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.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk