Health Secretary Andrew Lansley has unveiled the first draft of the National Health Service mandate that sets out what the incoming NHS Commissioning Board (NCB) is expected to achieve.

The 37-page document contains 22 so-called care objectives against which the NCB - which will control £80 billion worth of taxpayers' cash from next year - will be held to account, covering the period April 2013-March 2015.

The objectives in the mandate are based on indicators in the NHS Outcomes Framework and are grouped into five broad “domains”: preventing premature death; enhancing quality of life for people with long-term conditions; helping people to recover from episodes of ill health or following injury; ensuring people have a positive experience of care; and treating/caring for people in a safe environment and protecting them from avoidable harm. 

Standard objectives include increasing the number of Quality Adjusted Life Years for people in England with long-term conditions, developing a collaborative programme of action to place mental health on a par with physical health, and promoting access to clinically appropriate drugs and technologies as

recommended by the National Institute for Health and Clinical Excellence.

However, the mandate also sets out that the availability of personal health budgets should be extended to anyone who might benefit from them, and confirms that patients should be able to choose an alternative provider if they are likely to overshoot the 18-week referral to treatment target. 

Also, it says clinical commissioning groups are to be established across England by April 2013 and that, somewhat controversially, financial incentives such as the quality premium should be available for commissioners and providers to "support better outcomes and value for money".

Although eagerly awaited details on the quality premium are still somewhat thin, but it has been confirmed that funding will come from within the overall administration costs limit set for the NHS commissioning system. 

Commenting on the draft mandate, Mike Farrar, chief executive of the NHS Confederation, said it "broadly ticks the main box - it keeps things relatively simple and consistent".

"The NHS Commissioning Board will have a responsibility to allow local commissioners to take the decisions that are in the best interests of their community, while providing national consistency in areas like quality, safety, access and value for money," he said, but added "We will have to wait to see whether this can be put in to practice, and ensure the NHS Commissioning Board avoids returning to the old style of command and control".

The government's proposals in the mandate are now up for consultation until September 26, and the final version should be published sometime in the Autumn.

First annual report 

Lansley has also published his first ever annual report on the National Health Service, concluding that it has "performed well" during the year 2011/12, hitting targets and "meeting the financial challenge".

The NHS has maintained or improved its performance against a range of quality indicators contained within the NHS Operating Framework, the report claims, hitting key targets on time to treatment and infection markers.

Referral to treatment consultant-led waiting times remained low and stable during the period, with over 90% of admitted patients treated within 18 weeks of referral, while MRSA and C. difficile bloodstream infections were at the lowest levels since mandatory surveillance was introduced.

Want to know more? The next PharmaTimes Directors Club meeting - Life after the new Health and Social Care Act - takes place on July 12 at The King's Fund, London. Speakers include Anthony Keely, Director of the NHS Commissioning Board and Dr Gillian Leng, Deputy Chief Executive of NICE. Click here for the full meeting agenda and how to book your place.