Next Stage Review June 2008

High Quality Care for All
NHS Next Stage Review Final Report
DH June 2008

Some Key Quotes

1 Change - Locally led, patient centred and clinically driven

Planned Care. Those looking at planned care found more care could, and should, be provided closer to peoples homes, with greater use of technology, and outpatient care not always meaning a trip to hospital.

Ensuring timely access. Improving access is a priority articulated in every vision, across every pathway of care.

Providing convenient care closer to home. The local visions will make care closer to home a reality for many patients. For instance, in London, there are plans to deliver more outpatient appointments in community settings and carry out routine and straightforward procedures in GP practices, where appropriate.

Improved Diagnostics. All the visions emphasised the importance of rapid access to diagnostics in convenient locations.

Innovation. The desire to bring the benefits of innovation to patients more rapidly is a common theme. Across the country, we heard that there is much to be gained by the NHS working in partnership with higher education and the private sector.

2 Changes in healthcare and society

The NHS and all its many partners must respond to the shifting disease burden and provide personalised care for long term conditions.

The NHS must respond by improving the quality of care it provides. This is because the evidence shows that, in general, higher quality care works out better for patients and the taxpayer.

3 High quality care for patients and the public

Patients need improved access to the treatments they need supported by improved diagnostics to detect disease earlier.

Alongside the NHS, we need to ensure that a range of organisations, public and private, play their part in supporting people to stay healthy.

Additional resources will enable the local NHS to develop over 150 GP led health centres to supplement existing services.

These health centres will provide additional, convenient access to primary care services, including in the evenings and at weekends. PCTs have been developing proposals locally not only for additional access to GP services, but also to a much broader range of services such as diagnostic services to match the needs of their communities.

4 Quality at the heart of everything we do

Our goal is that every provider of NHS services should systematically measure, analyse and improve quality.

We will require, in legislation, healthcare providers working for or on behalf of the NHS to publish their 'Quality Accounts' from April 2010.

The Care Quality Commission will provide independent validation of provider and commissioner performance.

The World Class Commissioning programme will hold PCTs to account for the involvement of the full range of informed clinicians.

5 Freedom to focus on quality

Giving greater freedom to the frontline. We will continue the journey of setting frontline staff, both providers and commissioners, free to use their expertise, creativity and skill to find innovative ways to improve quality of care for patients.

We need to give greater freedom to those working in community services.

The NHS is exploring new approaches such as community NHS Foundation Trusts or social enterprises.

The purpose of practice based commissioning is to empower family doctors and community clinicians to assemble high quality care around the needs of the patients. We will work with the NHS and with the professions to redefine and reinvigorate it.

We will ensure that PCTs are held fully to account for the quality of their support for practice based commissioning.

6 High quality work in the NHS

Working together for patients. We put patients first in everything we do, by reaching out to staff, patients, carers, families, communities and professionals outside the NHS. We put the needs of patients and communities before organisational boundaries.

If frontline staff are going to focus on improving the quality of care provided by the NHS, they need the right working environments and the right training and education.

7 The first NHS constitution

As the NHS evolves, a wider range of providers, including those from the independent sector are offering NHS commissioned services.

Patients expect that whenever they receive their NHS funded treatment, the same values and principles should apply. All organisations are part of an integrated system for the benefit of patients. We propose that all organisations providing NHS services are obliged by law to take account of the Constitution in their decisions and actions.

8 Implementation

By Spring 2009, each PCT will publish its strategic plan, setting out a five year plan for improving the health of people locally.

They will show a strong emphasis on partnership working between PCTs, local authorities and other partners (public, private and third sector including social enterprise) to ensure that local health and wellbeing needs are better understood and addressed.