Health secretary Andrew Lansley’s white paper on Monday 12 July reflects the Government’s wish to put clinicians and patients at the heart of the NHS, cut bureaucracy and put more power in the hands of frontline staff.
The white paper will have implications for all health organisations in the NHS, particularly PCTs and SHAs, which will be phased out under the proposals.
In the short term, however, SHAs and PCTs will have a role to play in the quality, innovation, productivity and prevention (QIPP) programme. This will continue with even greater urgency, but with a stronger focus on general practice leadership.
Empowering clinicians and GPs
GPs will be handed the majority of the commissioning budget and local authorities will be handed control of local health improvement budgets. Professionals will be free to focus on improving health outcomes so that these are “among the best in the world”.
NHS pay
Under the proposals all NHS trusts will become foundation trusts by 2014 and will have the same rights to set pay locally as Foundation Trusts do now. Pay decisions will be led by employers rather than imposed by the Government and it is recognised that many providers will want to continue to use national contracts as a basis for their local terms and conditions.
In the short term, during the two-year pay freeze, the Government will ask the pay review bodies to make recommendations for staff earning under £21,000 and will consult with employers and trade unions on long-term arrangements.
Healthcare skills planning
Healthcare employers and their staff will determine workforce development and training needs and these decisions will determine education commissioning. The NHS Commissioning Board will provide national oversight of healthcare providers’ funding plans for training and education and GP consortia will provide this oversight at a local level.
Government consultation
The white paper is the start of an extensive consultation that will take place over the coming weeks. The Department of Health will shortly be publishing a number of consultation documents.