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Choice mandate ‘to increase integration of services’

By Nigel Praities

The NHS Commissioning Board's mandate to improve patient choice in the health service can help integration of services, the Government's panel of experts advising on the future of the health bill has claimed.

In a controversially worded report, a panel of experts - led by Sir Stephen Bubb, chief executive of the Association of Chief Executives of Voluntary Organisations – said competition and integration were not ‘opposing forces' and should both be encouraged.

It argues that the policy of ‘any qualified provider' – a policy that has been criticised by both the RCGP and the BMA – should be retained, and that a new framework of choice and competition should be established, with the NHS Commissioning Board taking on a ‘choice mandate' set by the health secretary.

This mandate will set the parameters for choice and competition in the NHS and ensure that it will promote more integration and improve outcomes. The board will have to required to report on its progress.

Monitor should have the requirement to promote competition removed and replaced with a primary duty should be to ‘protect and promote the interests of the patient'.

The public will also have a new ‘right to challenge' if they are not getting the choice they desire, and a new Citizens Panel, part of Healthwatch England, will publish an annual assessment for Parliament on how well organisations have done in delivering the ‘choice mandate'.

The report said: ‘We have also heard many people saying that competition and integration are opposing forces.'

‘We believe this is a false dichotomy. Integrated care is vital, and competition can and should be used by commissioners as a powerful tool to drive this for patients.'

‘There needs to be a culture in the service that both encourages innovation and supports collaboration. We also believe competition will play an important role driving change.'

‘There is a wealth of talent and untapped resource in our country's third sector which can benefit the NHS, so there is a good argument for greater commissioning from alternative providers of care where appropriate.'