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Equity and excellence: Liberating the NHS - DOH Consultation and white paper

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kevin's picture
Joined: 09/03/2009

Charities could be marginalised by the Government's Health Reforms

We have responded to the Government's 'Listening Exercise' on the future of the NHS and have sent a letter to the Prime Minister outlining some of our concerns with the Health Bill.

In the letter, we warn that the Health Bill risks hampering voluntary providers’ ability to influence GP consortia and urge the government to place obligations on the consortia to work more closely with Local Health and Wellbeing Boards and Local HealthWatch, which are the main bodies that communities and local organisations can use to influence decisions on commissioning services.

Sir Stuart Etherington, Chief Executive of NCVO, said: ‘The voluntary sector is a valuable source of expertise in helping to design health services that meet the needs of local people. However, the Health Bill as it currently stands risks sidelining voluntary organisations from contributing properly to service design. We urge the government to strengthen the measures in the Bill to ensuring that GP consortia incorporate the expertise and knowledge of their local voluntary and community sector in their thinking.’

We also raise concerns that larger providers could end up dominating the market, undermining one of the main aims of the Health Bill.  We believe that GP consortia should have a remit which includes helping new organisations to become service providers, ensuring there is a diverse market of service providers in their area, and encouraging innovation.

Our response (PDF 57KB) is based on discussion with our members and feedback from a listening event held jointly with the Kings Fund.

anonymous (not verified)
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Liberating the NHS: greater choice and control - Government response. Extending patient choice of provider (Any qualified provider)

In 'Equity and Excellence: Liberating the NHS' the Government made a number of commitments to extend the choices people have over their healthcare as part of the vision of patients and the public being at the heart of the NHS.

In the subsequent consultation 'Liberating the NHS: Greater choice and control' the Department of Health sought the views of patients, the wider public, healthcare professionals and the NHS about implementing the choice commitments.

We have now published the Government's response to comments received on extending patient choice of provider (any qualified provider)

We have also published guidance for the NHS on extending patient choice of provider with accompanying impact assessment and equalities analysis. In drafting the guidance, we have taken into account the relevant issues raised in response to the consultation, and the NHS Listening Exercise.

A fuller response covering all of the remaining issues and questions in the consultation document will follow later this year.

Please note: the attached consultation response document has not been tagged for accessibility<

anonymous (not verified)
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Operational Guidance to the NHS : extending patient choice of provider

Liberating the NHS: Greater Choice and Control sought views on proposals for extending choice in the NHS. This document provides guidance to providers and commissioners on implementation of the Government commitment to extend patient choice of provider.

Please note: the attached document has not been tagged for accessibility.<

anonymous (not verified)
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This revised Business Plan is a core part of the Department’s commitment to the Governments transparency agenda. It sets out the vision and priorities for the Department and the Structural Reform section of the Plan includes key commitments involved in delivering our reform programme up to 2015. The Transparency section of the Plan (which is supported by annexes) sets out the key indicators that we believe are most useful to the public in understanding the costs and outcomes of health and social care services, and also provides a wealth of additional data that the public will find useful.

Please note that these documents are for print purposes only as they have not been tagged for accessibility. An accessible version will be available soon.<

anonymous (not verified)
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Following a public consultation on proposed changes to the NHS Bursary Scheme, changes have been agreed. This is a report of the outcome of that consultation including a description of the consultation process, key findings and a summary of the responses. An Impact Assessment and Equalities Impact Assessment are being published alongside the consultation report

Related documents

Current scheme


Andrew Lansley’s letter of 28 June 2011


anonymous (not verified)
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A new value-based approach to the pricing of branded medicines: Government response to consultation

A public consultation on the Government's proposals for a new value-based system of pricing medicines took place between 16 December 2010 and 17 March 2011. This document sets out the Government's response to the consultation. It provides a summary of the responses received, highlights the key themes from the consultation and sets out the Government's response and actions to be taken<

anonymous (not verified)
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Patients will today have a stronger voice under plans set out by Health Secretary, Andrew Lansley.


75 Local HealthWatch pathfinders, introduced as part of the Government’s plans to modernise the NHS, were announced today. These new learning networks will champion patients’ views and experiences, promote the integration of local services and improve choice for patients through advice and access to information.

Local HealthWatch will provide a collective voice for patients and carers, and advise the new Clinical Commissioning Groups on the shape of local services to ensure they are informed by the views of the local community.

