Department of Health and Social Care
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More choice for NHS patients across the country
NHS patients will have more freedom to choose where they go for their healthcare from April 2012, Health Secretary Andrew Lansley announced today.
More choice will mean that when patients are referred for selected services, usually by their GP, they should be able to choose from a range of qualified providers who meet NHS quality, prices and contracts.
These providers could be NHS providers, independent sector providers, or voluntary or third sector organisations. This will enable patients to choose the provider best-placed to meet their individual needs and help to drive-up the quality of services for everyone.
To date, choice has only been available in non-urgent hospital care, but guidance published today sets out that the choice offer will be extended to community and mental health services for the first time. Following advice from patient groups, clinicians and voluntary organisations, there are eight services that have been recommended as the most suitable:
Services for back and neck pain Adult hearing services in the community Continence services (adults and children) Diagnostic tests closer to home Wheelchair services (children) Podiatry (feet) services Leg ulcer and wound healing Talking Therapies (Primary Care Psychological therapies, adults)
Every area across England will be expected to offer more choice in a minimum of three services by September 2012 – either from the recommended list or for another community or mental health service that is a high local priority. The number of services will be expanded further from April 2013.
Andrew Lansley said:
“This is a big day for patients – real choice over how and where they are treated is becoming a reality. There is often confusion about these policies – a mistaken idea that competition is there for the sake of it, or to increase the independent sector’s role in the NHS.
“But let’s look at what this is really about: it’s about children getting wheelchairs more quickly. It’s about people with mental health conditions choosing to receive their care somewhere closer to home. It’s about older people being able to choose a service that will come to their home – perhaps the vital difference between staying at home or having to move into care. It’s about real choices for people over their care, leading to better results.
“We are taking a phased approach, offering choice for services where it will improve outcomes, responding to the recommendation of the NHS Future Forum which supported the Government’s policy to offer patients greater choice of provider.”
The Department of Health is also publishing its official response to the consultation on this issue, which sets out that:
Over half of respondents agreed that mental health and community health services are the best services to offer more choice from April 2012 The policy will be implemented more slowly than was originally planned Providers will be paid a fixed price determined by a national or local tariff – competition will be on quality, not price A national qualification process will be established to ensure that providers meet NHS quality standards, to minimise bureaucracy and reduce transaction costs A national directory of qualified providers will be created to inform commissioners and patients
Any providers wanting to offer services to patients will be subject to a qualification process. They will need to be registered with the Care Quality Commission where appropriate and licensed by Monitor (after 2013) and will need to accept NHS prices. It will never be appropriate for some services, for example emergency ambulance admissions or A&E.
Ruth Owen, CEO of Whizz Kids, a charity that helps people access wheelchairs more quickly, said:
"We believe Any Qualified Provider will remove the barriers to faster, better wheelchair services by enabling organisations like ours to work collaboratively with the NHS to provide unmet needs, shorten waiting lists and drive innovation.
"The NHS will benefit from cheaper, more integrated services; children will benefit from better equipment and shorter waiting lists; Whizz-Kidz will benefit by developing as leaders in this field, spreading best practice and being successful in our goal to help make children's lives better - and in turn, their families and communities."
Sophie Corlett- Director of External Relations at Mind said:
“Mind is in favour of extending choice and availability for individuals in psychological therapies - both of provider and of type of therapy. We would hope that this enables people to have access to treatment in a provider near to their home or workplace and in a manner or by a therapist of their choosing.
“Choice can also make talking therapies much more effective. In a survey carried out by Mind in 2010, service users that reported having a choice of therapy were 3 times more likely to be happy with their therapy than those who wanted a choice but didn't get it.”
Chief Executive of Action on Hearing Loss, Jackie Ballard, says:
"People tell us that what matters to them is timely and convenient access to services of a reliable quality which are available free at the point of delivery. They also want their hearing loss and communication needs to be understood and to receive information on other technology or support which could be helpful. They are less concerned about who delivers the service as long as it meets their needs."
Currently patients needing elective hospital treatment (such as a hip or knee replacement, removal of a cataract or hernia repair) have a free choice of where they are treated, including many independent hospitals. Over 200,000 procedures a year are carried out by an independent hospital, paid for by the NHS. This is more than a five-fold increase over the three years this policy has been in place.
Notes to Editors
1. The Department of Health has published two documents, guidance on how the NHS will deliver greater choice and the official Government response to the consultation on the policy delivering this, Any Qualified Provider (AQP). Both are available at http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_125442
2. The guidance sets out how patient choice of AQP will be extended over the period from now to April 2013, and the principles governing AQP in the new system architecture. Specifically:
· By October 2011, Primary Care Trust clusters are expected to engage with local patients, carers and professionals and identify three or more community or mental health services in which to implement patient choice of Any Qualified Provider in 2012/13, driven by patients' priorities fro improving the quality of NHS services.
· Between April and September 2012, PCT clusters should implement patient choice of AQP for those services.
· PCT clusters, supported by pathfinder clinical commissioning groups, should select three or more services for implementation in 2012/13 from the list set out above. Alternatively, they may choose other services which are higher local priorities, if there is a clear case to do so based on the views of service users and potential gains in quality and access. Details of how registered will be published in the autumn, along with details of who is registered on a directory.
We will work with national patient and carer groups and professionals to identify a range of services for which patient choice of AQP could be implemented next. These could include:
· Maternity – antenatal education and breastfeeding support
· Speech and Language Therapy
· Long Term Conditions self management support
· Home chemotherapy
· Primary Care Psychological Therapies (CAHMS)
· Wheelchair services (adults)
Key principles of an Any Qualified Provider approach:
· Providers qualify and register to provide services via an assurance process that tests providers’ fitness to offer NHS-funded services.
· Commissioners set local pathways and referral protocols which providers must accept
· Referring clinicians offer patients a choice of qualified providers for the service being referred to
· Competition is based on quality, not price. Providers are paid a fixed price determined by a national or local tariff.
Department of Health
Phone: 020 7210 5221