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Analysis: Another step in the drive for patient choice

The DH’s response to the ‘Liberating the NHS: No decision about me, without me’ consultation further drives home the Government’s choice agenda – and outlines the practical next steps.

Research from the Nuffield Trust has shown that patient choice has contributed to an expansion of the independent healthcare market. Choice policies first introduced by Labour in 2004 do appear to be influencing patient behaviour, with 20% of hip replacements, hernia repairs and gall bladder removals now courtesy of a private provider.

Now GPs are to facilitate patients being able to choose who they go to for a range of common diagnostic tests, as well as their first outpatient appointment and the consultant-led team charged with their care.

CCGs have been instructed to ensure patients are offered choice. The DH plans to write this into sector 75 regulations for the first time, with Monitor given the power to investigate CCGs that fall short.

According to the impact assessment published last week, the DH expects the proposals to be welcomed by GPs. The assessment pointed to research from the King’s Fund which concluded GPs and other healthcare professionals were ‘broadly positive’, or ‘ambivalent at worst’, about choice.

The King’s Fund research did also acknowledge though that in the past problems with Choose and Book may have somewhat dented GPs’enthusiasm for choice. ‘This perception needs to change’ in order to fully embed the expanded choice policy, the DH concluded.

Since the original consultation in May, the DH has begun publishing waiting times on the Choose and Book system so patients can factor this into their decisions, and it is still working on the possibility of developing Choose and Book and NHS Choices to provide a combined source of information accessible by patients.

But other concerns expressed in the consultation – that more choice requires more capacity, that health inequalities could be exacerbated, that consultation times are not long enough – were given short shrift. Choice, it seems, is very much here to stay.

Madlen Davies is a reporter at Pulse