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NHS Operating Framework

Volume 512: debated on Monday 21 June 2010

Today I am publishing a document setting out the revisions to the NHS operating framework for 2010-11. The document has been placed in the Library and copies are available to hon. Members from the Vote Office.

In now moving towards a health service which puts patients at the heart of decision making, which focuses on quality and outcomes not processes, and with more devolved responsibilities, this short document sets out a number of areas subject to immediate change.

The Department will cease to centrally performance-manage the previous Government’s targets on 18-week waiting times and access to primary care. More clinically relevant accident and emergency indicators will be developed for 2011-12. Locally led plans should deliver improvements in median waiting times and access.

The coalition Government are committed to stopping top-down reorganisations of the NHS that have got in the way of patient care. To that end, a moratorium is in place for future and ongoing reconfiguration proposals. All current and future reconfiguration proposals will need to meet four new tests as I set out in the document; and can go forward, if and when they do so.

I shall set out that primary care trusts (PCTs) should accelerate the process to transform community services with clear deadlines.

I have asked each strategic health authority (SHA) region to now go further, faster, to release all possible resources to meet demand and quality challenges. The overall ceiling for management costs in PCTs and SHAs will now be set at two thirds of the 2008-09 management costs (£1,509 million), the ceiling will therefore be £1,006 million. In aggregate, PCTs and SHAs will need to save at least £222 million in 2010-11 and a further £350 million by the end of 2011-12.

I am asking NHS organisations to ensure that they demonstrate similar discipline to central Government on consultancy, marketing and information, communications and technology spend, recruitment, and centralised procurement for goods and services.

The number of best practice tariffs shall be expanded where payment is linked to best practice care, as well as expanding the list of never events so that no payment is made for services, which compromise patient safety.

I announced on 8 June 2010 my intention to make hospitals responsible for patients 30 days after discharge, one of the key health commitments in the coalition agreement. If a patient is re-admitted during that time, the hospital will not receive any further payment for the additional treatment. Making hospitals responsible for a patient’s ongoing care after discharge will create more joined-up working between hospitals and community services and may be supported by the developments in re-ablement and post-discharge support. This will improve quality and performance and shift the focus to the outcome for the patient.

These are the only changes I am making in-year. The remainder of the NHS operating framework 2010-11, which was published on 16 December 2009, still stands and I expect the NHS to play its role when partnership approaches are needed to secure better outcomes.