The NHS White Paper 2010

1. The NHS White Paper 2010

5. An NHS Commissioning Board � providing leadership on commissioning for quality � promoting patient and public involvement and choice � supporting the development of GP commissioning consortia � commissioning specific services (maternity, highly specialised services, primary care, dentistry, community pharmacy and primary ophthalmic services) � allocating and accounting for NHS resources.

6. GP Commissioning Consortia All GP Practices to be part of local consortia No size indicated � likely to be minimum population of 100 � 150k so � 3-500 consortia No prescribed form at this time but will be statutory bodies Impact on gp income is key � risk management Preformance management of Practices, but do not hold contracts Do hold contracts for secondary care services (not specialised or maternity)

7. When will this happen? In 2010/11: GP consortia to begin to come together in shadow form (building on practice based commissioning consortia, where they wish). In 2011/12: a comprehensive system of shadow GP consortia in place and the NHS Commissioning Board to be established in shadow form. In 2012/13: formal establishment of GP consortia, together with indicative allocations and responsibility to prepare commissioning plans, and the NHS Commissioning Board to be established as an independent statutory body. In 2013/14: GP consortia to be fully operational, with real budgets and holding contracts with providers.

8. Providers All NHS Provider Trusts to become Foundation Trusts Strong pressure to use social enterprise models Any willing Provider concept Regulation requires two part licence�

9. Regulation

10. HealthWatch Local �HealthWatch� groups are to replace the existing LINKS Local authorities are to fund local HealthWatch groups. A national HealthWatch body will be located within the Care Quality Commission. Local authorities will operate statutory health and wellbeing boards, which can agree local joint commissioning across health and social care, and scrutinise local service reconfigurations proposed by GP consortia LAs can refer GP Consortia them to the NHS Commissioning Board, or ultimately the Secretary of State for Health. Local Overview and Scrutiny Committees would transfer to the health and wellbeing boards.

11. From Performance Targets to Outcomes The Coalition Government�s NHS reforms outline plans to move to outcome targets and relax �process� targets such as the 18-week wait target for planned care and the 48-hour GP access target. However, the four-hour A&E target will continue to be performance-managed, although the target will be revised to 95 per cent of all patients being seen within four hours rather than the current target of 98 per cent. It is intended that greater public reporting of outcomes will result in patients choosing better providers, and pressure from commissioners through contracting will provide the stimulus for providers (mainly hospitals) to keep waiting times down. NICE will have greater role in setting evidence based care pathways, standards and treatments

14. References Department of Health (2010a) Equity and Excellence: Liberating the NHS. Cm7881. Department of Health (2010b) Transparency in Outcomes � A framework for the NHS. Department of Health (2010c) Liberating the NHS: Increasing democratic legitimacy in health. Department of Health (2010d) Liberating the NHS: Commissioning for patients � consultation on proposals. Department of Health (2010e) Liberating the NHS: Regulating healthcare providers. Department of Health (2010f) Liberating the NHS: Report of the arms-length bodies review.

15. NHS Alliance Conference Slide here