NHS Future Forum to provide channel for patient and staff opinion

Andrew Lansley has announced that a new group of patient representatives, doctors and nurses will be brought together to listen and report back to Government.

Chaired by Birmingham GP and former Royal College of General Practioners Chairman Steve Field, the new NHS ‘Future Forum’ will provide a valuable channel for the thoughts and opinions of patients and staff on the ground.

Steve Field, the Chair of the new NHS Future Forum, said:

“It’s a great pleasure to chair the NHS Future Forum. Listening to people on the ground is vital, and I see this as a real chance for people to have their say in shaping the future of the NHS.”

In News, NHS Future Forum, Working together for a stronger NHS | Tagged , ,

40 Responses to NHS Future Forum to provide channel for patient and staff opinion

  1. Dr Bob Cant says:

    As a retired healthcare professional (not a GP) I am pleased to see that there is to be further opportunity for consultation on the proposed NHS reforms.
    I have two particular points of concern:
    - the fact that competition and ‘any willing providers’ are central to the reforms makes me concerned that patients’ needs will take on a secondary role. Private providers from large multi-national companies will be at an advantage over voluntary sector providers and agencies with more local knowledge. Any competitive element needs to be treated as a factor which is secondary to patients’ needs.
    - the commissioning bodies need to be more broad based and more representative than what is currently being proposed and I hope that secondary care providers, public health professionals, local councils and community representatives, among others, will be included as equal, voting members of these bodies.
    I await the outcome of the consultation with interest.
    Yours sincerely,
    Dr Bob Cant

  2. Isla Dowds says:

    Please advise how the patient representatives on this forum will be selected and how you will ensure that seldom heard and overlooked groups are well represented. What provision will be made for people who have sensory, physical, mental, learning impairments to participate? What provision will there be for people who may not speak English as their first language? How will the views of young people be included? What are you doing to ensure that people who would find participation difficult becuase of financial limitations are included?

    How will you communicate the findings of this exercise clearly and completely to the public?

    How will you evaluate this exercise, where and when will that evalaution be published?

    I look forward to hearing from you.

    I Dowds

  3. Hedda Lilley says:

    If you are really listening, then retain PCT’s, who have been working hard over the last few years to implement DOH policy. Staff are knowlegable, know their local health needs, and are best placed to continue to do the work in an accountable way. PCT’s look at health needs of their local population in a strategic way to ensure that services are delivered in a responsible and all inclusive way. Patients and the public know who to go to with a complaint. PCT’s have worked hard to join up services and work with local partners, all of this will be lost if they are not retained. Please rethink the abolition of PCT’s, they could be so much more effective and deliver on so much more. Knowlege and expertise will be lost and patients will ultimately lose out.

    • Daniel Bratchell says:

      Hedda Lilley

      I believe you are wrong about PCTs. In my opinion they have too much power over hospitals and regulate what the hospital may do. Under the new regulations some should be retained merely to collect statistics and point out anomalies.

      As far as complaints are concerned there used to be Community Health Councils, largely voluntary. alongside hospitals. They were there to help the patient not the NHS. Years ago I had trouble in moving my 90 year old mother from a hospital 100 miles away from her home to a nearer one. I spent a week fighting social services and her GP to no avail. Then on the Saturday morning in desperation I telephoned the local Health Council, not expecting anyone to be there. But the Chief Executive was there and listened to my problem. By Monday morning I received a telephone call to tell me that a place had been found. That is service par excellence. There was obviously a complaints service in the NHS but it is formal and cannot act quickly.

      Then the last government disbanded them and put everything through the NHS with all its formality in case there is litigation.

    • Robert Dennes says:

      If PCT’s were to go then the best commissioners will be snapped up by GP consortia as they do not have the time to devote without releasing practice managers, whom may not have the right experience. The excess cost and duplication will be removed and this will release funds for patient care.
      Services currently provided by PCT’s will be provided either by hospitals managing outreach clinics or private/volunteer services that offer the best care to suit the patient’s needs.
      Yes it will need careful management, but this should not prevent change.

