Press release: NHS leaders call for more open debate about increasing patient choice

23 Jun 2004

As the battle lines for the general election are drawn around patient choice and personalised care, NHS leaders will today warn that the debate on choice must not exclude the majority of patients, or avoid the difficult decisions that greater choice will bring.

The warning comes as the NHS Confederation publishes a poll of 100 NHS chief executives in England and a manifesto consultation to mark the start of its annual conference.

The poll reveals that while much of the current debate focuses on choice of hospital and surgery waiting times, NHS leaders want the political parties to prioritise better support for patients with long-term conditions and investment in primary care.

In her keynote address to the conference, Gill Morgan, NHS Confederation chief executive will say: "It is important to give people who need surgery a say in when and where it takes place. But with 17.5 million people living day in, day out, with long-term conditions, it is vital the choice debate does not become exclusively preoccupied with hospital care."
 
Gill Morgan will add: "In the past, hospitals and waiting lists have dominated election campaigns. We welcome the fact that political parties have given greater recognition to long-term conditions in recent months. The real challenge now is to translate this rhetoric into reform. Our manifesto consultation sets out proposals - drawn up with an alliance of 15 patient groups - to develop better services and real choice for the majority of patients who rely on the NHS." [1]

However, the Confederation's poll raises concerns that attempts to prioritiselong-term conditions could be undermined by existing Government policies:

•  84% of NHS leaders said current productivity measures fail to accurately reflect NHS performance. By only taking hospital activity into account, the figures exclude the care provided to many in their homes and local communities;
• 70% are concerned that the new Payment by Results system, which enables money to follow the patient, could incentivise hospital admissions rather than promoting improved care for people with long-term conditions.

The Confederation's poll also shows that 77% of NHS leaders feel the current health debate ducks many of the difficult decisions facing local NHS organisations. It highlights a number of issues which now require political leadership and a new dialogue with the public:

•  Postcode variation - 70% believe variation between areas is legitimate if based on local choices
• A new role for hospitals - 97% of chief executives polled believe not all hospitals will be able to provide all services in the future;
• Encouraging innovation -  73% believe there is a lack of political support for risk taking and innovation in the NHS; 
• Investing in management - 68% say their organisations do not have sufficient management capacity to deliver the current reform agenda.

Gill Morgan will tell delegates: "If we are to tackle the challenges of the next stage of reform we need a political debate which is more willing to admit the improvements that have been made, more honest about the difficulties we still face, and more open about the tough choices and difficult decisions ahead. As the political parties concentrate their efforts on extending patient choice, they need to face up to its implications, and not forget the broader challenges facing NHS staff at the frontline."

Notes for editors

1.       The NHS Confederation's manifesto consultation paper - drawn up with an alliance of 15 patient groups - sets out three proposals that could increase choice and improve care for patients with long- term conditions:

•  Investment in rapid, expert and accurate diagnosis and reassessment -  to ensure people receive the right care at the right time. This should include support for more diagnostics in primary care, 'one stop shop' referral centres for groups of conditions and direct access to relevant specialists where appropriate
• A personalised route-map for information and advice - given to patients as part of their consultation, setting out how they can get relevant support, including access to a navigator to help them through the system
• A personal Care Plan - to match the patient's particular condition and personal preferences with the best care available to maximise their quality of life.

2.       The NHS Confederation annual conference, Real Leadership: Tough Choices, Difficult Decisions, runs from Wednesday 23rd-Friday 25th June at the International Convention Centre and National Indoor Arena, Birmingham. Gill Morgan, NHS Chief Executive, will deliver a keynote speech on Wednesday at 1.00pm. The Rt Hon John Reid MP will speak on Thursday 24th June at 5pm.  Andrew Lansley MP and Paul Burstow MP will take part in a debate at 9.30am on Friday 25th June.

3.       The NHS Confederation poll is based on a survey of 100 NHS chief executives in England across a range of NHS trusts, primary care trusts and Strategic Health Authorities. This represents approximately a sixth of all Chief Executives in England. A copy of the survey is attached.

4.       The NHS Confederation represents the organisations that make up the NHS. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts and local health boards in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.

Contact details

For more information, please contact William Little on 020 7959 7239 or Jenny Reindorp on 020 7959 7237.

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