NHS Future Forum
We have presented our recommendations to the Prime Minister, Deputy Prime Minister and Secretary of State for Health. We believe they represent a sensible set of amendments to the current Health Bill, and that they are likely to secure a broad consensus around its contents.
We have spent eight weeks listening to over 6,700 people, at over 200 separate events. We have received over 25,000 emails, 2400 comments on our website, and 1500 other electronic responses, while 175 individuals and organisations have taken the time to post us their thoughts and responses.
We have listened, we have heard from thousands of individuals, and now it is our turn to represent those views to Government. Our recommendations represent important changes in future policy, crystallising those thousands of voices, as well as our own views.
The Forum is independent of Government. Its recommendations will now be considered and responded to by Government.
There is little doubt that the NHS needs to change. And we have heard that many of the stated principles underpinning the Government’s NHS reform programme – such as devolving control to clinicians and giving patients real choices – are supported. But the bottom line is that any change must aim to improve patient services and patient safety.
We have made 16 core recommendations, including:
• The pace of the proposed changes should be varied so that the NHS implements them only where it is ready to do so;
• The Secretary of State for Health should remain ultimately accountable for the NHS;
• Nurses, specialist doctors, and other clinicians must be involved in making local decisions about the commissioning of care – not just GPs. But we need to make sure that in doing so, the NHS avoids tokenism, or the creation of a new bureaucracy;
• Private providers should not be allowed to ‘cherry pick’ patients and the Government should not seek to increase the role of the private sector as an end in itself.
• Competition should be used as a tool for supporting choice, promoting integration and improving quality and must never be pursued as an end in itself. Monitor’s role in promoting competition should be replaced with a duty to promote real integration and collaboration between different parts of the NHS;
• Patients should have a ‘right to challenge’ local health commissioners if they feel that they have not been offered real choice, or if their service is of substandard quality;
• All organisations involved in NHS care and spending NHS money should be subject to the same high standards of public openness and accountability;
Now we will wait with interest to hear how the Government responds. Not everyone will agree with all our recommendations. But a degree of agreement is beginning to emerge about the best way forward, and we hope that we have helped that process.
We would like to thank the thousands of people who have taken the time to tell us what they think. We have not had time in the course of eight weeks to listen to everyone who had something to say – which we regret. Nonetheless, we hope Government will not only learn from our conclusions, but will continue to listen, reflect and improve.