In December 2007, the Department of Health published the operating framework for the NHS in England in 2008/09. The framework sets out the priorities and specific policy, business and financial arrangements expected of the NHS for the year ahead.

Key points

Listening and responding to patients, public and staff and improving patient outcomes and experience is at the heart of the framework. Other key points include:

• Moving towards local targets while delivering on national priorities
• Developing world-class commissioning as the key agent for change
• A financial regime that supports reform goals and incentivises improvements in services
• A transparent approach to planning that supports locally-led decisions while providing accountability
• An emphasis on partnership working between PCTs, local authorities and other partners to ensure local health needs are better understood and addressed.

Vital signs

On 1 February 2008, the Department of Health published the vital signs that will underpin the operating framework. The vital signs - a framework for assessing health outcomes and healthcare performance at PCT level - cover:

• Cleanliness and healthcare associated infections
• Access to personalised and effective care
• Improving health and reducing health inequalities
• Reputation, satisfaction and confidence in the NHS
• Finance.

The five signs are structured in three tiers:

• National requirements
• National priority for local delivery
• Local action.

Confederation viewpoint

We believe the national priorities in the operating framework reflect what matters to patients and the public and NHS management is clear it must deliver on this agenda. However, the framework is more prescriptive than the five national priorities might initially suggest. We are clear that the vital signs should not turn into national targets for performance management.

For the 2009/10 operating framework, we will argue for a longer timescale, a shorter list of things to do and greater transparency.

Information for members

Our briefing for members and supporting diagram outline the key points and timetable for implementation.

The operating framework explicitly requires planning for and implementation of four separate long-term strategies: healthcare associated infection; child health; stroke; and cancer. We have produced summaries of each strategy drawing out the key points of relevance to members.