The first NHS Mandate between the Government and the new NHS Commissioning Board has been published this week. The Mandate sets out the objectives for the NHS and highlights the areas of health and care where the Government expects to see improvement.
It has been produced as part of the Government’s reforms to the NHS and was drawn-up after a three month consultation during which time the public were given the opportunity to highlight what they wanted to see improved.
The Government believes that the Mandate reaffirms the commitment to an NHS that remains comprehensive and universal, available to all, based on clinical need – not ability to pay, and that it will help patients to hold the NHS to account.
It is up to the NHS Board, which will take charge of the day-to-day running of the health service from April, to make sure that what is set out is achieved. The Board will produce yearly reports showing how the NHS is doing.
The key objectives of the Mandate include:
- Improving standards of care and not just treatment, especially for the elderly.
- Reducing premature deaths from the biggest killers, such as cancer and heart disease.
- Better diagnosis, treatment and care for people with dementia.
- Better care during pregnancy, including women getting a named midwife to ensure personalised care throughout pregnancy.
- By 2015, everyone will be able to book their GP appointments and order repeat prescriptions online.
- Every patient will be able to give feedback on the quality of their care through the Friends and Family Test starting from next April.
- Putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment.
- By 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.
Health Secretary, Jeremy Hunt, has said:
“Never in its long history has the NHS faced such rapid change in our healthcare needs, from caring for an older population, to managing the costs of better treatments, to seizing the opportunities of new technology. This Mandate is about giving the NHS the right priorities to deal with those challenges. By focusing on what matters to patients, and giving doctors and professionals the freedom to deliver, we will make sure the NHS stays relevant to our needs and continues providing the best possible care for us all.”
The NHS Confederation Chief Executive added:
“The real challenge for the Government now is to stay true to its word and use the Mandate to give the NHS stability, rather than use it as a tool to reset priorities on a regular basis.”
However, the Shadow Health Secretary, Andy Burnham, was reported as saying that the Mandate was:
“dangerously at odds with the reality on the ground and risked raising unrealistic expectations. Across England, services are under severe pressure – ambulances queuing outside A&E, patients left on trolleys in corridors for hours on end, increasing numbers of A&E and ward closures.”
Sir David Nicholson, Chief Executive of the NHS Commissioning Board, welcomed the Mandate and said:
“Our aim and passion is to deliver a better NHS on behalf of patients and the public. We will do this by working side by side with local clinical leaders; by focusing relentlessly on the outcomes that the NHS delivers for people; and by freeing those on the frontline to transform services in line with the needs of local communities. The Mandate enables us to do this. It marks a major step on the road to the more liberated and innovative NHS that can be more responsive to its patients.
“Make no mistake, the NHS will find this a challenging and stretching ask – and it comes against the most challenging financial environment the NHS has ever experienced. But I believe the goals are achievable.”
Comment
In the face of the major changes ahead for the NHS, the Mandate is the first of many challenges. It sets out objectives that are hugely important to patients and it is promising to hear that the main focus is to deliver a better NHS.
It remains to be seen whether improvements can be made under the new NHS Commissioning Board, especially at a time when services are under such pressure, but the first Mandate does appear to signify a step in the right direction.
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Danielle Young is an Associate in our Medical Negligence team.
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