Headlines: January 27th, 2006

Primary Care and NHS Trusts will have to work with their Strategic Health Authorities to confirm their investment plans as part of a package of measures to get the health service back into the black and to move forward reforms and improve services for patients.The Health Secretary, Patricia Hewitt, has outlined what she sees as the next steps in creating a patient-led health service in “The NHS in England: the operating framework for 2006/7″. It sets out priorities and expectations for progress on reform and details new rules on financial management.

It includes a requirement for PCTs and NHS Trusts, working with their strategic authorities, to reconfirm their investment plans, including major capital developments and PFI schemes. Business cases will have to be assessed in the light of the reform programme, particularly patient choice and the movement of services into primary and community settings. This process will have to ensure the cases are robust, affordable and sustainable. Final guidance on how this must be done will be issued soon.The framework will act as the agenda to push forward reform, including more choice for patients through new providers, more say for frontline staff like GPs in commissioning services and the extension of payment by results as the system by which providers of care will be paid. It specifies six areas which are seen as in need of particular focus, including reducing health inequalities, cutting cancer waiting times, improving sexual health and dealing with MRSA.

It also contains plans to make sure the health service recovers any overspend from this year and for a surplus in 2007-8, as well as arrangements for a smooth transition to the new Primary Care Trusts and Strategic Health Authorities.

Patricia Hewitt said the next financial year would be a significant one for reform and added that excellence in financial management must be a prerequisite for high quality, sustainable services.”A breakeven culture, dependent on balance sheet adjustments and hand-outs, stops next year. Planning for a surplus should become the norm for the service,” she said.