The Department of Health has committed to working alongside the NHS to support the phased roll out of extended patient choice of Any Qualified Provider (AQP).
Operational guidance to the NHS setting out plans to deliver the Government’s commitment to extending patient choice of provider has been published.
The roll out will start with selected community and mental health services from April 2012. These services* are:
Services for back and neck pain
Adult (18+), community service for back and neck pain – manual therapy
Adult hearing services in the community
Age-acquired 55+ and GP referral only
Continence services (adults and children)
Bladder and bowel, non-prescribable products, referral and self-referral
Direct Access Diagnostic tests
Non-obstetric ultrasound, MRI
Wheelchair services for adults and children – access, assessment, provision and on-going support
Primary Care Psychological Therapies (adults) (‘talking therapies’)
16+ years, referrals and self-referral, including IAPT
Adult and children’s core podiatry (including diabetes); specialised orthotics and footwear provision including biomechanics
* 12 October 2011: The above list was updated to add definitions of each service.
The guidance sets out key actions for implementation:
- by 30 September 2011, all PCT clusters, supported by pathfinder clinical commissioning groups, should have engaged patients, patient representatives, Health and Wellbeing Boards, healthcare professionals and providers on local priorities for extending choice of provider.
- by 31 October 2011, clusters and clinical commissioning groups should have used the feedback from this engagement to identify three or more community or mental health services for implementation, drawing from the national list or local priorities.
- SHAs should be notified of cluster/commissioning group priorities for 2012/13. This information will be shared with the Department to inform the next phase of the national choice offer.
To provide support to the NHS and gain the benefits of shared learning, the Department will work with volunteer PCT Clusters to produce ‘Implementation Packs’ for the priority services. Each region is, currently, confirming volunteer AQP commissioners (PCT clusters working with emerging Clinical Commissioning Groups) to co-produce packs with the Department. The implementation packs will be available for the NHS to use from November 2011. This approach will enable to test implementation and secure the benefits of collaboration, for example, minimising the cost and bureaucracy to the system and creating effective but simple governance arrangements.
Why this is being done
In developing this guidance, DH has engaged with clinicians, providers, commissioners, patient groups and voluntary organisations on how best to extend patient choice of provider. The Department has talked to these groups about which services should be subject to patient choice, how qualification criteria for providers can help to reduce bureaucracy and assure quality, and how the procurement process for extending choice of provider should operate. The approach to implementation has been developed in response to what we have heard.
The goal is to enable patients to choose any qualified provider where this will result in better care. Choice of provider is expected to drive up quality, empower patients and enable innovation. Importantly, extending choice of AQP provides a vehicle to improve access, address gaps and inequalities and improve quality of services where patients have identified variable quality in the past.
A phased approach is being adopted and commissioners are being asked to engage locally to determine where choice of any qualified provider best meets the demands of patients, and is expected to deliver quality improvements. The department will work with the NHS to ensure lessons are learned from each stage of the rollout. Commissioners will continue to control both contracts and prices, and to challenge providers to deliver services of the highest quality.