Frontline yet to be convinced on reform pledges
pharmafile | May 9, 2008 | News story | |Â Â Â
A new code of practice for the NHS has been launched which aims to ensure any future reforms to the service are appropriate and not led by central government or politically motivated.
The new 'five pledges' have been put together by the government minister Lord Darzi, and is an acknowledgement that previous reform programmes have been 'top-down' and with little engagement with local NHS staff or patients.
But the new pledges have been greeted with some scepticism, as the come just ahead of another centrally-led reform programme, Lord Darzi's Next Stage review.
In particular, there is widespread concern among GPs that they will be forced to give up existing practices and be made to form new 'super surgeries', which the government believes could be the answer to improving patient care and controlled NHS costs.
The five pledges
* Change will always be to the benefit of patients.
* Change will be clinically driven
* All change will be locally-led
* The public and patients will be involved
* You will see the difference first
Commenting on the five pledges, Lord Darzi said: "The nature of healthcare means services will always need to change, and sometimes that means re-organising how services are provided.
"Our nationwide listening events have shown me that patients, the public and NHS staff are not opposed to change in principle but want to ensure it is done to save lives and improve quality and is not driven by cost or politics.
"This is not about change for change's sake. It's about change for the right reasons, improving quality of care for patients and saving lives. These pledges mean change will be locally-led, clinically-driven and evidence-based. And an independent high clinical bar for change should reassure local people everywhere that we mean what we say."
But Dr Hamish Meldrum, chairman the BMA said the five pledges were so general that they were impossible to disagree with, and that evidence of the priciples needed to be seen in action.
"The problem is that the public and healthcare staff alike have yet to see much evidence of these principles being delivered up to now.
"As part of the initial Darzi review, it appears that every PCT will have to meet a centrally imposed requirement to have a new 'super surgery'. This is despite a lack of sound evidence to show that they all need one, or that proper local consultation is always taking place."
The NHS Alliance also responded to the new announcement, and welcomed the principles.
Dr Michael Dixon, NHS Alliance chairman, said: "We applaud Lord Darzi's five principles. But now we need to see clear evidence that the NHS supports him and that there is a real change in the way the health service operates.
"Frontline clinicians and managers should be the power source of change instead of merely being 'engaged' and 'consulted' about change directed from the top."
He added that 'paradoxically' firm direction needed to come from central government to help empower frontline clinicians. This included strengthening Practice Based Commissioning, setting up a Clinical Leadership Academy to develop skills, and the establishment of local primary care public engagement groups.
Lord Darzi's final Review report will be published in June.
