1. A patient-led NHS
by Department of Health on 12 July 2010 | 17 commentsStrengthen the patient’s ability to exercise extended choice, to manage their care and to have their voice heard within the NHS
Actions: Extend patient choice | Put patients in charge | Publish detailed performance data | Introduce Personal health budgets | Create HealthWatch | Strengthen Care Quality Commission
1.1 Extend patient choice – including how, and by whom, care is delivered
i. Amend the NHS operating framework to allow patients to choose any healthcare provider (from all sectors) to deliver care within the NHS, at NHS standards and within the NHS tariff – (Start Jun 2010)
ii. Publish proposals for extending choice in White Paper – (Start Jul 2010)
iii. Begin preparatory work to give every patient the right to register with the GP practice they want, without being restricted by where they live – (Start Jul 2010)
iv. Give patients the right to register with GP practice of their choice – (Start 2012)
v. Begin preparations for a 24/7 urgent care service (new 111 access number) – (Start Jul 2010)
vi. Begin implementation of comprehensive urgent care services, joining together services such as the ambulance service, GP out-of-hours services, and NHS Direct – (Start Apr 2011)
vii. 24/7 urgent care service operational in every area of England – (Start Apr 2012)
1.2 Put patients in charge of decisions about their care, giving control of health records
i. Outline “information revolution” proposals in White Paper – (Start Jul 2010)
ii. Publish information strategy – (Start Sep 2010)
iii. Consult on information needs and the best methods for structure, collection and distribution, encouraging more organisations to provide information to patients – (Start Sep 2010 – end Jan 2011)
iv. Begin implementation of patient-held records – (Start Apr 2011)
1.3 Begin regular publication of detailed performance data, in an open and standardised format, on all healthcare providers
- (Start Jun 2010)
1.4 Introduce personal health budgets for people with chronic/long-term conditions
i. Continue piloting of personal health budgets – (Start Jun 2010 – end Oct 2012)
ii. Publish final evaluation report of pilot sites – (Start Oct 2012)
iii. Initiate national roll-out, informed by the results of the evaluation – (Start Oct 2012)
1.5 Create HealthWatch, a new body to act as the voice for patients and the public
i. Publish proposals for HealthWatch in White Paper – (Start Jul 2010)
ii. Begin transformation of patient Local Involvement Networks into local HealthWatch – (Start Apr 2011)
iii. Launch HealthWatch nationally – (Start Apr 2012)
1.6 Strengthen the role of the Care Quality Commission
i. Publish White Paper including proposals for the strengthening of the Care Quality Commission and include provisions in Health Bill – (Start Jul 2010)
ii. Implement proposals set out in White Paper, so that the Commission will inspect on the basis of essential standards – (Start Aug 2010 – end Apr 2012)
On 15 July 2010 janine ford said:
A lot of the ‘new’ initiatives are actually existing intitiatives under a new guise or extensions of existing initiative.
It would be helpful to make clear the difference between how the ‘new’ initiative differ from existing ones and . Eg, LINks vs HealthWatch or ‘Putting patients in charge of their care = the old CHoice agenda
On 21 July 2010 Robert said:
Will the private companies have to have patient input as the NHS ones will under the new Local Health Watch or will they be exempt? and how will NHS monies be allocated for investment when Private companies can take patients away (and the money that goes with them)?
On 27 July 2010 paul said:
re 1.1 Extend patient choice – including how, and by whom, care is delivered
i. Amend the NHS operating framework to allow patients to choose any healthcare provider (from all sectors) to deliver care within the NHS, at NHS standards and within the NHS tariff – (Start Jun 2010)
ii. Publish proposals for extending choice in White Paper – (Start Jul 2010)
iii. Begin preparatory work to give every patient the right to register with the GP practice they want, without being restricted by where they live – (Start Jul 2010)
iv. Give patients the right to register with GP practice of their choice – (Start 2012)
As someone who works in an NHS service which has had 3% cuts in real terms in past several years and which plans to have 6-8% cuts in next number of years (this before the coalition government) I would like to query how the above plan will be workable?
With GPs being the commissioners and people being able to choose a GP (say from another area) the patient could for example live in Leeds but decide to have a GP in Liverpool and their care in Brighton. How precisely will this work? Who will get the money (and more importantly the staffing) for this? Leeds/Liverpool or Brighton? Whilst I am all for consumer choice I think the choice does have to be limited as with a menu in a restaurant – you cannot simply decide to have the main meal from the restaurant across the road/in Llandudno.
Some explanors of how this might work on the site would be very useful.
Thanks
On 27 July 2010 Sue said:
Not sure how 1.3 will work i.e Begin regular publication of detailed performance data, in an open and standardised format, on all healthcare providers. For example I am Head of Nursing for a very large regional renal unit. Our pts are immunocompromised and very prone to infection, we put a massive amount of energy, time and finance into the best possible infection control practice, however due to our pts condition we still get over and above the national average for MRSA cases. If figures are just published as raw data and with no explanation of population demographic then some areas will appear to be falsely poor in terms of practice and outcome.
