PCTs... After all the pain they are going
Secretary of State for Health Andrew Lansley this week set out the Government's ambitious plans to reform the NHS during this Parliament and for the long-term.
The White Paper ‘Equity and Excellence: Liberating the NHS’ published last week, details how power will be devolved from Whitehall to patients and professionals.
Professionals will be free to focus on improving health outcomes so that these are amongst the best in the world. Improving the quality of care will become the main purpose of the NHS.
Patients will get more choice and control, backed by an information revolution, so that services are more responsive to patients and designed around them, rather than patients having to fit around services. The principle will be "no decisions about me without me".
Under the new plans, patients will be able to choose which GP practice they register with, regardless of where they live, and choose between consultant-led teams. More comprehensive and transparent information, such as patients’ own ratings, will help them make these choices together with healthcare professionals.
Groups of GPs will be given freedom and responsibility for commissioning care for their local communities. Providers of services will have new freedoms and they will be more accountable. There will be greater competition in the NHS and greater cooperation. Services will be more joined up, supported by a new role for Local Authorities to support integration across health and social care.
As a result of the changes, the NHS will be streamlined with fewer layers of bureaucracy. Strategic Health Authorities and Primary Care Trusts will be phased out. Management costs will be reduced so that as much resource as possible supports frontline services. The reforms build on changes started under the previous Government.
Health Secretary Andrew Lansley said:
'People voted for change and the Coalition Agreement set out a bold and exciting vision for the future of the NHS – a vision based on the principles of freedom, fairness and responsibility. The NHS is our priority. That is why the Coalition Government has committed to increases in NHS resources in real terms each year of this Parliament. The sick must not pay for the debt crisis left by the previous administration. But the NHS is a priority for reform too. Investment has not been matched by reform. So we will reform the NHS to use those resources far more effectively for the benefit of patients.
The Government’s ambition is for health outcomes – and quality services – that are among the best in the world. We have in our sights a unique combination of equity and excellence. With patients empowered to share in decisions about their care, with professionals free to tailor services around their patients and with a relentless focus on continuously improving results, I am confident that together we can deliver the efficiency and the improvement in quality that is required to make the NHS a truly world class service.'
Change always provides an opportunity for the future and the lessons we have learnt at PHN and particularly with Primary Health Support is that one size does not fit all. One of the advantages of the PCT role was that of providing for the needs of each local community. Many never understood this concept and complained of a post code lottery with some services being available in one area and not in a neighbouring one. But this was usually because of greater need for one service or another and is proof that National Frameworks can only Be a guide for local implementation.
We know from experience that GPs working together in commissioning groups can be highly effective, but they will need background assistance so that future services are joined up. Many GPs on the other hand either won’t be bothered or at worse will try to cling to their budgets and will not understand a multi disciplinary approach to Primary Care in the Community. These will be interesting times and PHN Support will be on hand to advise where necessary. Rome was not built in a day however and one hopes that all the gains we have seen and been associated with over the past 3 years will remain as examples to the new budget holders.