NHS Reforms in England – a quick guide

NHS Reforms in England – a quick guide

The NHS Reforms in England take effect from April 2013

NHS reforms in EnglandHere’s a quick overview of the changes (and some thoughts on NHS Continuing Care):

  • All Primary Care Trusts (PCTs) and Strategic Health Authorities are being abolished.
  • General Practitioners (GPs), along with hospital doctors and nurses, are now in Clinical Commissioning Groups (CCGs), to buy in and provide health services for patients. They have responsibility for 80% of the NHS budget.
  • These new CCGs are taking full financial responsibility for commissioning care/services – including, in most cases, managing the NHS Continuing Care assessment process. Given how little many GPs seem to know about NHS Continuing Healthcare funding, this could however leave people even more vulnerable in the assessment process – and it may transpire that those who hold the purse strings from April 2013 actually know even less about the legalities surrounding Continuing Care than many PCT assessors previously demonstrated.
  • The new National Commissioning Board oversees the CCGs and is responsible for some specialised services on a regional and national basis.
  • New local and national HealthWatch bodies are located within local authorities; these will (in theory) be able to prompt inspections of the NHS.
  • The CQC has been given more power across health and social care. The CQC is itself the subject of much bad press for its ineffectiveness in properly inspecting care homes.
  • Hospitals will be able to accept many more private patients. Where does that leave priorities and resources for frail elderly people in hospital, who, as seen frequently in the press, are already seriously neglected?
  • Health and social care bodies need to work together more.
  • The NHS regulator, Monitor, has a duty to promote better integration between care services.
  • In addition, the government is rolling out Personal Budgets – and is first targeting people in receipt of NHS Continuing Care. However, Personal Budgets do not seem to always cover the full cost of care – and this could certainly be a viewed as a way of saving money, not of providing better care. And who will manage a Personal Budget for an individual elderly person with dementia in full-time nursing care?

Patient choice

In the reforms…

“Patients will have choice of any provider, choice of consultant-led team, choice of GP practice and choice of treatment.”

If GPs hold most of the budget power and it is advantageous to live near the best GPs who understand specific care needs, where does that leave people who are isolated in care homes with no choice of GP, no power and no means to relocate?

It could potentially lead to a return to the postcode lottery that the National Framework for NHS Continuing Healthcare sought to end, where every health authority had its own rules about funding nursing care.

Let us know how the NHS reforms affect you – good or bad.


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