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Implementation key to NHS mandate success

The NHS mandate is ‘an encouraging strategic vision’ but success will depend upon how it is implemented, doctors leaders have said.

BMA council chairman Mark Porter said the government had taken on board many of the views expressed by doctors leaders during a consultation on the draft mandate. As a result, there is now more emphasis on the role the NHSCB (NHS Commissioning Board) in driving greater integration of services.

The NHS mandate, published this week, sets the objectives for improving health in England. It will be issued to the NHSCB.

The BMA had called for fewer and more strategic objectives in the NHS mandate. Health secretary Jeremy Hunt said the final mandate was around half the size of an earlier draft and did not set specific targets.

Instead, Mr Hunt said there should be ‘measurable progress’ towards the NHS achieving mortality rates comparable with those of the best performing countries in Europe by 2016.

The BMA is also awaiting details of how the NHSCB will measure the performance of CCGS, through the Commissioning Outcomes Framework, and what the arrangements will be for the quality premium.


Welcome reduction in targets

Dr Porter said: ‘The mandate reflects the BMA’s opinion that the NHSCB needs flexibility to exercise its judgement on how to deliver this vision.’

He added: ‘There are measures to encourage the NHSCB to innovate, and a welcome reduction in targets, objectives and micro-managing that marred the draft mandate.’

Priorities include:

  • Prevent people from dying prematurely from cancer and cardiovascular, respiratory and liver disease
  • Enhance quality of life for people with long-term conditions
  • Help people recover from ill health or injury
  • Make sure people have a positive experience of care
  • Treat and care for people in a safe environment and protect them from avoidable harm.


‘Historic moment’

Announcing the mandate, Mr Hunt said: ‘This is a historic moment … because finally something is happening … which has been talked about by politicians for many years, which is making the NHS operationally independent.’

NHSCB chief executive Sir David Nicholson said he believed the mandate was ‘more radical than the structural changes that we have seen’.

Dr Porter added that the BMA was keen to discuss practical implementation of some aspects of the mandate, such as how the NHS uses new technology and IT. The mandate includes a goal for everyone to book GP appointments, order repeat prescriptions or talk to their GPs online by 2015.

He said addressing the key issues of ‘genuine clinical involvement’ and ‘adequate resourcing’ would be vital to ‘ensuring that the NHSCB and the mandate are a success’.

Dr Porter said: ‘The NHS is currently operating in a tight financial environment, and there is some evidence of a lack of engagement with clinical CCGs among many healthcare professionals.’