Visiting a new HealthWatch pathfinder in Cambridgeshire, Andrew Lansley said:

“Putting patients and the public at the very heart of the health service is central to our vision of modernising the NHS and today is a huge step forward.

“Local HealthWatch will give patients and carers a real say over how their local health service is run. They will act as patient champions, drive local involvement in the community and ensure patients understand the choices available to them.”

Councillor Catherine Hutton, Portfolio Holder for Adult Services at Cambridgeshire County Council, said:

“Cambridgeshire’s HealthWatch Pathfinder will build on the strong joint work that is happening in health and social care services across the county. The County Council is working together with local GPs, the local health service and Cambridgeshire Local Involvement Network to make sure that people have a voice in health and social care services.”

Mike Hewins, Chairman of Cambridgeshire Local Involvement Network, said:

“Cambridgeshire LINk has always worked hard to put patients and service users at the forefront of its work. As a HealthWatch Pathfinder, we’ll be able to reach out and work with many more people in Cambridgeshire and ensure that they are fully involved in health and social care in the county.”

The 75 Local HealthWatch pathfinders established today will pioneer plans ahead of their full establishment across the country in October 2012.


Notes to editors

  1. For media enquiries including to request an interview with Andrew Lansley please contact the Department of Health press office on 020 7210 5221
  1. The NHS White Paper - Equity and Excellence: Liberating the NHS can be found here:<

  1. A list of all the HealthWatch Pathfinders can be accessed via the attached file.<

anonymous (not verified)
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Innovative care could help over 15 million people with long-term conditions

The NHS could help improve the care of over 15 million people living with long-term conditions and reduce the number of unnecessary trips to hospital if the most innovative work being pioneered in other parts of the NHS were adopted nationwide.


In addition to helping patients manage their conditions better and reducing distressing emergency episodes, new approaches to reduce ambulance call-outs by over 900,000 and hospital bed days by over 10.2 million can deliver huge savings – an estimated £2.2 billion to reinvest in frontline patient care, helping to meet the rising demands our NHS faces.

People with long-term conditions are some of the most frequent users of the NHS. In 2009-10, an estimated £70 billion of total health and social care expenditure was spent on patients with long-term conditions. The number of people with a long-term condition is set to rise to around 18 million within 20 years – combine this with our ageing population and the NHS faces even greater pressures.

People living with long-term conditions currently account for:

  • 50 per cent of all GP appointments;
  • 64 per cent of outpatient attendances; and
  • 77 per cent of all hospital bed days.


Plans to modernise the way the NHS works will encourage a more integrated approach to patient care and help personalise services to the needs of individual patients. Clinicians from the ambulance service, hospitals and GPs and nurses from Kirklees in West Yorkshire are already leading the way by working together to identify patients who frequently use emergency services in order to help them manage their condition better and avoid unnecessary hospital visits.

Secretary of State for Health, Andrew Lansley said:

“We have a vital opportunity now to modernise the NHS. People with long-term conditions have some of the most complex health needs in the country and we need to personalise services to suit their needs, not fit them around how the NHS is organised. We want clinicians to take the lead locally in developing health services so that they can support patients, to take decisions about their care and help them take charge of their health and the care they receive. With this approach, they will find new ways to tackle this problem for both the NHS and patients.

“I know the NHS can work more efficiently to improve care for their local communities, as it has shown in West Yorkshire. It is innovative changes like this that will help us create a modern NHS that can respond to 21st century needs.”


Today, Health Secretary Andrew Lansley will meet clinicians from Kirklees to see how their inventive joined-up approach of sharing information on a patient’s full clinical needs helps develop more tailored treatment and care options. Electronic patient records enable these to be seen by any health professional treating the patient.

Emergency care plans are also saved on this record and given to the patient as a hardcopy to ensure that no decision is made about them without them.

This initiative has reduced ambulance trips by 16 per cent and saved NHS Kirklees £1.09 million – improvements which could easily be seen around the country.


Notes to editors

  1. For media enquiries including to request an interview with Andrew Lansley please contact the Department of Health press office on 020 7210 5221
  1. The NHS White Paper - Equity and Excellence: Liberating the NHS can be found here:


3. Notes on the statistics: The estimated number of people with long-term conditions is derived from the GP patient survey Jan-Dec 2011, scaled to General Lifestyle Survey 2009.

