The NHS is on course to move from the internal market to an approach based on fairness and co-operation. This policy direction was set out by Frank Dobson, Secretary of State for Health in Commissioning Guidance for 1998/99.The areas where greater fairness will be pusued include the distribution of resources between planned and urgent activity and between GP fundholders andnon-fundholders. There will also be common waiting time standards covering all patients within a Health Authority. These standards will be introduced from 1 April.
The ending of competition and its replacement with co-operation will be brought about through a partnership approach. Mr Dobson said: “We want to end the competitive secrecy that has dogged the internal market by ensuring that NHS hospitals are open and co-operative. Longer term agreements will build on this approach and stop the stop-go short term contracting system.”
The Guidance makes it clear that in preparing for next year, health authorities, NHS trusts and GPs should seek to work closely together. There should be an open approach to sharing information and full consultation with other agencies and with the public. The aim is to publish service and financial framework documents by November and service agreements in March next year.
The belief is that longer-term service agreements covering three to five years will lead to greater stability and allow services to be planned over a longer timescale. It is hoped that this in turn will mean less administration, and end the stop-go annual contracting round, and allow more time to concentrate on quality of care.
The Guidance also sets out areas for development in 1998/99 and into the medium term. These build on previous priorities set for the service, but the detailed requirements reflect the new Government’s agenda for action:
- developing a leading role for primary care
- developing better mental health services
- more attention to clinical effectiveness to ensure the use of successful treatments
- openness in conducting business and involving the public, users and carers
- working in partnership with other agencies to achieve accessible and responsive services for people with continuing care needs
- good employment practices
- health and safety
- reducing junior doctors’ hours, family-friendly employment policies and effective policies on equal opportunities.