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NHS Constitution for England

Volume 486: debated on Wednesday 21 January 2009

Lord Darzi’s review of the NHS, “High Quality Care for All”, concluded that there was a case for a constitution to enshrine the principles and values of the NHS in England. A draft constitution based on extensive evidence and research with public, patients and staff was published for consultation on 30 June 2008. The consultation process was led by strategic health authorities and overseen by a group of experts on the Constitutional Advisory forum. Consultation events for patients, the public and staff were held in each primary care trust and the outcomes fed back to the strategic health authorities and then the Constitutional Advisory Forum. The Department also received over 1,000 direct responses to the consultation, which closed on 17 October 2008.

The NHS values, which form part of the constitution, were developed separately and were the subject of extensive engagement with staff, patients and the public.

The Constitutional Advisory Forum published its report on 11 December, emphasising that the response to the consultation had been overwhelmingly positive, with a broad consensus in favour of an NHS constitution. They made a series of recommendations on how to improve the document and on how to embed it in the NHS. The Department has responded to these recommendations and to the responses to the consultation in the Government response, published today and placed in the Library.

The final NHS Constitution for England, which has been placed in the Library, is an enduring document that sets out the principles and values of the NHS and for the first time brings into one place NHS pledges and the rights and responsibilities of patients, the public and staff.

As a result of the consultation, the NHS Constitution contains a new right to receive the vaccinations that the Joint Committee on Vaccination and Immunisation recommends under an NHS-provided national immunisation programme. The new right to choice has also been extended to include a right to information to support that choice. This currently means that any person requiring an elective referral may choose any clinically appropriate secondary care provider for their first consultant-led outpatient appointment and has a right to information to support that choice.

The new legal rights in the NHS Constitution will be created through separate regulations and directions, which are due to come into force on 1 April. Regulations on the right to receive vaccinations have been laid today. Directions on the right to choice and draft directions underpinning the right to rational local decisions on drugs and other treatments have also been published today.

The Health Bill, published on 16 January, provides for a legal duty on all NHS bodies and independent contractors providing NHS services to have regard to the NHS Constitution in their decisions and actions. The Bill also requires the NHS Constitution to be reviewed at least every 10 years following full consultation.

Also published today are the handbook to the NHS Constitution and a statement of NHS accountability, both of which have been placed in the Library. The handbook to the NHS Constitution is designed to give NHS staff and patients all the more detailed information they need. It explains what the rights, pledges and responsibilities mean and explains what to do if rights are not met or pledges are not upheld. It also explains the legal basis of each right.

The consultation on the NHS Constitution asked whether the Government should produce a statement of NHS accountability. The response was highly positive. The Statement of NHS Accountability is a public-facing document, which describes the system of responsibility and accountability for taking decisions in the NHS and provides a summary of the structure and functions of the NHS in England. The NHS Constitution commits the Government always to make available an up-to-date statement of accountability in the future.

An impact assessment on the NHS Constitution has also been published today and a copy placed in the Library of the House.