    • John says:

      Hedda Lilley,

      Take a look at http://WWW.Savethecrescent.org.uk here you will see that the local PCT NHS Hertfordshire have terminated a service without even consulting the users. No equality impact assessment seems to have been carried out. The PCT doesnt even know who the service users of this organisation are. The ethos of “No decision about me without me”, as detailed in the DoH document “Equity and Excellence, Liberating the NHS, has been ignored and consider the fact that there has been no tender issued for services going forward, have ignored the principles in “Principles and Rules for Competition and Co-operation” too.
      I do not agree that the PCT have acted fairly, nor in the interests of the service users/taxpayers. It is time for a fresh look at how health care is commissioned, and by whom. Yes I am sure there are good PCT’s with concerned, involved and committed staff. However it is not consistent it seems, and if you have a situation where it appears the staff may not be as committed, then it is a very difficult situation to overcome.

  4. Dr Laura de Neumann says:

    I am pleased that the government is taking some time to ‘listen and reflect’, however I remain concerned that allowing increasing involvement of the private sector in the provision of health services means that patient interests, and doctors’ training will be put at risk. I fear that it will lead to fragmentation of services, and a reduction in the availability of less profitable, but vital services.

    Additionally, the government would do well to focus on improving how we discharge patients from hospital as ‘bed blocking’ is an incredible strain on financial and staff resources. I work as an SHO in respiratory medicine in Brighton and sometimes up to half of my patients are ‘medically fit for discharge’ but remain in hospital for weeks as we try to find suitable places for them to go once they leave hospital. Increasing the availability of nursing homes, rehabilitation centres, residential homes, and community services such as physiotherapy, as well as expanding services provided by social workers would take the strain off hospitals and allow more efficient use of services and better patient care.

    Best wishes,

    Dr de Neumann

    • jessica says:

      Bed blockers happen because labour tried to centralise everything. They have closed alot of community services that enabled patients to fee up acute beds. I understand why you are concerned about private sector involvement but there has been lots of good examples of this working. I too work for the NHS and i’m sure you agree the NHS is a bottomless pit as healthcare is becoming more and more expensive to run as there is advances in medicine. Premature babies is an example of this we are saving these babies at younger gestations this costs the NHS huge amounts also litigation . We have to accept there needs to be another way to provide health care. The most important thing that as health professionals we are giving good quality care. Let patients choose .

    • sheila watkinson says:

      I agree with Dr Laura’s comments, as I work in elderly rehab where patients are awaiting a safe discharge home or to a long term placement, funding is a major issue in regards to any plan of care and with cuts being made where do we look to place these people? Some want to go home but again issues are raised in regards to finance, I understand the NHS isn’t a bottomless pot of money but medical improvements mean people are living longer and their care needs become more complex so what will the new bill provide?

  5. neil nerva says:

    Interested to see the forum has been set up
    Please would the DH publish the following about the forum
    Terms of reference
    Membership
    Timeatable
    Reporting arrabngmets

  6. David Farmer says:

    It is good to tarry a while and reflect on where we may be travelling. For some time I have had misgivings about how the various parts of the scheme will mesh together: choice when choice can be difficult and costly; the commissioner:provider split and its effect or not on health care outcomes and cost, the marketisation of the health economy and how the various new NHS entities will relate to themselves and partner organisations.
    Yet the reforms have engendered some enthusiasms for reform, that have been largely inspired by clinicians, be they primary or secondary care; I would not wish to see this spirit dampened by new layers of regulation.

  7. Dr Pete Driver says:

    How do we know this won’t be a group of patsys?

  8. Martin Alexander says:

    How exactly is competition supposed to drive up standards in areas where patients are in no position to exercise choice?

  9. Martin Gee says:

    GPs on their own will be no better at organising the NHS than the surgeon Lord Darzi was because they have vested interests and they are not that democratic. Commissioning must be representative and should focus on the changing needs of society.
    In my area of mental health the private sector has been expanding only because the state is receeding; my view is that it offers less for greater costs and focuses on “hotel issues” rather than providing a robust service to the community.
    Whilst the SHAs are currently perhaps too many and too large; there are areas such as training, recruitment and some standard setting which are best organised on a “regional” rather than local or national level. A slower more thoughout process of change is required.
    We all agree that bureacracy in the NHS has got out of control. PBR and “Care Pathways” are inflamming this at present. I think we should return to block contracts but expect providers to produce activity and quality/outcome reports changing personnel rather than provider if these are poor.
    The underlying principle should be: “Keep it simple”.

