Government Accepts Changes to NHS Reforms

The government has responded to the recommendations made by the NHS Future Forum, accepting the “core” changes to its NHS reforms and making changes to put patients at the centre of the health service.

The NHS Future Forum was launched on April 6 as part of the government’s listening exercise on the current Health and Social Care Bill in order to “pause, listen and reflect” on the content of the existing Health and Social Care Bill.

Its 45 members, a group of health experts, have attended around 200 events, and over 25,000 people have sent their views to the Forum by email.

A further 4,000 have sent private comments, completed questionnaires or website responses.

Responding to the NHS Future Forum recommendations, Deputy Prime Minister Nick Clegg, Health Secretary Andrew Lansley and the Prime Minister said: ”We have listened, we have learned, and we are improving our plans for the NHS.

“The fundamentals of our plans – more control for patients, more power to doctors and nurses, and less bureaucracy in the NHS – are as strong today as they have ever been.

“But the detail of how we are going to make this all work has really changed as a direct result of this consultation.”

Key Changes

The government has outlined a number of key changes to the bill.

A wider involvement in clinical commissioning groups was announced:

“A wider range of experts will be given the power and freedom to make decisions about health services for their local community by, for example, including nurses and specialists on the boards of clinical commissioning groups.”

The government promised stronger safeguards against a “market free-for-all”, ensuring that the duty of Monitor will be to “protect and promote patients’ interests”:

“[Monitor] won’t be required to promote competition as if it were an end in itself.”

Additional safeguards against privatisation were also promised:

“We will never privatise the NHS, and will create a genuine level playing field to stop private companies ‘cherry-picking’ profitable NHS business. We will ensure that competition is on quality, not price.”

A policy of “evolution, not revolution” was confirmed, as the government said that they will allow clinical commissioning groups to take charge of commissioning “when they are ready and able”.

They also advocated breaking down barriers “within and beyond the NHS”, bringing in “a new duty for clinical commissioning groups to promote joined up services both within the NHS and between health, social care and other local services”.

The independent NHS Future Forum will continue to lead on listening in the NHS, ensuring an effective communication channel with the NHS.

Among other areas, they will focus on education and training, patients’ rights and public health.

Relevant parts of the Health and Social Care Bill will be recommitted.

The government confirmed that further details and amendments will be set out shortly.

NHS Future Forum: A “refreshing experience”

Ahead of the government’s response, Dr Hamish Meldrum, Chairman of BMA Council said of the NHS Future Forum:

“The way the government and the Future Forum have engaged with the profession during this listening exercise has been a refreshing experience.

“It is vital that this constructive approach is maintained in the following months as the detail is worked on.

“Obviously, the critical factor is now how the government responds, as well as ensuring that the detail of the changes matches up to expectations.

“But if the government does accept the recommendations we have heard today we will be seeing, at the least, a dramatically different Health and Social Care Bill and one that would get us onto a much better track.

Dr Clare Gerada, representative from the Royal College of Practitioners stated: “We are reassured things are moving in the right direction,” adding that “the real focus on health inequalities is to be welcomed”.

Mike Farrar, Chief Executive of the NHS Confederation, announced in a statement how pleased they were that their voice had been heard in the consideration of the Forum: “We are delighted that it has taken the lion’s share of our recommendations on board,” he said.

However, it is apparent that the ideas due to be presented by the Future Forum are not to everyone’s liking; his opinion did not concur with that of Dr Peter Carter, at the Royal College of Nursing:

“It is disappointing that the Future Forum appears not to have accepted the view of thousands of our members.”

“The Right Decision”

A spokesperson for The Royal College of Physicians (RCP) exclusively told Fresh Outlook: “The government made the right decision in pausing the passage of the legislation,” in order to prevent the risk of “cherry-picking profitable services by private providers” and the risk to medical education and training:

“The RCP expressed concerns with the Health and Social Care Bill when it was published in January and believed it required amendment.

“Specifically, our concerns were around the extent to multi-professional, including hospital doctors, input in the highest levels of commissioning decisions would be guaranteed across the country.

“We therefore believe that the government made the right decision in pausing the passage of the legislation to address stakeholders’ concerns and formulate possible improvements to the Bill.”

The RCP had several hopes for the results of the reforms. Among these aspirations include the “commitment for the NHS Commissioning Board to have strong links with the royal colleges”, “seamless care for patients” and “a fundamental review of the government’s current proposals for reform medical education and training”.

She added: “The reforms have potentially far reaching consequences for the 25,000 hospital doctors that are members of the RCP.

“The government has now mandated hospital doctors’ place on clinical commissioning boards, which we welcome.

“Our members will have a crucial role in designing health services for their local communities.”

By Millie Schurch and Caitlin Gabe-Jones

[Image courtesy of Official U.S. Navy Imagery]