The NHS Commissioning Board has published its blueprint for the new local commissioners in the health service, but many are still worried about the impact of QIPP.
The Board, which gains statutory powers in April, has set out its ambitions for the NHS in its new form, with a focus on helping local clinicians deliver more responsive health services, improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution.
The Board, which will be in charge of the 227 new clinical commissioning groups from next year, is part of the major reform of the NHS that will see the old management structure of the 162 primary care trusts and strategic health authorities abolished next year.
The ‘Everyone Counts’ document outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS.
Specifically, the new guidance says that CCGs will be judged on 48 measures of care including death rates and emergency hospital admissions. These groups, made up primarily of GPs, will be judged on areas including premature death, quality of life, recovery, patient experience, safe environment and protection against avoidable harm.
Targets also include antipsychotic prescribing rates and patient experience of GP out-of-hours care, meaning practices are likely to face renewed scrutiny from their CCGs in these areas.
As PharmaTimes UK News reported earlier this week, the NHS will in addition look to move towards routine services being available seven days a week.
The King’s Fund director of policy, Anna Dixon, said the think-tank welcomed much of the new guidance, but warned “some commissioners and providers may find it challenging to fully implement the guidance at a time of unprecedented financial constraint”, given that the NHS is looking to save £5 billion per year until at least 2015 under the QIPP challenge.
The doctors’ union the BMA has also issued the same warning, with its chairman Dr Mark Porter saying: “[The] guidance is an extremely ambitious plan for the NHS in England, particularly at this time of major structural change and continuing financial pressure. While many of the aims are laudable, new CCGs will have the very real challenge of putting these aspirations into practice.”
Sir David Nicholson, the NHS Commissioning Board’s new chief executive, did not make light of the financial problems facing the NHS. He said: “There are big challenges – not least the financial backdrop – but we must be ambitious. We want to make the NHS the best customer service in the world by doing more to put patients in the driving seat. We are determined to focus on outcomes and the rights people have under the NHS Constitution, as well as ensure those most in need gain most from the support we provide."
He added: “At the heart of our approach is local control over decision making. We want to put power in the hands of clinicians who know their patients best. We want to give them the money, information and tools to do the job. And we want the public to have the information they need to make choices and participate fully in the development of their health services.”
NHS Confederation interim director of policy, Jo Webber, said it was now time for local commissioners to take advantage of this blueprint and use their knowledge and skill to deliver improvements in their local areas. “This will require close working relationships with local organisations across health and social care,” she said, adding that they must make sure “that services are joined up to provide the best care for people".