 1 priority actions

  1. Deliver elective care more efficiently

For further details about key deliverables across the next five years, please refer to page 78 and 79 of the PDF.


ICB Strategic Priority:

Deliver a programme of cancer improvement to support our population living well with and beyond cancer.

2023/24 and 2024/25 Cancer Service Development Funding:

  • support delivery of LTP commitments for cancer, including ambition to diagnose 75% of cancers at an early stage by 2028 and improvements in operational performance for cancer.

ICB Challenge:

  • Meet the Long-Term Plan ambition of 75% of patients diagnosed with Stage 1 and 2 cancers.
  • Improved operational performance underpinned by implementation of best practice timed pathways to support ongoing recovery and time to diagnosis and treatment.
  • Cancer Alliance funding received in 2023/24 for a programme of support and improvement initiatives to deliver
  • improved diagnostic pathways that underpin an earlier stage of diagnosis.

Expected outcomes:

Early diagnosis and detection of cancer

  • Improved stage 1 and 2 rates of cancer
  • Patient living healthier and longer with their cancer diagnosis
  • Reduced rates of mortality and 1 and 5 years
  • Improved outcomes
  • Improved screening uptake
  • Targeted screening activities
  • Community based models of earlier detection of precancerous conditions.

Improved time to diagnosis and treatment

  • Improved operational performance for 28-day Faster Diagnosis Standard and 31-day treatment times.
  • Reduced 63-day backlog size
  • Less invasive diagnostic and treatment interventions
  • Improved and faster tumour site specific pathways
  • Non-site-specific symptoms pathway developments

Year 1 priority actions

Improved stage 1 & 2 diagnosis – (75% by 2028) - Ongoing awareness session and activities to support cancer information, awareness, and understanding

Improved cancer operational performance

  • Take steps to improve performance against the Faster Diagnosis Standard (FDS)
  • Reduced 63-day Priority Target List (PTL) size

In addition to the above continued performance against the following cancer waiting times standards:

  • 31-day treatment (First Treatment, Subsequent Surgery, Subsequent Drugs & Subsequent Radiotherapy)
  • 62-day urgent referral to first treatment (Urgent GP, Urgent Screening and Consultant Upgrade)

Improved screening uptake

Targeted Lung Health Checks (TLHC)

  • Mobilisation of a TLHC health check programme within an identified area (east & north Herts) 4-year
  • programme, aligned to the national aim of 100% population coverage for eligible populations (55-75
  • years, smokers or ever smoked) by 2026/27.


  • Improved screening uptake - maximise uptake of breast, bowel and cervical screening.
  • Ongoing activities to support cancer awareness, understanding and engagement across the population.

Improve extended use and implementation of cancer innovation tools and techniques

Faecal Immuno Testing (FIT):

  • Further embed the utilisation of FIT testing in primary care to support Lower GI referrals.

Cytosponge – Supporting the Upper Pathway:

  • Further develop the secondary care services in place as Pilots at ENHT and PAHT.
  • Deliver a Cytosponge pilot within Community Setting (CYTOPRIME2).

Tele-dermatology – supporting the Skin pathway:

  • Evaluate current Tele-dermatology pilots and implement Tele-dermatology services for patients referred for a suspected skin cancer

Other Priority Cancer Pathway developments

  • Embed and extend Non-Site-Specific Pathways
  • Support patients who present to their GP or ED within non-site-specific symptoms. 

Breast – Community Breast Pain Clinics

  • ENHT – has a community-based breast pain clinic pilot in place and the aim is to embed this pilot, evaluate after the 12-month period.
  • PAHT – small acute based breast pain clinic in place for a limited patient cohort (<40yrs of age).
  • WHTH –acute based breast pain clinic will be launched. 

Transition ENHT community-based breast pain clinic pathway to substantive.

  • Develop PAHT and WHTH community-based breast pain clinic pathway and commence transition to a community-based model.

For further details about key deliverables across the next five years, please refer to pages 80 - 83 of the PDF.


Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

Download the full plan