The Government has published its coalition agreement in full, including agreed proposals on the NHS.
Many of the proposals have been taken from the Conservative Party election manifesto and will have been anticipated. However, there are also a number of Liberal Democrat proposals, and compromises between both Parties manifestos, that are included in the agreement as well.
There are a number of proposals that will affect the way PCTs operate including:
- Directly elected PCT board members: In line with the Liberal Democrats’ manifesto, there will be directly elected individuals on the boards of local PCTs. The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will now be appointed by the Secretary of State on the advice of the new independent NHS board.
- Commissioning: GPs will commission care on patients’ behalf. PCTs will commission ‘residual services that are best undertaken at a wider level, rather than directly by GPs’. PCTs ‘will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations’.
- Public health budgets: Local communities will be given greater control over public health budgets with payment by the outcomes they achieve in improving the health of local residents. GPs will also be given greater incentives to tackle public health problems.
Independent NHS Board: An independent NHS board will be established to allocate resources and provide commissioning guidelines.
- Stopping top-down reorganisations: Top-down reorganisations of the NHS ‘that have got in the way of patient care’ will be stopped. The ‘centrally dictated closure of A&E and maternity’ will also be stopped. ‘If a local authority has concerns about a significant proposed closure of local services, for example an A&E department, it will have the right to challenge health organisations, and refer the case to the Independent Reconfiguration Panel. The Panel would then provide advice to the Secretary of State for Health.
- Providers: Patients will be given the power to choose ‘any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers.
- Administration: The cost of NHS administration will be cut by a third, although there is no clarity at this stage whether this includes or excludes the previous Government’s proposals to cut management costs by a third.
We will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers.
Other key health announcements include:
- GPs: Patients will be able to register with the GP they want, without being restricted by where they live.
- New dental contract: A new dentistry contract will be introduced to improve dental health and access to NHS dentistry, with an additional focus on the oral health of schoolchildren.
- Social care: Establish a commission on long-term care, to report within a year.
- Regulation: There will be a strengthened role for the Care Quality Commission, with Monitor developing into an economic regulator that will oversee aspects of access, competition and price-setting in the NHS. The Comprehensive Area Assessment is to be abolished.
- NICE: NICE will be reformed and there will be a system of value-based pricing for drugs.
- Local government: Councils will be given a general power of competence, and the Government will introduce new powers to help communities save local services and services threatened with closure.
- Measuring performance: Success will be measured on outcomes – such as improving cancer and stroke survival rates or reducing hospital infections. Detailed data about the performance of healthcare providers will also be published online.
- Mutual’s and social enterprises: The Government will support the creation and expansion of mutual’s, co-operatives, charities and social enterprises, and enable these groups to have greater involvement in the running of public services.
- Health inequalities: Ways of improving access to preventative healthcare to those in disadvantaged areas will be explored to help tackle health
- Urgent care service: A 24/7 urgent care service will be developed in every area of England.
- Foreign healthcare professionals: The coalition will seek to stop foreign healthcare professionals from working in the NHS unless they have passed robust language and competence tests.
- Health spending increase: There will be health spending increases in real terms in each year of the Parliament.
There is no official announcement about the role of SHAs or the structure of PCTs at this stage. However, the number of ‘health quangos’ will be ‘significantly cut’ although it is unclear at this stage which organisations this will involve.
The PCT Network will be seeking to quickly arrange meetings with Government ministers with responsibility for community services and commissioning to discuss some of the changes being proposed, and to clarify current policy. We will keep members updated as further details on these proposals emerge.