DH makes choice an obligation

GPs may be given a contractual obligation to offer choice and hospitals will be required to offer appointments to named consultant-led teams from April 2011 under government proposals set out today.

The Department of Health has published aconsultation on Patient Choice alongside its proposals for an ‘information revolution’, and claims the two documents together will give patients more choice and a louder voice within the NHS.

The consultation document – ‘Liberating the NHS: Greater Choice and Control’ – says that the government wants to extend the principle of choice from "any willing provider" by giving patients a choice of provider for diagnosis and choice of named consultant team for treatment.

It also wants to introduce greater choice in maternity care, mental health services and end-of-life care. Patients will also be able to choose to register with any GP practice with an open list, regardless of where they live.

To make choice as widely available as possible, the DH says it is considering consulting the BMA on changing the GMS contract to require GP practices to offer patients a choice of healthcare provider when they are referred for a first out-patient appointment.

It says it would want any change to the GMS contract to be reflected in other types of contract held by GP practices. It says choice of any willing provider should be the reality in most NHS-funded services no later than 2013-14.

The DH says the moves set out in the consultation are a response to its own surveys and a King’s Fund report, which showed that fewer than 50% of patients recall being offered choice of provider by their GP.

This figure has changed little for several years. The report says making greater choice a reality will mean that “many people will need to change their attitudes and behaviours”. 

It says these people may include health professionals, who may not be offering choice, and patients, who may be relying on health professionals to give advice without question.

To “make sure some progress is made on delivering this target by April 2011” the DH says it plans to alter hospital standard contracts by amending the 2011-12 choice guidance.

The amendments will require hospitals to accept patients who are referred to a named consultant-led team, so long as this is clinically appropriate.

It will also require services to be listed on Choose and Book in such a way as to allow users to book appointments with named consultant-led teams as well as general clinics.

Health secretary Andrew Lansley said the government wanted to go further than offering patients a choice of hospital and to extend choice to every stage of the patient journey.

“Patients and service users should be in control and involved as much as they want to be in every decision about what, where, how and from whom they want to receive care.

"By giving people real choice over their care, we can build a patient-centred NHS that achieves outcomes for patients that are among the best in the world.”

The consultation document says the introduction the 111 number for urgent care will offer “a more comprehensive” service than NHS Direct by delivering consistent clinical assessments of callers’ needs and ensuring they are then linked up to the service that is best able to meet those needs.

The DH says that, subject to consultation, the proposed NHS Commissioning Board will take the lead on promoting and extending choice and that GP consortia will be held to account by the Board for their performance in offering choice.

The consultation closes on 14 January 2011.