
No specific targets in NHS mandate
pharmafile | November 14, 2012 | News story | Sales and Marketing | CCGs, NHS, commissioning
The government has given the first public directive to the nascent NHS Commissioning Board, which assumes its new responsibilities from 1 April 2013.
The government’s NHS Mandate sets out objectives and highlights five key areas the government wants to see improved between then and March 2015.
Health secretary Jeremy Hunt said his head would be ‘on the block’ if England’s figures on preventable deaths did not become among the best in Europe.
But shadow health secretary Andy Burnham warned that the 28-page document was nothing more than a ‘wish list’ which is “dangerously at odds with the reality on the ground” as NHS staff are cut.
The idea behind the Mandate – which Hunt mentioned in his party conference speech last month – is to take away political target-setting from the running of the NHS. The document sets out a map of where the NHS is expected to be by 2015 but leaves decisions on how best to get there to doctors.
It is certainly short on specifics: a draft version of the document released in July contained a number of points carrying the figure ‘X’ which the Department of Health said would be filled in following consultation.
For example, the first objective was to secure an additional X life years for the people of England, through the reduction of avoidable mortality, by 2015, X life years by 2018 and X life years by 2023.
However, these have all disappeared to be replaced by the general point that ‘progress will be expected’ in various facets of these five main areas in the NHS:
- Preventing people from dying prematurely
- Enhancing quality of life for people with long-term conditions
- Helping people to recover from episodes of ill health or following injury
- Ensuring that people have a positive experience of care
- Treating and caring for people in a safe environment and protecting them from avoidable harm.
Sir David Nicholson, chief executive of the NHS Commissioning Board, said he was ‘under no illusions’ about the scale of the task his team faced “in the most challenging financial environment the NHS has ever experienced”.
But he said the mandate was a “major step on the road to the more liberated and innovative NHS that can be more responsive to its patients”.
The Board’s chair, Malcolm Grant, added that the mandate recognised the importance of clinical commissioning groups (CCGs) operating independently of government.
“We will ensure maximum freedom for CCGs, so that local clinical leaders may respond more effectively to the needs of their local population,” he said.
NHS Confederation chief executive Mike Farrar welcomed the mandate as a ‘major sea change’ for the NHS.
“We argued that it should not be too detailed or prescriptive,” he said. “It was really important that the government avoided stuffing the mandate to the gunnels with detailed targets for every condition under the sun.”
He warned that ministers must resist the temptation to tinker with the document now that it has been published.
“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,” he concluded.
ABPI chief executive Stephen Whitehead said the provision of drugs would be crucial in helping the NHS succeed, as would implementing the government’s Innovation, Health and Wealth initiative.
“If the NHS and the pharmaceutical industry can deliver IHW successfully, the NHS Mandate can be readily achieved and deliver better healthcare whilst helping to reduce expensive secondary care,” Whitehead concluded.
For details on attending Pharmafile’s conference ‘CCGs, the new NHS and Pharma’ on 5 December in London, click here.
Adam Hill
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