  10. N Campen says:

    My concerns regarding the reforms come from a community health perspective. I am concerned that the involvement of private business will result in fragmentation of service provision, and ‘cherry-picking’ by business of low risk and profitable aspects leaving the NHS to mop up the rest. I feel that this will not save money but just introduce another layer of bureaucracy and further development of managers, while leaving those delivering care in fighting for their jobs and resources.
    How will quality be ensured when using social enterprise in the provision of services? How will continuity be maintained in service provision if they are limited by short contracts? What if the social enterprise organisation is failing to deliver the service, who will audit and judge the quality?
    Off greatest concern to me though, is how will the most vulnerable members of our society, children, the physically and mentally disabled, those who are mentally ill and the elderly be safe guarded and protected while part of this ‘big’ experiment which will have fundamental impact on their lives?

  11. joanne swancott says:

    I work with adults with a learning disabilities and those on the autistic spectrum and I have witnessed an increase in private organisations over the years. Currently I am very cocnerned that as a health and social care service we offer very little in the way of support for these individuals and there families and we are being asked to streamline this further.

    This is allowing more private organisations to pop up but I can honestly say the level of care is costly to the indivdual and not of a great quality. These services focus on confinement and think nothing of taking on more and more people to the detrimental to the qulaity of life of those that already use their service. This is based on fact and true stories of people that I know and from staff who work in these organisations.

    Please do take some time out to think about the future of the NHS and I apprecaite savings need to occur but dont hit those already dealt a poor hand.

  12. Anthony Rodriguez BSc Health Sciences (Hons) says:

    The reforms are on the wrong track by giving GPs the majority of control when modern healthcare services involve a wide variety of players including hospital consultants, modern matrons, home carers, health promoters, physiotherapists and above all the patient as the ultimate “expert”. SHAs and PCTs should be merged to create Community Healthcare Commissions drawing upon local expertise across the health professions, local authorities and local lay people. Commissioning powers should not be exclusive to GPS, specialist hospital units shouls also be able to form consortia to fund areas such as cancer care and maternity services. Streamline the bureaucracy but retain an element of local control and accountability in the vast space proposed between the central NHS funding board and local GP consortia.

  13. Nicola Low says:

    I am an Occupational Therapist working in a social care organisation (not the NHS) in the south east of England. The surest way of reflecting a broad concensus in commissioning is to involve a wide a range of professionals and service users/patients in the process. This means GPs, patients/representatives, local authority representatives, nurses, and reabling specialists including OTs sitting round the table. The opportunity for ‘joined up’ commissioning should not be missed – pooled budgets have delivered some integrated working between health and social care but it is not universal. This is the ‘reform’ that would be popular with the public and deliver most benefit to service users/patients, carers and their families. Anomolies around funding what constitues ‘medical’ and ‘social’ care needs to be resolved at the health/social care interface – not least to ensure speedy and successful discharges from hospital and reduced admissions into expensive acute beds.

    • Anthony Rodriguez BSc Health Sciences (Hons) says:

      This chimes very much with the ideas I put forward above. In modern health care, a state of well-being is not just about getting pills from the GP. So it makes little sense for GPs to control the NHS when there many others involved (from nurses to care assistants to surgeons). There are many professional and lay players in today’s health care and the revised Bill should reflect that fact. The prescription pad is not the solution to all ills.

  14. Di Scruntled says:

    It seems to me that many of us have already commented and not had our opinions listened to so I am very sceptical of this listening pause. In the meantime, the pace of change is moving us relentlessly onwards. Good, knowledgeable staff at PCTs are being made redundant and huge numbers of independent sector consultants are being brought in – at an enormous cost and with virtually no knowledge of thier subjects.
    Just a final comment, for now, on the new document. How completely patronising and insulting! We don’t need stick people drawings to illustrate the points and white doctors= good, black managers= bad, oh please!

  15. Sparky Mark says:

    To some extent the issue is not about whether the new model of healthcare is better than the old, but more about how it might be executed without putting patients at risk.
    Giving GPs more responsibility is perhaps a worthy aspiration, but most GPs work hard caring for their patients and don’t have the capacity to undertake the roles proposed. Perversly if they can find the time- that time is very expensive, much more expensive than the management costs that it is intended to replace.
    The emerging GP consortia all have different ideas and aspirations which potentially could increase the so-called post-code lottery of healthcare provisions.
    Service providers will be franticly trying to keep their contracts with the various commissioners and they will lose focus on some of the softer aspects of healthcare which are so valued by patients.
    PCTs should in my view be retained, but that doesn’t mean to say that they can’t be reformed or revised. Sadly I think it is too late. All but one of the Exec Team at my local PCT have already moved on.

