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DH expands choice to wider range of diagnostics

The DH revealed that patients will be offered a choice of provider for 20.5 million tests annually, including endoscopy, audiology assessments, ophthalmology tests and imaging tests such as CT and DEXA scans by 2015.

This extends previously announced plans that choice should be offered for MRI scans and non-obstetric ultrasounds

Cardiac physiology tests, respiratory and sleep physiology, urodynamics and vascular physiology tests were also listed as priority areas in the response to the ‘Liberating the NHS: no decision about me, without me’ consultation.

As part of an impact assessment on the plans, the DH estimated that 1% of patients will choose a different provider under the proposals, affecting 103,000 tests, and added that this was only a ‘conservative’ estimate.

They said that if the average time a patient saved through choosing a more convenient provider was one hour – and assuming this cost the equivalent of £6.19 under the national minimum wage – the total costs recouped by patients could be valued at £635,000.

The response reiterated the Government’s proposals for patients to be offered choice for their care, including GP practices, choosing where to go for the first appointment as an outpatient and a choice of consultant who will be in charge of their treatment.

Analysis: Another step in the drive for patient choice

They proposed a pledge to be included in NHS Constitution, that GPs would create a written agreement or ‘personalised care plan’ with the patient, recording decisions that were jointly made regarding their care. GPs could then be ‘held to account’ by patients who did not receive the care they were promised, they said.

The Government also rebuffed concerns sent by respondents to its consultation. They said that there is ‘no evidence’ current consultation times are too short to include a full discussion on choice with patients.

They ‘fully acknowledged’ the RCGP’s concerns that offering choice could widen health inequalities, as better educated patients will demand GPs talk through their choices while those less literate or assertive but with greater needs might miss out. But DH said that their policies should reduce inequalities by ‘providing a choice for those who previously had no choice but to stay with their local services or providers.’

Commenting on the Government’s consultation response, health minister Earl Howe said: ‘Giving patients more choice and more control in their healthcare is an essential part of the Government’s work to put the NHS on the side of patients.

‘No two people are the same, which is why our plans offer patients more personalised care, ensuring that no decision about me is made without me. I would like to thank the people who took part in the consultation, to help us build a strong set of proposals to give more involvement and more choice to patients.’

But Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire Oxfordshire LMCs, said: ‘In my area there is only one hospital so patients look at you like you’re mad when you start talking about choice.

‘It’s a meaningless government fop. It may be different in London, where most policy is formed, but it has little relevance to my area of the country at least. Most people want to go to their local hospital because of proximity.

‘It sounds like it will create extra work for GPs and not do much for patients.The articulate section of the population will get what they want, but the other half won’t so it will widen inequalities.’