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Historic NHS Mandate published today

Government sets out future of the NHS in England

Jo Carlowe

Wednesday, 14 November 2012

Health Secretary Jeremy Hunt will today deliver the government’s first mandate to the NHS, setting out its priorities for the health service over the next two years.

The mandate, which explains what patients in England can expect from GPs and hospitals, will be issued to the NHS Commissioning Board.

Priorities listed include: improving early diagnosis, cutting premature deaths from the biggest killers, improving care for new mothers and better help for dementia sufferers.

The Mandate has been drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012.

The key objectives contained within the Mandate include:

  • improving standards of care especially for the elderly and vulnerable
  • better diagnosis, treatment and care for people with dementia.
  • better care for women during pregnancy, including a named midwife
  • patients will be able to give feedback on the quality of their care through the “Friends and Family Test” starting from next April. 
  • Online appointments with GPs for all by 2015
  • Treating mental and physical health with equal priority
  • Preventing premature deaths from the biggest killers.
  • Publication of results of local NHS providers by 2015.

The Commissioning Board will be given a budget of over £95 billion for 2013/14, in order to deliver the objectives set out in the Mandate.

Launching the mandate Health Secretary Jeremy Hunt said: “Never in its long history has the NHS faced such rapid change in our healthcare needs, from caring for an older population, to managing the cost of better treatments, to seizing the opportunities of new technology.

“This mandate is about giving the NHS the right priorities to deal with those challenges. We do not want an NHS that focuses on narrow performance indicators but instead looks at true measures of whether all of us are receiving the highest quality of care.

“The new NHS will be locally led and locally responsive. While the Government will continue to set overall goals for the NHS, the decisions on how to deliver the objectives in the NHS Mandate will be made by the people who know patients best – doctors, nurses and other health professionals.”

The Mandate has been broadly welcomed in the medical arena.

Commenting on it, Dr Mark Porter, chair of the British Medical Association’s Council, said: “It is encouraging that the government has taken on board many of the views expressed by the BMA in our response to the draft mandate for the NHS Commissioning Board (NHS CB).

“The mandate reflects the BMA’s opinion that the NHS CB needs flexibility to exercise its judgement on how to deliver this vision. There are measures to encourage the NHS CB to innovate, and a welcome reduction in targets, objectives and micromanaging that marred the draft mandate. “

However, he added that the BMA wanted to discuss the practical implementation of some areas of the mandate including how the NHS could take advantage of new technological and IT developments.

“These proposals will require significant resource and technical commitments that must be considered if they are to become a reality. It is also vital that any changes that affect patient records do not in any way compromise patient confidentiality, especially if they may be placed online. The NHS CB must consider this matter very carefully before any implementation.

“There also needs to be greater clarity on how the NHS CB is to be held to account and a clear plan to communicate the cultural change the mandate seeks to achieve to NHS staff and patients.

“Most importantly, if the NHS CB’s strategic vision is to be delivered, ministers must ensure there is genuine clinical involvement and adequate resourcing.

“The NHS is currently operating in a tight financial environment and there is some evidence of a lack of engagement with Clinical Commissioning Groups (CCGs) amongst many healthcare professionals. Addressing these key issues will be vital to ensuring that the NHSCB and the mandate are a success.”

Sir David Nicholson, chief executive of the NHS Commissioning Board also welcomed the mandate, describing it as: “A major step on the road to the more liberated and innovative NHS that can be more responsive to its patients.”

NHS Confederation chief executive Mike Farrar said he was pleased the government had listened to the Confederation’s views but said it was vital that the NHS be given a period of stability:

"The real challenge for the Government now is to stay true to its word and use the mandate to give the NHS stability, rather than use it as a tool to reset priorities on a regular basis...We will hold ministers to their word that they will not try to revise the mandate on an ad hoc piecemeal basis in response to the latest issue that hits the headlines. 

"The NHS has just undergone the biggest structural reorganisation of its history. It faces enormous strategic challenges to remain sustainable in the future. It desperately needs a stable environment so that it can concentrate on these big issues on behalf of the public.”

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