  16. Gill Cotterill says:

    If you are really listening- learn from history too. The GP fundholding experience made services that normally worked well together into competitors and necessary dialogue for patient care became really difficult.
    Economies of scale and the necessity to have experience of purchasing led to GP practices grouping together…which became PCTs. Over the years they have developed, learnt alot and gained experience- to throw that away is to go back 15 yrs.
    This time there is greater emphasis on private providers- who don’t have to conform to the rigorous standards that the NHS does- including taking students of all professions, so of course they can provide a service cheaper. All the emphasis seems to be about driving down costs.
    So many aspects of this proposal are flawed. Continue with making changes to improve standards but this method is privatisation on the cheap. Our NHS is NOT safe with this government.

  17. George says:

    If the government want to save money, they need to look no further than the actual spend, the waste is obvious and big money, might be a small percent but it is real money. A real business would be allowed to spend money the way the nhs does.

  18. Maggie Whitlock says:

    Why doesn’t the Government add GP Consortia to the PCT Commissioners? The GP would lead but the expertise to back them is there.

    Get HeathWatch England to start supporting Local HealthWatch.

    Fund Local HealthWatch Directly and not via Local Authorities who are skimming off pump priming funding for HealthWatch in a lot of cases.
    How if the Local Authorities control the purse strings can Local HealthWatch be independent.

    Why are enthusiastic amateur expected to take on complains and advocacy services?

    These services currently exist the expertise is there reconfigure this service and bring it under the local authority and not HealthWatch

    • Pete Fox says:

      Perfect Maggie, I agree with this as it suggests evolution not revolution, so established relationships for organisations to function are maintained and we build competence in an establish structure and system. Large scale strutural system change only causes confusion, uncertainty and anxiety.
      We also larger PCT’s over a wider area to have the capacity to shift resources to provide services in the community. GP clusters will increase management costs with a reported 500+ clusters when we should be considering matching local authority boundaries to integrate health and social care. Additional we need to continue to build the competence of PCT working in partnership with GP’s with board structure accountable to their community and with representatives from that community. The PCT CEO must also have seat in the Local Authority to enable integration of health, education, prison, social care and police in providing integrated services. Evolution of the PCT’s not revolution please

  19. Alan Alexander says:

    Bearing in mind that the LINks are soon to become Healthwatch a patient and public involvement network why aren’t they part of the new consultation? Bodes ill for the future!!

  20. Wendy Savage MBBCh FRCOG MSc(Public Health) Hon DSc says:

    I came to the website to get the information that neil nerva asked for. It is significant that Steve Field who backed the ‘reforms’ when he was Chair of the RCGPs has been chosen to lead this group and not a disinterested doctor. The DH has fialed to answer the health select Committee’s question about the cot of the reulated market that was set up under New Labout and gave a figure of 14% for management costs in 203. The ‘efficiency savings’ asked for by David nicholson could be achived by getting rid of the market-tendering, contracting etc but this debate has been absent from the media or parliament. There is not doubt that the government wants to set up a fully fledged market as the emhasis on Monior in the H&SC Bill shows. The British people do not want that and I hope this new body will really listen and not just rubber stamp Lansley’s policy W

  21. N Thusiast says:

    Let us not overlook the obvious.The NHS was founded on three principles, free at point of delivery, universal to everyone , and comprehensive of all services.The first two are political imperatives so we have to debate how to use our NHS budget most effectively by focusing on ‘comprehensive’. Yes, we also need to increase the productivity of NHS staff, hence complaints from vested interests.We need to ensure we are delivering care in the most effective ways, hence the need for GPs and consultants to work together.But above all, we need the British people to recognise that we have to stop asking the NHS to do some things if we want it to invest in others.This prioritisation demands the involvement of the democratic process.The excellent white paper has clearly outline mechanisms for all of these factors to happen.Those who demand delay, are merely asking for the time to face reality and get up to speed. The longer they are allowed to procrastinate, the more difficult the task will be of saving the NHS. And here is the catch 22.Do those who clamour for delay, actually recognise that delay will accelerate the demise of the NHS, and they wish that crisis to happen under the current political administration ?

