Hospital Dr News

More detail needed on white paper proposals

Doctors’ leaders have called for more detail from the government following the launch of the white paper Equity and excellence: liberating the NHS, which spells out the way a head for the NHS.

They also want more consultation with clinicians on the proposals which will shake-up primary care with the creation of GP consortia and the phasing out of PCTs and SHAs. These consortia will have responsibility for commissioning services.

Under the new plans, patients will also be able to choose which GP practice they register with, regardless of where they live, and choose between consultant-led teams. More comprehensive information, such as patients’ own ratings, will help them make these choices together with healthcare professionals.

Professor Sir Ian Gilmore, president of the Royal College of Physicians, welcomed the shift towards a greater focus on quality and outcomes than targets.

He said: “We are particularly pleased that the crucial role of national clinical audit will be strengthened and that GPs will again be able to refer patients to individual hospital specialists in line with the patient’s wishes.

“Nonetheless the task of putting into place measures that are genuinely useful to patients and clinicians should not be underestimated. It is essential that commissioning groups work collaboratively with specialists to develop integrated care pathways and that any shift in clinical priorities is carefully considered to ensure that the desired outcome is not overshadowed by unintended consequences.”

The white paper also outlines the creation of an independent NHS Commissioning Board. It will lead on quality improvement and the achievement of health outcomes, allocate and account for NHS resources, and promote patient involvement and choice.

Mr John Black, president of the Royal College of Surgeons, said: “The best results and the best patient experience are achieved when there is continuity of care. If these new proposals are to benefit patients having surgery, they must enable GPs the flexibility to make decisions based upon the need of the individual patient and allow them to refer to a single, named consultant who will see their patient through the operation and afterwards.”

He added: “We need to hear more detail, especially on the composition of proposed GP consortia and the powerful new independent NHS commissioning board.”

The white paper makes a commitment to giving health service providers new freedoms in return for greater accountability. It also says there will be greater competition, cooperation and more joined up services. Councils will have a new role supporting integration across health and social care.

Dr Hamish Meldrum, chair of BMA council, said: “Doctors, and their staff, already take the lead on designing services and innovating new treatments for patients and will be interested in discussing how these roles will be enhanced. They will wish to see how the proposed changes allow them to work collaboratively, and in partnership with their patients, to facilitate improvements in the care pathway and to see unnecessary barriers and bureaucracy removed.

“Any reorganisation of the NHS must take place in consultation with clinicians so that it does not cause any disruption to patient services or needlessly waste the valuable time of healthcare professionals.”

Read the full report.

Read our bloggers Stephen Campion or Bob Bury on the issue.

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