Department of Health and Social Care
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New constitution to secure the NHS for the future
A draft Constitution that enshrines the principles and values of the NHS for the future was published today for consultation by the Secretary of State for Health, Alan Johnson.
The first of its kind in the world, the Constitution follows extensive discussions with staff, patients and the public over the last year. It reaffirms the rights to NHS services, free of charge without discrimination of any kind. For the first time, it will bring together in one place and clarify for staff and patients their rights and responsibilities to ensure the NHS operates fairly and effectively.
The Constitution also recognises that the NHS is too important to be left to chance. The Government will be obliged by law to renew the NHS constitution every ten years so that any changes are the result of a full and transparent debate and cannot be changed by stealth. We will place a new legal duty on all NHS organisations to take account of the Constitution in decisions that are made.
Alan Johnson said:
"This is a momentous point in the history of the NHS. As we approach the 60th anniversary of our health service, it is striking how its founding principles still endure and have resonance for staff, patients and public alike.
"The content of the Constitution was not dreamt up by me or civil servants in Whitehall. It is something that has arisen out of discussions with thousands of NHS staff and patients across the country.
"What we have come up with is not set in stone but is a good basis for further consultation. I think it strikes the right balance between the need for clarity and avoiding undue litigation, between the need to state what is enduring while ensuring the NHS has the flexibility to change and keep pace with rising expectations and medical advances.
"As the draft Constitution states at the outset, the NHS belongs to the people. I would therefore urge everyone with an interest in preserving what's best about the NHS, as well as ensuring that it is fit for the future, to participate in the consultation and tell us what they think."
For patients, the Constitution collects together important rights around access to drugs and treatments, health services, information, quality of care and environment, dignity & respect and complaint and redress. These include:
- The right to drugs and treatments approved by NICE for use in the NHS if clinically appropriate. Patients will also have a right to expect local decisions on funding of other drugs, where NICE has yet to issue guidance or where NICE will not be appraising a drug, to be made rationally following proper consideration of the evidence. If the local NHS decides not to fund a drug that a patient and their doctor feel would be right for them, the PCT will have to explain that decision to them. We will also work with NICE to speed up the process for appraising new drugs so that NICE can issue the majority of its appraisal guidance within a few months of a new drug's launch;
- The right to make defined choices about your NHS care with clear options. This is a new legal right which will give patients the right to make choices about their healthcare based on information made easily accessible by the NHS so those choices are real and informed. This includes the right to choose your GP practice and express a preference for consulting a particular doctor. Enshrining the right in the Constitution will make sure that choice endures and becomes a core feature of a responsive NHS in the 21st Century;
- The right to be treated with dignity and respect and given a professional standard of care, by appropriately qualified and experienced staff in a clean and safe environment;
- The right to complaint and redress. The constitution sets out a number of rights and pledges to ensure patients and the public are able to make complaints and get access to swift redress if they are unhappy with their healthcare. We do not want to create a litigious culture with the development of an NHS Constitution, but we do want to ensure that it has enough teeth to make a difference.
At the same time, it is important that patients play their part too and recognise they have responsibilities to help the NHS work effectively. Although patients will still be treated based on clinical need, there will be an onus on them to contribute to their own good health and take some personal responsibility. Patients will also be expected to register with a GP and keep appointments, or cancel within a reasonable time.
For staff, the draft constitution recognises that it is their commitment, loyalty, professionalism and dedication that really makes a difference to patients' quality of care and experience. A series of pledges are outlined which the NHS will strive to deliver to ensure that staff are provided with rewarding jobs and with the training and support they need to do their jobs as well as they can.
The Constitution also reaffirms the enduring values of the NHS, based on discussions with staff, patients and the public. They include values such as respect and dignity, compassion, commitment to quality of care and putting patients first in everything the NHS does.
David Nicholson, NHS Chief Executive, said:
"Ara Darzi asked me in his interim report to lead a work programme exploring the merits of a Constitution for the NHS. This has been a fantastic opportunity to listen to what matters most to our patients, public and staff and to use this to clearly set out the values and purpose of the NHS system. It also pulls together in one place what the patients who use the NHS, the public who fund it and the staff who provide it can expect to receive from the NHS, and the contribution they can make themselves. The draft Constitution will be a powerful driver of change in the system and will help us to deliver care fit for the 21st century."
Steve Field, President of the Royal College of GPs, said:
"I became a GP because I wanted to help people improve their lives through better healthcare, whoever and wherever they are. The new NHS Constitution embodies the strong feelings and values I had then - and that I still have today. It strengthens the foundations on which the NHS is built and strongly articulates what the NHS stands for in the 21st century.
"The Royal College of GPs is at the forefront of patient-centred care based on a partnership between patients and clinicians. The Constitution sets out patients' rights and responsibilities in a clear way for the first time and it is very welcome. It is something to which all GPs, their practice teams and NHS staff can commit and have confidence in to improve standards and care for all our patients. I am privileged to have been involved in its development."
Sally Brearley, of the Patients Association, said:
"It will be important what patients and public have to say during the consultation and I hope that as many people as possible participate in it and share their views on what should be included. I think this will be a valuable and powerful document in the hands of patients to help them get the best quality care."
Notes to editors
1. The draft NHS Constitution is a short declaratory document. All the rights and pledges are underpinned by existing law or policy, except the new right to choice. A 14 week consultation on the draft Constitution, starts today and a final version will be published by the end of the year.
2. The legislation to put a requirement on the Secretary of State for Health to renew the Constitution every ten years and for NHS organisations to take account of it will be introduced in the next session as part of the new NHS Reform Bill.
3. The draft Constitution and consultation, booklets for staff and patients and the Constitution handbook can be found at http://www.dh.gov.uk/consultations Copies can be read at 3:30pm.