Nhs Reform

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Equity and Excellence: Liberating the NHS White paper briefing, July 2010 The Secretary of State for Health, Andrew Lansley, has set out the government’s plans to reform the NHS in England. The plans, documented in a new white paper entitled ‘Equity and Excellence: Liberating the NHS’, state that more power will be given to patients and professionals in the design and delivery of health and social care. This briefing outlines a summary of the key reforms. Please note, some terms which require further clarification are explained in a glossary at the end of this document. The white paper focuses on four key areas: 1. 2. 3. 4. Putting patients and the public first Improving healthcare outcomes Autonomy, accountability and democratic legitimacy Cutting bureaucracy and improving efficiency

A brief note on social care In addition to these four key areas, the document confirms the Department of Health’s continued vital role in setting adult social care policy. The government intends to publish its vision for social care later this year. A commission on the funding of long-term care and support will be established and will report within a year. The government intends to bring together the conclusions of the Law Commission and the commission on funding, along with the government’s own vision and to publish a white paper in 2011.

1. Putting patients and the public first
Key reforms Shared decision making - “no decision about me without me”. Better accountability based on patient experience. Personalised care, reflecting individuals’ health and care needs. Strengthened collective voice for patients and the public, including the establishment of HealthWatch England, a new consumer champion. An NHS “information revolution” to provide people with the information they need on healthcare.

Information revolution Information generated by patients will be critical to improving the accountability of NHS providers and commissioners. The government intends to make wider use of tools such as PROMs (Patient Reported Outcome Measures) and patient experience surveys in this process.



The government intends to ensure that the right data is collected by the Health and Social Care Information Centre to inform patient choice. The Department of Health will publish an “information strategy” this autumn for consultation. Improved accountability In order to strengthen the patient and public voice, there will be provisions in the forthcoming Health Bill (to be published in the autumn) to create HealthWatch England, an independent consumer champion located within the Care Quality Commission (CQC). LINKs (Local Involvement Networks) will become the local HealthWatch and the role of local authorities will be enhanced in promoting choice and complaints advocacy. Local HealthWatch organisations will ensure that views and feedback from patients and carers are an integral part of local commissioning across health and social care.

Other reforms moving towards choice in end of life care to support people’s preferences about how to access the support they need and to have a good death; developing a coherent 24/7 urgent care service in every area of England with a single telephone number for every kind of urgent and social care; encouraging more pilots and the roll-out of personal health budgets; making choice of treatment and provider a reality by 2013/14, including choice of GP.

2. Improving health outcomes
Key reforms NHS will be held to account against clinically credible and evidence-based outcome measures, not process targets. Quality standards developed by NICE (National Institute for Health and Clinical Excellence) will inform commissioning. Role of NICE will be expanded to develop quality standards for social care. Value-based pricing for drugs will be introduced.

Outcome measures

Each NICE quality standard is a set of five to ten specific, concise quality statements and measures that are designed to indicate quality care...
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