The government is planning a 'major' update to the NHS Constitution, giving patients stronger rights to 'openness' and confirming their right to be involved in making decisions on treatment and care, under a wider drive to make it "more meaningful" to the NHS.

The key changes include a new 'duty of candour', under which patients can expect NHS staff to be open and honest when things go wrong, and a new right for complaints to be acknowledged within a three-day limit, as well as stronger rights on how these should be addressed.

But they also seek to clarify that patients, their families and carers should be fully involved in all discussions and decisions about care and treatment, including end of life care.

The new proposals form part of a wider public consultation on how the NHS Constitution could be strengthened, and stem from recommendations made by NHS Futures Forum, which carried out a review over the summer.

It concluded that three general steps must be taken to allow the Constitution to make a real difference to the NHS.

First off, awareness and understanding of the Constitution muse be "dramatically" increased among patients and staff, and the government agrees that it wants patients to be aware of their rights so they can get what they are entitled to right from the start.

As such, the Department of Health said it will work closely with the NHS Commissioning Board, clinical commissioning groups and Health Education England to developed a united approach to raising awareness of the Constitution.

Greater traction

NHS Futures Forum also recommends that the Constitution be given "greater traction", particularly with regard to what happens when the NHS fails on people's rights or expectations, and that it is beefed up in certain areas to give it more teeth, points which the government is trying to address in the consultation.

"At the same time as we are protecting [the NHS'] budget, we are strengthening this constitution, which enshrines the right of everyone to have first class care, now and in the future," said health minister Norman Lamb.

The closing date for public comment on the consultation is January 28, 2013, and a revised version of the Constitution is scheduled for publication by April 2013.