NHS Future Forum publishes recommendations to Government

The NHS Future Forum has published its recommendations to the Government on the modernisation of health and care.

Set up as an independent group in order to ‘pause, listen and reflect’ on the Health and Social Care Bill, the Forum has made 16 key recommendations, including:

  • the pace of the proposed changes should be varied so that the NHS implements them only where it is ready to do so
  • the Secretary of State for Health should remain ultimately accountable for the NHS
  • nurses, specialist doctors and other clinicians must be involved in making local decisions about the commissioning of care – not just GPs – but in doing this the NHS should avoid tokenism, or the creation of a new bureaucracy
  • competition should be used to secure greater choice and better value for patients – it should be used not as an end in itself, but to improve quality, promote integration and increase citizens’ rights
  • the drive for change in the NHS should not be based on Monitor’s duty to ‘promote’ competition, which should be removed, but on citizens’ power to challenge the local health service when they feel it does not offer meaningful choices or good quality
  • all organisations involved in NHS care and spending NHS money should be subject to the same high standards of public openness and accountability.

The Forum’s recommendations will now be considered and responded to by the Government.

Forum Chairman Professor Steve Field, a practising GP from Birmingham, said: ‘There is no doubt that the NHS needs to change. The principles underlying the Bill – devolving control to clinicians, giving patients real choices and control, and focusing on outcomes – are well supported.

‘However, during our listening we heard genuine and deep-seated concerns from NHS staff, patients and the public that must be addressed if the reforms are to be progressed. If the substantial changes we propose are accepted by Government, then I think the resulting framework will place the NHS in a strong position to meet this objective and tackle the pressing challenges in the years ahead.’

>> Download reports and summary.

The NHS Future Forum was launched on 6 April as part of the Government’s listening exercise on the current Health and Social Care Bill. Since then its 45 members have attended around 200 events and have met more than 6,700 people face to face. More than  25,000 people have sent their views to the Forum by email, while a further 4,000 have sent private comments, completed questionnaires or website responses.

In Health and Social Care Bill, News, NHS Future Forum, Pathfinder Learning Network | Tagged , ,

13 Responses to NHS Future Forum publishes recommendations to Government

  1. Michael Vidal says:

    I have had a cursory glance at the proposals in relation to Public Involvement. While there is a lot in there that I am happy with. I must strongly disagree with the recommendation that Local Authorities should commission Healthwatch it is inconsistent with other parts of the report that seeks to require high standards of conduct. It reinforces the conflict of interest in the local authority as a provider of social care having a say in the body that monitors social care.

    • A Rodriguez BSc MPhil (Cantab) says:

      Yes, indeed, the offloading of health promotion roles to local authorities is a retrograde and dangerous step. Councils are already cutting services to the bone so just how are they going to be placed to take on public health roles? A big rethink needed here.

  2. A Rodriguez BSc MPhil (Cantab) says:

    At first sight, it looks as if the whole HSC Bill needs to be rewritten from scratch and it needs adequate time for this to be done properly. Rest this until the autumn under a new Health Secretary. A rushed, botched process will ruin the NHS which will never be foregiven. A new vision and new energy are badly needed.

  3. MG says:

    This may be very controversial, but, this report labours the point that many people can now live with many complex illnesses and multiple conditions. Whilst that is a plus in most occasions, there are also people that are kept alive with use of technology, equipment and drugs who, if they had the ultimate choice in the matter would wish to die. This brings up the whole issue around euthanasia and whether it is appropriate to make the ultimate choice.

    I also know that any decision around euthanasia should certainly not be made on the basis of cost or use of resources, but clearly, in many instances, and providing it is the choice of the patient, to be able to die appropriately and with dignity would also be cost effective. I am sure it would be cheaper to end someones life slightly prematurely than use up considerable resources to prolong a miserable existence.

    I know that this is an entirely seperate debate, but given the economic climate shouldn’t it at least be considered???

    After all, you wouldn’t allow an animal to suffer, indeed you would be prosecuted for it, but it is entirely acceptable to make a human endure suffering at the end of their life.

    • Roland Baker says:

      MG, with great respect, you say that a decision about euthanasia should not be made on cost grounds and then proceed to do exactly that.

      Assisted suicide is not within the remit of this legislation nor of the Future Forum review and nor should it be. You may like to note that the Swiss Government is so sick of the bad name Dignitas has given to assisted suicide that they carried out a review to bring “suicide tourism” to an end.

      The cost implications of the NHS are enormous but any reforms and the review must proceed on the basis that all available treatment to prolong and preserve life must be provided unless otherwise ordered by a court according to the existing law. The existing law does not permit assisted suicide in England which is the area covered by the NHS Bill.

  4. David Rees says:

    To quote from the report:

    ‘nurses, specialist doctors and other clinicians must be involved in making local decisions about the commissioning of care – not just GPs – but in doing this the NHS should avoid tokenism, or the creation of a new bureaucracy’……and please Prof. Field why have you excluded Patient Representation in helping to make these local decisions?!

    • A Rodriguez BSc MPhil (Cantab) says:

      Perhaps that underlines the central flaw in handing over most NHS services to the control of doctors.

      They need to find more time for patients, not pen-pushing.

    • woo says:

      Patient representation, exactly, the fact that this has come no where near the present so called listening exercise except through, perhaps the personal submissions of individuals – if the knew how to submit their views at all – is proof that it is a sham. There are some excellent skills among Patients built up over years of working to represent patient interests in local and national services and health research. But actually, our voices have been barely listened to. A lot of this is becuase of funding issues, and a lot of it because the professionals usually think they know best, and have not been concerned with the improvements that could be made by good, knowledgable patient input.

  5. Walter D. Park MBE says:

    Local HealthWatch should be totally independent of the local authority, and the funding from central government should be ring fenced.

  6. Gillian Jillett says:

    I totally agree with Michael Vidal and Walter D Parkin in their comments about Local Healthwatch. Currently the Local Involvement Networks (LINks) as statutory bodies, monitor the Local Authorities as providers of Social Care, to give them the power to control the funding of local Healthwatch would be counter-productive and a conflict of interest. The LINks have already had dramatic cuts to their budgets, which are currently in control of the local authorities, simply because the Government failed to ring-fence it and it would be almost inevitable that this would be repeated with local Healthwatch, especially as the funds allocated are likely to be greater than currently available to the LINks. How would Local Healthwatch monitor local authorities effecitively? After all you don’t bit the hand that feeds you!!

  7. Kathy Smith says:

    Very pleased to see that Clinical Networks are getting a positive mention as they do some good work in many clinical areas in most regions of the country.

    • A Rodriguez BSc MPhil (Cantab) says:

      At least they listened on this one. As any patient or carer will know, the major frustration is often the lack of “joined-up” thinking across healthcare services and providers. Integration need not exclude elements of patient choice and competition but full-blown commercialisation would have blown the NHS apart in today’s fragile economic climate.

  8. Jean Roberts as a Health Informatician and concerned end user of health services says:

    Any changes (or in practice, committment to keep things the same) will need a baseline and ongoing monitoring in order to prove effects. This will require quality information for clinical, management and patient decision support. That will need professional handlers of health information, who are recognised for their skills, competence and domain sensitivity and can prove they have kept up to date and ‘street-sharp’. If not the whole premis for change will have feet of clay. Recognition of the informatics (see definition on http://www.ukchip.org.uk) contribution to patient safety, increased public confidence in health advice and information and more efficient and effective design, development and delivery of health services is crucial.