liberating the nhs:

Liberating the NHS:

Legislative framework and next steps

The NHS White Paper reforms

An NHS that puts patients and the

public first…

…which focuses onimproving healthcare

outcomes…

…with more autonomy for professionals, more

accountability to patients, and stronger

local democratic legitimacy…

…with reduced bureaucracy and improved efficiency…

…leading to an NHS that achieves healthcare outcomes that are among the best in the world




•Shared decision-making

•An “information revolution”

•Greater patient choice

•Public/consumer voice through HealthWatch


public first…


outcomes…







•NHS Outcomes Framework

•Backed by clinically-evidenced NICE quality standards

•Money to follow the patient, with incentives for quality


public first…


outcomes…







•GP-led commissioning, supported by new NHS Commissioning Board (Commissioning for patients)

•Stronger role for local authorities and better integration (Local democratic legitimacy in health)

•More autonomy for providers; all providers regulated on a consistent basis (Regulating healthcare providers)


public first…


outcomes…

…with more autonomy for professionals,

more accountability to patients, and stronger





•Significant cuts in cost of administration•Abolition of SHAs and PCTs, and rationalisation of arm’s-length bodies


public first…


outcomes…




Consultation process and Government response

• White Paper consultations closed early October

• More than 6,000 responses in total

• Consultation events across the country, led by SHAs and by Regional Voices

• Discussion events with key national stakeholders – in particular on equality and diversity

• Liberating the NHS: Legislative Framework and next steps:

• sets out the next level of detail on reform and

• responds to consultation

• Consultation response on Transparency in outcomes published separately

• Recently closed consultations on choice and information

• Still consulting on workforce

Liberating the NHS: Legislative framework and next steps

• Some respondents opposed the White Paper entirely

• Many others had specific concerns, criticisms or suggestions

• Most people welcomed the White Paper’s principles

• There was support (and passionate enthusiasm) from a range of respondents, across the spectrum of the reforms

• In response we have:– Modified and

improved several of our proposals

– Adapted our draft legislation in the Bill

– Significantly strengthened our approach to transition and implementation

Examples of how we will modify our approach

Set up a GP pathfinder programme, already

covering a quarter of the country

Strengthen transparency by requiring each GP

consortium to publish a constitution and adhere to

principles of good governance

Give primary responsibility for commissioning

maternity services to GP consortia,

backed by national support

Significantly strengthen the role of health and

wellbeing boards, and accelerate progress through

early implementersAllow a more phased

transition for completing reforms to providers – with Monitor retaining some temporary controls over some Foundation Trusts

Not merge LAs’ formal scrutiny powers into the

health and wellbeing board, but extend them to cover all

NHS-funded providers

Create a more distinct identity for HealthWatch

England, led by a statutory committee in CQC

Legislative timetable

• Health and Social Care Bill was introduced in January

• This is a major restructuring of NHS legislation, based on principles of:

• minimising political interference and • maximising the autonomy of commissioners and

providers

• Subject to Parliament, new system will start coming into force from April 2012

Effective implementation and a managed transition

2011/12 Learning

and planning for

roll-out

2010/11

Design and early

adoption

2012/13

Full dry run

2013/14

First full year of the

new system

•A phased transition over four years, with:

• freedom for enthusiasts to make progress early

• more time to plan, test and learn

liberating the nhs:

Documents