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SR2002/DH

15 July 2002

NHS & Personal Social Services: New Public Services Agreement sets out key priorities, backed by resources and reforms

The Government today published a new Public Service Agreement for the Department of Health, setting out key delivery priorities for the NHS and social services.

The Rt Hon Alan Milburn MP, Secretary of State for Health, said:

"The new Public Service Agreement describes the key improvements that the public can expect to see from the Government's programme of extra resources backed by far-reaching reform. The document that I published at the time of the Budget, Delivering the NHS Plan, set out how we will continue increasing the number of trained staff working in the NHS and reforms to strengthen devolution, encourage diversity and promote choice. Resources plus reforms are already delivering results: last week my Department was able to announce that we now have 39,000 more nurses and 10,000 more doctors in the NHS than in 1997. Waiting times are falling and death rates from cancer and heart disease are improving."

In Budget 2002 the Chancellor of the Exchequer announced the biggest ever sustained growth in NHS expenditure, with real terms growth in UK resources of 7.3 per cent over the next five years, amounting to over £40 billion more spent on the NHS in 2007-08 than in 2002-03. The Chancellor also announced that Social Services resources in England would increase by an average of 6.0 per cent a year in real terms, providing an extra £3.2 billion by 2005-06.

The Prime Minister and Chancellor have agreed with the Secretary of State for Health a new Department of Health Public Service Agreement (PSA). The PSA (attached at the annex) sets out the priorities that the NHS and social services will be expected to deliver with the new resources. It includes maximum waiting times for hospital treatment, with the existing target of a 6 months maximum wait by 2005 reinforced by a new maximum target of three months by 2008. Existing priorities are restated on introducing booked appointments for all hospital appointments by 2005 to increase patient choice, tackling health inequalities, reducing death rates from cancer and heart disease and tackling drug abuse. And a new target is being set for social services to help more older people live independently at home. The Department of Health will shortly be making an announcement on how the extra social service resources will be used to deliver this target.

To ensure that the new resources deliver the PSA priorities, the Secretary of State for Health announced at the time of the Budget a series of reforms to strengthen devolution and accountability in the NHS:

  • Resources and responsibility for delivery will be progressively devolved, with the greatest freedoms and flexibilities going to the best performing local organisations, underpinned by a new incentive system of payments to hospitals by results.
  • Accountability of local organisations for delivery will be reinforced by the creation of two independent streamlined inspectorates for health and social services, with an annual report to Parliament by the new health inspector on performance and how resources have been used. As capacity grows, accountability to patients will also be strengthened by greater patient choice. And from this autumn every household in the country will receive a patient prospectus on local NHS performance, using data validated by the independent inspector.

Notes for editors

1. The NHS and Personal Social Services settlements were announced by the Chancellor in his Budget Statement on 17 April 2002, in the light of the recommendations of the Wanless Review of long term health trends.

2. The Government conducted a comprehensive review of public services - the Comprehensive Spending Review - in 1998. The 2000 Spending Review built on this by setting targets and allocating resources for the three years to 2003-04. The 2002 Spending Review revises these plans for 2003-04 and outlines new plans for 2004-05 and 2005-06 for social services spending and up to 2007-08 for the NHS.

3. For further details please contact the Department of Health media centre on 0870 000 6244.

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Annex

Department of Health Public Service Agreement

AIM: Transform the health and social care system so that it produces faster, fairer services that deliver better health and tackle health inequalities.

Objective 1 Improve service standards

  1. Reduce the maximum wait for an outpatient appointment to 3 months and the maximum wait for inpatient treatment to 6 months by the end of 2005, and achieve progressive further cuts with the aim of reducing the maximum inpatient and day case waiting time to 3 months by 2008.
  2. Reduce to four hours the maximum wait in A&E from arrival to admission, transfer or discharge, by the end of 2004; and reduce the proportion waiting over one hour.
  3. Guarantee access to a primary care professional within 24 hours and to a primary care doctor within 48 hours from 2004.
  4. Ensure that by the end of 2005 every hospital appointment will be booked for the convenience of the patient, making it easier for patients and their GPs to choose the hospital and consultant that best meets their needs.

Enhance accountability to patients and the public and secure sustained national improvements in patient experience as measured by independently validated surveys.

Objective 2 Improve health and social care outcomes for everyone

  1. Reduce substantially the mortality rates from the major killer diseases by 2010: from heart disease by at least 40 % in people under 75; from cancer by at least 20 % in people under 75.
  2. Improve life outcomes of adults and children with mental health problems through year on year improvements in access to crisis and CAMHS services, and reduce the mortality rate from suicide and undetermined injury by at least 20 % by 2010.
  3. Improve the quality of life and independence of older people so that they can live at home wherever possible, by increasing by March 2006 the number of those supported intensively to live at home to 30 per cent of the total being supported by social services at home or in residential care.
  4. Improve life chances for children, including by:
    - improving the level of education, training and employment outcomes for care leavers aged 19, so that levels for this group are at least 75% of those achieved by all young people in the same area, and at least 15% of children in care attain five good GCSEs by 2004. (The Government will review this target in the light of a Social Exclusion Unit study on improving the educational attainment of children in care.)
    - narrowing the gap between the proportions of children in care and their peers who are cautioned or convicted; and
    - reducing the under-18 conception rate by 50% by 2010.
  5. Increase the participation of problem drug users in drug treatment programmes by 55 % by 2004 and by 100 % by 2008, and increase year on year the proportion of users successfully sustaining or completing treatment programmes.

By 2010 reduce inequalities in health outcomes by 10 % as measured by infant mortality and life expectancy at birth.

Objective 3 Value for money

  1. Value for money in the NHS and personal social services will improve by at least 2 % per annum, with annual improvements of 1 % in both cost efficiency and service effectiveness.

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