Doctors leaders and patient groups have challenged the focus of the NHSCB (NHS Commissioning Board) on choice as the body formally launched today.
The BMA warns that choice has been ‘confused’ with an ambition for shared decision making with patients, and comes at the expense of integration.
In its written response to Developing Our NHS Care Objectives: A Consultation on the Draft Mandate to the NHSCB, the BMA says the proposals ‘do not provide a clear vision for the NHS’.
The response says: ‘We believe that integrating care pathways to improve the quality and efficiency of healthcare should be the focus of improvements through commissioning, rather than focusing on choice of provider and competition among healthcare providers.’
National Voices, a coalition of more than 140 health and social care charities, echoed the BMA’s views, saying it could not support proposals to increase choice until patients had true involvement in care planning, treatment options and management of long-term conditions.
Threat to patient involvement
National Voices director of policy Don Redding said: ‘Choice is valuable but, at this point, there is a real risk that the objective on extending choice will occupy commissioner and provider attention to the detriment of patient involvement.
‘The draft mandate does not provide clarity about what patient involvement means, nor its central importance in meeting the challenges facing the NHS and social care.’
The NHSCB officially begins as an executive non-departmental public body today, after existing in shadow form since last year.
From April 1, 2013, it will assume its full statutory responsibilities, which include authorising 212 proposed CCGs, improving health outcomes, and overseeing how £85bn in NHS funds will be best spent.
BMA council chair Mark Porter said: ‘The NHSCB has many tasks to undertake. Uppermost among these will be making sure that the rhetoric about putting clinicians in the driving seat is actually delivered in practice.
‘Consultants must believe that their expertise and specialist knowledge are being acknowledged and used. GPs must feel that CCGs are accountable to them, and not the other way around.’
Action on personal budgets
In response to the consultation on the draft mandate, the BMA also criticises the fact that plans to extend personal health budgets are firmly entrenched even though pilots are ongoing.
And doctors leaders reiterate their concerns about plans for quality premiums being paid to clinical commissioning groups that hit outcome targets and remain within budget.
Today also marks the end of Medical Education England, as its work programmes are transferred to Health Education England.
The new body will oversee a new system for medical education and training that involves providers playing a greater role in developing the workforce.