The first NHS mandate published today has not set specific targets for the NHS Commissioning Board to achieve over the next two years, opting instead to see ‘measurable progress’ against the outcomes framework.
It is a marked change from the draft mandate published under then health secretary. Andrew Lansley in July, which indicated an actual figure be inserted– given as a X in the draft – for the number of life years, QALYs and illness recovery rates that the NHS would achieve over the next three, five and 10 years.
The NHS outcomes framework for 2013/14, also published today, explained the Department of Health decision not to set ‘levels of ambition’ because of ‘criticism’ about being ‘too reliant upon precise technical assumptions for which the evidence base is not robust’. It adds there were also concerns they would be seen as local ‘targets’ and so risk distorting local priorities.
Health secretary, Jeremy Hunt, said today: ‘Never in its long history has the NHS faced such rapid change in our healthcare needs.
‘This mandate is about giving the NHS the right priorotoes to deal with those challenges. By focusing on what matters to patients and giving doctors and other professionals the freedom to deliver, we will make sure the NHS stays relevant to our needs and continues providing the best possible care for us all.’
The final mandate also announces the Government expects by 2015:
– Patients to have online access to own health records held by their GP
– Everyone able to book GP appointments and order prescriptions online
– For the board to have made ‘measureable progress’ towards having the best diagnosis, treatment and care of people with dementia in Europe
– For mental health and physical health to be on a par with timely access to evidence based services requiring an extension for the ‘Improving Access to Psychological Therapies (IAPT) programme
– Introduction of the Friends and Family test to cover all those using NHS services. Hospitals with good scores will be financially rewarded
The mandate also makes it explicit, that the NHS Commissioning Board will be responsible for the allocation of budgets to avoid ‘any perception of political interference’.
NHS Confederation chief executive Mike Farrar said the mandate represents a major ‘sea change’ for the NHS.
‘It was really important that the Government avoided stuffing the mandate to the gunnels with detailed targets for every condition under the sun. While that might have looked superficially attractive, it would have meant more top-down prescription and less innovation and responsiveness to local needs.
‘The real challenge for the Government now is to stay true to its word and use the mandate to give the NHS stability, rather than use it as a tool to reset priorities on a regular basis.’
He added: ‘We will hold ministers to their word that they will not try to revise the mandate on an ad hoc piecemeal basis in response to the latest issue that hits the headlines.’
Dr Anna Dixon, director of policy at the King’s Fund said:
‘It is pleasing to see that mental health has been given parity with physical health – our own work shows that physical and mental health needs often overlap. Mental health must not simply be tacked on to physical health but should be an integral part of it.
‘The Mandate includes a strong focus on decentralisation and freeing up local organisations to innovate. The real test will be how this translates into practice, especially given the tight financial climate and need to maintain financial control.’