The statistics on possible savings from ambulance journeys apply the reduction achieved in Kirklees (16 per cent reduction) to the total number of ambulance journeys in the Primary Care Trust(s) containing that city. The source is an Health Service Journal investigation 2008-09.

The average cost of an ambulance journey is a weighted average of the unit cost of ambulance incidents across categories A, B & C from Department of Health reference costs 2009-10.

The source of data on emergency bed days is Hospital Episode Statistics 2009-10. “long-term conditions” is defined in the same way as the Department’s indicator on “Emergency admissions for long-term conditions” SQU29, see link

Savings from reductions in hospital bed days assumes an average daily cost of a bed day to be £200.

anonymous (not verified)
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anonymous (not verified)
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The official report on NHS performance shows the NHS continues to perform strongly for patients - achieving good results against the majority of key quality standards.

The Quarter 1 report, which sets out NHS quality and financial performance between April and June 2011, shows the NHS has not only maintained the quality of care patients receive but achieved improvements in key areas – reducing MRSA and C. difficile infection rates as well as driving down breach rates for mixed sex accommodation.

Overall, the NHS has continued to perform strongly in the first quarter of the financial year as it begins to deliver local plans to meet the pressures of an ageing population and the rising costs of drugs and treatments.

The NHS needs to save up to £20 billion from within its budget to meet these challenges. To do this, the local NHS has developed plans to improve quality, productivity and innovation that will see more care provided closer to home and more empowered patients in control of their own care.

The Quarter 1 report shows Primary Care Trusts (PCTs) are estimating they can achieve £5.9 billion savings this financial year. Every penny saved will be reinvested in patient care. This means the NHS is broadly on track to deliver the efficiency savings it needs by 2014/15.

Health Secretary Andrew Lansley said:

“We passionately believe in the NHS - one that is free at the point of use. That’s why there will be a £12.5 billion increase in funding over the next four years. But even with this, we know the NHS must be more efficient to meet the pressures of an ageing population and the rising costs of drugs and treatments.

“We know that despite the increase in funding, the NHS needs to save up to £20 billion from within its budget to meet these future challenges. Where the NHS can do things better and save money to reinvest in patient care, it must do so. We are already seeing the results – the Audit Commission found that last year, the NHS made £4.3 billion of efficiency savings – at the same time keeping waiting times low, performing more tests, and reducing infections even further.

“We are absolutely clear that this does not mean cutting services - this means getting better value for every pound spent in the NHS so that it can continue to improve and deliver services for patients every day.”

Deputy Chief Executive of the NHS David Flory said:

“The NHS is in the very early stages of its plans to deliver up to £20bn of efficiency savings by 2014/15 whilst maintaining or improving quality. The results from the first quarter of 2011/12 are encouraging, showing the NHS continues to deliver strongly for patients while maintaining a healthy financial position.
“But we know that the NHS faces unprecedented challenges with an ageing population and the rising costs of complex technology and medicines.
“The challenge going forward is to maintain high quality care, while ensuring we maintain strong financial control.“
Highlights from today’s report include:
• The NHS Constitution commitments to meeting the 18-week waiting time standard for 95% of non-admitted and 90% of admitted patients were met during the first quarter of 2011/12.
• MRSA infections were 25% lower than during the same quarter last year with C.difficile infections 17% lower. 97 MRSA infections were reported in June, the lowest figure since mandatory surveillance began in 2011.
• The number of breaches of mixed-sex sleeping accommodation standards fell significantly, from 3.6 per 1,000 episodes in March to 1.3 per 1,000 episodes in June.
• Waiting time standards for cancer services, A&E services and ambulances services were all achieved during Quarter 1, and new outcomes data for A&E and ambulance service was collected for the first time in this period.
• A comprehensive monitoring and prevention system for reducing Venous Thromboembolism (VTE) is being implemented, the only one of its kind in the world. 86% of adult inpatients received a VTE risk assessment in June 2011, meaning we are continuing to make progress towards the ambition of 90%.
• The NHS made important progress in preparing to modernise, with 257 pathfinder clinical commissioning groups (CCGs) now established, covering 97% of the population and increasingly taking on delegated responsibility from PCT clusters.



1. The Quarter report updates the NHS on progress towards key priorities, including financial health for April to June 2011 and can be found at:<<