I belive many of the plans in the White Paper are ill though out, rushed and show a complete lack of understanding with regadr to managing the nations health care.
On 27 July 2010 Peter Edwards said:
To really enabe patients to have an effective say in the running of their Health Services; bring back Community Health Councils for every Acute Trust/ P.C.T area. They proved themselves in the past ( to 2002) to be the only effective “regulator” of local health services,and they had the power to make senior health executives listen and change.
On 29 July 2010 Dianne said:
Although it sounds wonderful to be able to register with any practice you wish and this means patients have choice- how practical is this? Surely there has to be some limits in terms of boundaries? Do you really expect a home visit from a GP you are registered with 50 miles away or more ?
I am disappointed that the previous Choice agenda of the last government is being continued,
All patients deserve good quality services as close to home as practical for the type of service. If this was provided why would patients need choice?
On 29 July 2010 Mike Lyall said:
Let Volunteers such as School Goveners Play a part in the setting up
of HealthWatch as commented by Earl Howe recently. Volunteers from
Local communities must be directly be in the new Consotium`s
On 30 July 2010 Anon said:
Does anyone know where PALS (Patient Advice & Liasion Service) fits into the new scheme of things?
On 31 July 2010 Paul said:
GP choice should be limited geographically either at home address or work address. Of course no home visits for work registrations. Dual registration will lead to confusion .
Also commisioning groups will be unable to commision if patients locally use a surgery outside the local commisioning groups but use local A&E, walk-in services.
On 03 August 2010 YS said:
none of what is metioned here is ‘new’ alot of this has already started for e.g. the implementation of the 3 digit number the processes have already strated to implement this.
CQC was strengthened under the Labour Government –
A lack of detail as to what exactly Mr Lansley is proposing to do that is different
GP registration to any GP is clearly not going to work – this has come up so many time over the years and has not been implemented for the simple issue of how is the funding arrangments going to be sorted to allow for this to happen?
On 08 August 2010 Cancer drug fund and public engagement « (the) health informaticist said:
[...] what patients want and expect from a healthcare system. The new government asked people what they wanted from the NHS and also how to save money, it would be good if these were explicitly linked. For now patient [...]
On 09 August 2010 Anne said:
Totally agree with comments above from Paul, Sue, Dianne, YS. As an NHS employee and a patient, choice makes no sense. We just want good services locally. My family and friends agree. Having more commissioning bodies rather than less also makes no sense. You need more bureaucracy to deal with them.
On 24 August 2010 Brian Hepburn said:
On reading through my reaction what a load of complete & utter nonsense.
For choice of GP practice read competition among GP’s i.e. they will be enabled to poach patients from each other. What this government fails to understand is that the NHS is a vital public service, not a for profit business.
What the public wants & indeed, deserves is consistently good quality, properly resourced healthcare delivered locally.
Unfortunately, the government will pay absolutely no heed to us the public & will simply ride roughshod over us.
On 24 August 2010 Jon said:
It is too easy to say all choice is always good…. and it is a nonsense. No one likes to have their own choice reduced – because it feels like disempowerment – but when all the consumers choose and all the choices come into play many people will be disempowered and not get what they want – because supply is always finite. We already see this with the “choice” of schools.
In health if for example a Shrewsbury cardiac unit got the best score in the country and every patient suffering a cardiac complaint chose to go there – who would benefit? Those who got in first would do well (until the staff were overwhelmed and the resources ran out) and those turned away in ambulances would fair less well.
Lets have some bravery and limit the choice juggernaut!
On 26 August 2010 Mike Llywelyn Cox said:
Patient Led? You should get the message across to government ALBs too. For instance NMHDU are having their Recovery Demonstration Sites led by mental health trusts: top down and controlled by the trusts – despite a statement of co-production.
Strategy on the whole a collection of good warm words but we’ve all seen these before. We’ll let you know.
On 08 September 2010 Wendy Elizabeth Day (Miss) said:
Patients should be able to choose which hospital they go to, one nearest them, particularly if they do not drive – accessiblity is important. Perhaps if a hospital can treat you more quickly, it should be ok to go there.
On 09 September 2010 sue said:
I think properly used patient held records could be a great opportunity to involve people in their own health care and encourage them to take more responsibility for the successful outcome of their treatments/ongoing health conditions. In theory they would also ensure geater openess between health professionals and their patients/client. However unless the records are truly a complete and accurate reflection of a persons record they will become simply another form filling exercise. Full and proper sharing of written records will require a substantial change of attitude within the nhs bureaucracy and a committment amongst staff to share power with patients. At the same time it has to be recognised that a depth of relationship between health professional and patient will be vital to to maintain honest and accurate records and this can not be achieved when consultations are timed at 5-10 minute intervals. There is a lot of rhetoric about patient choice and control but this can only be achieved if there are opportunities for patients to be involved in the commissioning of services and have a real imput at all levels of the nhs from ward to board.