    • Penelope Jarrett says:

      Dear “N Thusiast”,

      I entirely agree that we do need to disinvest from some services. This was already happening using evidence on cost and effectiveness from NICE eg most PCTs would not fund cosmetic procedures, varicose vein operations etc. And I do agree that further disinvestment should be properly and democratically debated, as well as evidence based. However, the Health and Social Care Bill says we do not have to listen to NICE any more, and pays only lip service to democratic involvement. Apart from a greater role for Local Authorities (which are run by elected councillors) there are no mechanisms for public involvement, no requirements for transparency and incomplete lines of accountability. The commercial nature of the envisaged contracts will further obscure what is going on.

      Do you know who are the members of your local shadow consortium? Can you find out?? Do they have any conflicts of interest???

  22. R Harper says:

    I agree with the streamlining of NHS beaurocracy and ensuring that money is being spent in the correct way (not wasted on unneccessary items/staffing or extravagancies). However, I do feel extremely uncertain of the future of the NHS with the complete transformation from PCT to GP consortia; as previously mentioned I do agree there needs to be a change, but not a full reformation when there are obviously highly skilled and knowledgeable people already in place to do the job well – why fix something that already works?

  23. I would welcome a listing of which charitable organisations are being consulted. All to often the select few are patsy, we in the amputee community are all to often out of sight out of mind

    • web editor says:

      Thanks for your comment.

      We will be publishing more information about how you and other organisations can submit your views later this week.

  24. Deborah Milburn says:

    Why is Lansley interested only in the views of doctors and nurses? What about the rest of us – occcupational therapists, physios, psychologists,dieticians, speech and language, radiographers, support workers, social workers etc? Why should reform only concern nurses and doctors?

    In fact, this would be an ideal opportunity to really engage the British public in who is doing what in the NHS, particularly in mental health services which seem to have been overlooked yet again in the general hooha over general hospital stuff. What kind of health service do they want? What should be the nations’s health priorities? Does mental health matter as much as physical health and if so, why does it not enjoy a higher profile and greater resources?

    At the moment many arguments seemed to be predicated in sentiment and romantic cliche around saintly doctors and nurses in physical settings losing their jobs. The NHS serves the public and it is the public who should have the ulitimate say in how it is run. They should be given the facts rather than tabloid junk so that they can make an informed choice on this matter which Lansley should then honour in his reforms.

  25. GA says:

    I think that this is an excellent opportunity.

    I’d echo some of the questions already raised:
    * When will the following be published:
    – Terms of reference
    – Membership
    – Timetable
    – Reporting arrangements
    * When will there be more details of events to be held?
    * How can we register to receive details?
    * Other than posting comments, how can individuals/orgainsations get involved?

    My personal view having recently left a role as a Commissioning Director in a PCT is that it is too late to stop the process as PCTs have already started to wind down with many staff leaving, arrangements for clustering in place and GP Commissioners starting to set themselves up.

    However, there are huge challenges ahead as DH bureaucracy is being piled on to GP Commissioners with their terms of reference which could just drown them.

    The pace may be too fast but once you start out on a major reorganisation, the power starts to shift quite rapidly.

  26. Nicholas Dove says:

    I have tried to post a comment, but your system refused to accept it.

  27. Pete Fox says:

    My hope of the next reform is evolution not revolution with Quality, Innovation, Performance and Prevention (QIPP) working with really listening to the cared, really enabling the carers to care with kindness, framed within stable predictable systems and processes, with simple rules, which those receiving the care and providing the care’ judge to be useful’. This must be the last time politicians have the power to change the NHS in such a revolution. Liberating the NHS white and green papers must include as its first statement ‘The NHS is liberated from politicians and the political party process, and it is NHS leaders free of politicans who are accountable to build the best structure, strategy, systems and processes to provide services to care for people in our communities’. The starting point is the PCT/GP commissioners of services working in partnership Local Authority services to support and improve the care of our communities.

  28. John Smith says:

    Keep patients at the forefront and GPs in charge. When a person is ill s/he wants to see a GP initially who takes the lead, the service determined by combined specialists’ Commissioning Boards devoid of bureaucracy.

    Custom-designed combined clinical and residential facilities for the growing elderly, overseen by GPs, staffed by NHS nurses, must replace the present private nursing homes. Pressure relieved on expensive hospital-based services would finance these polyclinics.

    The lay-patient should be represented at Commissioning Board level, not by local councillors. Local authorities could assist NHS Commissioning Boards to implement public health and preventive medicine campaigns.

  29. web editor says:

    Thanks for all your comments, which will be fed back to the NHS Future Forum.

    Comments on this page are now closed but please continue to send them via our Listening exercise: how to get involved page. They will all be fed back to the Future Forum.