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Reform of the NHS in England - Equity and Excellence

This document outlines the strategic intent, key principles, specific proposals, and next steps for the reform of the NHS in England. The focus is on putting patients at the center, improving outcomes and efficiency, and increasing accountability and democratic accountability.

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Reform of the NHS in England - Equity and Excellence

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  1. Equity and Excellence -Liberating the NHSReform of the NHS in England 8 September 2010 Reform of the NHS in England Mark Dickinson

  2. Summary • Strategic Intent • Key Principles • Specific Proposals • Next steps Reform of the NHS in England

  3. Strategic Intent • “The Government upholds the values and principles of the NHS: of a comprehensive service, available to all, free at the point of use and based on clinical need, not the ability to pay • We will increase health spending in real terms in each year of this parliament • Our goal is an NHS which achieves results that are amongst the best in the world” Reform of the NHS in England

  4. Key Principles • Putting patients at the centre of the NHS • Changing the emphasis to clinical outcomes • Increasing autonomy, accountability and democratic accountability • Cutting bureaucracy and improving efficiency Reform of the NHS in England

  5. Patients and Public First • Shared decision making • “No decision about me without me” • Access to information and control over records • Increased choice • Provider • Consultant led team • GP practice • Treatment Reform of the NHS in England

  6. Improving Outcomes 1 • Focus on outcomes • Reducing mortality and morbidity • Increasing safety • Improving patient experience • NHS will be held to account against evidence based outcome measures, not process targets • NHS Outcomes Framework from 2011 • Culture of open information, responsibility and challenge to ensure safety Reform of the NHS in England

  7. Improving Outcomes 2 • Quality standards developed by NICE • Commissioning • Inspection • New drugs to be paid for according to ‘value’ • Interim ‘Cancer Drug Fund’ • Money to follow patients and payment according to performance Reform of the NHS in England

  8. Improving Efficiency • NHS will need to achieve ‘unprecedented efficiency gains’ • £20 billion by 2014 • 45% reduction in management costs over four years • Savings invested in ‘front line services’ • ‘Delayering’ and simplification of NHS structure • Reduction of Department of Health NHS functions • Abolition of quangos Reform of the NHS in England

  9. Specific Proposals • Commissioning • Future of Providers • Regulation and Inspection • Social Care • Public Health Reform of the NHS in England

  10. Commissioning 1 • Commissioners will be free to buy from ‘any willing provider’ • Strategic Health Authorities and Primary Care Trusts to be abolished • GP Commissioning • Statutory basis with powers and duties in legislation • Commissioning consortia • System in shadow form by 2011/12, with full responsibility from 2013/14 • ‘maximum management allowance’ Reform of the NHS in England

  11. Commissioning 2 • NHS Commissioning Board (NHSCB) • Will commission primary care • Duty to establish GP consortia • Accountable to DH for managing within annual revenue limit • Will allocate resources to GP consortia ‘on basis of need’ • Shadow form as SHA from 2011 • Statutory body by 2012 Reform of the NHS in England

  12. Future of Providers • All NHS Trusts to become Foundation Trusts by 2013 • New Foundation Trust models with ‘staff only membership’ (social enterprise) • Foundation Trusts ‘will not be privatised’ • Consultation on increasing Foundation Trust freedoms • Monitor will regulate all NHS providers from 2013 Reform of the NHS in England

  13. Regulation and Inspection • Care Quality Commission will focus on ‘essential levels of safety and quality’ • Monitor • Economic regulator of health and social care • Promote competition and enforce competition law • Regulate pricing ‘where necessary’ • Responsible for ‘continuity of service’ • Powers to intervene in event of failure Reform of the NHS in England

  14. Social Care • Commission on the funding of long term care and support to report within one year • White Paper in 2011 Reform of the NHS in England

  15. Public Health 1 • A new national Public Health Service • Encompassing existing health improvement and health protection bodies and responsibilities • Will set national objectives for improving population health • Directors of Public Health • Joint appointments by Public health Service and local authorities • Control over ring fenced local public health budgets Reform of the NHS in England

  16. Public Health 2 • Local Authorities • Will assume the health improvement responsibilities of PCTs • Will determine how to meet national objectives at the local level • Health and Wellbeing Boards to coordinate commissioning of health, social care and health improvement services • White Paper in ‘late 2010’ Reform of the NHS in England

  17. Next Steps • Consultation on White Paper • Supplementary consultation papers • Health Bill – Autumn 2010 • Public Health White Paper – Late 2010 • Implementation from 2011 Reform of the NHS in England

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