Government pushes on with major NHS reforms
pharmafile | December 16, 2010 | News story | | GP consortia, Health and Wellbeing Boards, NHS, NHS Commissioning Board, NHS Operating Framework, NHS reforms, PCTs
The government has set out a roadmap for its wide-ranging NHS reform plans that promises no let up in the scale of the changes it wants to see.
These include launching an NHS Commissioning Board to prepare for expanding GPs’ roles, including social care in PCTs’ budgetary responsiblities and prioritising early cancer diagnosis.
The reforms will be contained in a Health and Social Care Bill that will come early next year and incorporate the 6,000 responses the Department of Health received during the White Paper’s six-month consultation period.
Health secretary Andrew Lansley said the government’s reform agenda was “back on track” after a difficult consultation period in which many groups, the BMA and King’s Fund chief among them, criticised the pace and nature of the reforms.
But Lansley said the clear purpose of the Health Bill was for “a more responsive, patient-centred NHS, which achieves outcomes that are among the best in the world”, and which would provide “certainty, through a clear legislative framework to support that ambition, with increased autonomy and accountability at every level in the NHS”.
He said he was “encouraged” by the activity taking place at a grass-roots level, with 52 GP pathfinder groups already in place, and “many more soon to follow”.
PCT funding increase
Outlining his reforms Lansley guaranteed an increase in funding for Primary Care Trusts (PCTs) in England for the coming year, but this is unlikely to translate into a real term increase for all PCTs.
Total funding allocations will increase by an average of 3%, or £2.6 billion, to £89 billion from 2011 but this will vary for individual PCTs, coming in between 2.5 and 4.9%.
Inflation, which in November hit a year-high of 3.3%, will also play a part. PCT budgets will also have to “support” social care costs for the first time, meaning funding must stretch even further than before.
Dr Hamish Meldrum, chairman of council at doctors association the BMA, said he didn’t accept the government’s claim to be increasing real term funding for the NHS.
“The stated 3% ‘increase’ in funding for PCTs includes £1 billion already announced to cover additional social care responsibilities and masks the fact that hospitals will have to do a lot more work to achieve the same income,” he said.
Outcomes Framework for GPs
The Department of Health will also published an Outcomes Framework, setting out the areas NHS organisations must focus on over the next two years to prepare for GP commissioning.
These include the need to continue to improve performance and to “streamline” PCTs into clusters, working with GP practices and the emerging GP consortia on commissioning as well as reducing running costs.
In addition, the government will ask the NHS to prioritise the implementation of earlier diagnosis for cancer patients by funding GP practices to scan for signs of cancer, instead of having patients automatically referred to a separate specialist.
The Framework will also sets out the role of the NHS Commissioning Board to ensure an “efficient and effective” transition to GPs being more in control and which will operate in shadow form from April next year.
Lansley said he expected “similar shadow forms of Health and Wellbeing Boards to emerge” in 2011. These are intended to give NHS commissioning decisions “local democratic legitimacy” by bringing together key NHS, public health and social care leaders in each local authority area.
Ben Adams
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