Liberating the NHS:

1. Liberating the NHS: Legislative framework and next steps

2. The NHS White Paper reforms An NHS that puts patients and the public first… …which focuses on improving healthcare outcomes… …with more autonomyfor professionals, more accountabilityto patients, and stronger local democratic legitimacy… …with reduced bureaucracy and improved efficiency… …leading to an NHS that achieves healthcare outcomes that are among the best in the world

3. The NHS White Paper reforms An NHS that puts patients and the public first… …which focuses on improving healthcare outcomes… …with more autonomy for professionals, more accountability to patients, and stronger local democratic legitimacy… • Shared decision-making • An “information revolution” • Greater patient choice • Public/consumer voice through HealthWatch …with reduced bureaucracy and improved efficiency… …leading to an NHS that achieves healthcare outcomes that are among the best in the world

4. The NHS White Paper reforms An NHS that puts patients and the public first… …which focuses on improving healthcare outcomes… …with more autonomy for professionals, more accountability to patients, and stronger local democratic legitimacy… • NHS Outcomes Framework • Backed by clinically-evidenced NICEquality standards • Money to follow the patient, with incentives for quality …with reduced bureaucracy and improved efficiency… …leading to an NHS that achieves healthcare outcomes that are among the best in the world

5. The NHS White Paper reforms An NHS that puts patients and the public first… …which focuses on improving healthcare outcomes… …with more autonomy for professionals, more accountability to patients, and stronger local democratic legitimacy… • GP-led commissioning, supported by new NHS Commissioning Board (Commissioning for patients) • Stronger role for local authorities and better integration (Local democratic legitimacy in health) • More autonomy for providers; all providers regulated on a consistent basis (Regulating healthcare providers) …with reduced bureaucracy and improved efficiency… …leading to an NHS that achieves healthcare outcomes that are among the best in the world

6. The NHS White Paper reforms An NHS that puts patients and the public first… …which focuses on improving healthcare outcomes… …with more autonomy for professionals, more accountability to patients, and stronger local democratic legitimacy… …with reduced bureaucracy and improved efficiency… • Significant cuts in cost of administration • Abolition of SHAs and PCTs, and rationalisation of arm’s-length bodies …leading to an NHS that achieves healthcare outcomes that are among the best in the world

7. Consultation process and Government response • White Paper consultations closed early October • More than 6,000 responses in total • Consultation events across the country, led by SHAs and by Regional Voices • Discussion events with key national stakeholders – in particular on equality and diversity • Liberating the NHS: Legislative Framework and next steps: • sets out the next level of detail on reform and • responds to consultation • Consultation response on Transparency in outcomes published separately • Recently closed consultations on choice and information • Still consulting on workforce

8. Liberating the NHS: Legislative framework and next steps • Some respondents opposed the White Paper entirely • Many others had specific concerns, criticisms or suggestions • In response we have: • Modified and improved several of our proposals • Adapted our draft legislation in theBill • Significantly strengthened our approach to transitionand implementation • Most people welcomed the White Paper’s principles • There was support (and passionate enthusiasm) from a range of respondents, across the spectrum of the reforms

9. Examples of how we will modify our approach Strengthen transparency by requiring each GP consortium to publish a constitution and adhere to principles of good governance Set up a GP pathfinder programme, already covering a quarter of the country Give primary responsibility for commissioning maternity services to GP consortia, backed by national support Significantly strengthen the role of health and wellbeing boards, and accelerate progress through early implementers Create a more distinct identity for HealthWatch England, led by a statutory committee in CQC Allow a more phased transition for completing reforms to providers – with Monitor retaining some temporary controls over some Foundation Trusts Not merge LAs’ formal scrutiny powers into the health and wellbeing board, but extend them to cover all NHS-funded providers

10. Legislative timetable • Health and Social Care Bill was introduced in January • This is a major restructuring of NHS legislation, based on principles of: • minimising political interference and • maximising the autonomy of commissioners and providers • Subject to Parliament, new system will start coming into force from April 2012

11. 2010/11 2011/12 2012/13 2013/14 Learning and planning for roll-out Design and early adoption First full year of the new system Full dry run Effective implementation and a managed transition • A phased transition over four years, with: • freedom for enthusiasts to make progress early • more time to plan, test and learn