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Some proposals were indicated in the Queen’s Speech, others have been announced by the new Secretary of State for Health, Andrew Lansley, some have come from the Department of Health. All items on this summary sheet have been extracted from the Health Service Journal 27 May 2010, pages 4 and 5, and reassembled here.
The main proposals are:
1. Strategic Health Authorities: SHAs will be abolished by 2012. SHA sources have told HSJ they will now start winding down their activities. Some senior SHA staff predict that practice-based commissioning consortia will be formed through a merger of existing consortia and primary care trusts.
2. NHS Providers: Providers will be overseen by an expanded Monitor, which the DH says will become an economic regulator overseeing “aspects of access, competition and price setting in the NHS”.
3. Commissioning: The government plans to manage commissioning through an independent NHS Commissioning Board, which will become fully operational from April 2012, “to allocate resources and provide commissioning guidance, and to allow GPs to commission services on behalf of patients”. The Programme for Government document confirmed the Government plans to make GPs the lead commissioners of NHS care - strengthening the power of GPs as “patients’ expert guides” by allowing them to commission care on their behalf. PCT network director David Stout said it was not clear where responsibility for holding GP commissioners to account would lie.
4. PCTs: The Government has said patients will be given a “stronger voice” through “directly elected individuals” on the Boards of PCTs – the process for which will be set out in an imminent white paper. The Programme for Government document said the remainder of PCT Boards would be appointed by Local Authorities, with the Chief Executive and “principal officers” appointed by the Health Secretary. The same document indicates that PCTs will take responsibility for public health and “residual services that are best undertaken at a wider level rather than directly by GPs”.
5. New pledges: The Programme for Government document and a further document sent to Strategic Health Authorities this week, set out 30 pledges on the NHS and a further four on public health including:
· Urgent care service: A 24-hour urgent care service in England, “including GP out-of-hours services” with a renegotiated GP contract, including an incentive scheme to improve primary care in “disadvantaged areas”.
· NICE: “Reform” of the National Institute for Health and Clinical Excellence and a move to a system of value-based pricing to promote better access to “treatments doctors think patients need”.
· Social care funding: A commission reporting “within a year” on the funding of long-term social care.
· Public health budgets; Ringfenced public health budgets, held by Primary Care Trusts.
· Special Military Wards: Dedicated hospital wards for injured military personnel and extra support for veterans with mental health problems
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