Commissioning

NHS Mandate a ‘once in a lifetime opportunity’

Industry professionals, royal colleges and patient organisations have reacted to the announcement of the NHS Mandate in positive terms.

Health secretary Jeremy Hunt announced the Mandate yesterday, which sets out priorities for the NHS Commissioning Board to deliver, using £95bn over 2013/14.

The objectives set out include more parity between mental and physical health, improved maternity care, better care for patients with dementia and reduced premature death through big killers.

Sir David Nicholson, chief executive of the NHS Commissioning Board said: “Our aim and passion is to deliver a better NHS on behalf of patients and the public. We will do this by working side by side with local clinical leaders; by focusing relentlessly on the outcomes that the NHS delivers for people; and by freeing those on the frontline to transform services in line with the needs of local communities.

“The mandate avoids the danger of excessively prescribing the actions of health professionals. We in the NHS Commissioning Board want to ensure power in the NHS sits with those who are closest to the patients. Our role will be to work closely with local clinical leaders and provide the support they need. Our role is not to tell them what to do.

“We have a once in a lifetime opportunity to do things differently. We will succeed only by releasing the energy, ideas and commitment of front-line staff and organisations. The NHS Commissioning Board wholeheartedly embraces this challenge.”

Chair of the NHS Commissioning Board, Malcolm Grant, called the Mandate “a vital milestone in the liberation of the NHS”.

He reiterated the importance of not prescribing action to NHS staff, and said that the board will “ensure maximum freedom for CCGs, so that local clinical leaders may respond more effectively to the needs of their local population”.

The Royal College of Midwives (RCM) welcomed the Mandate, particularly its focus on improving care for new mothers, and the objective of having a named midwife throughout pregnancy.

Cathy Warwick, chief executive and general secretary, said the RCM believes it “reflects a more personalised service”, but cautioned: “This objective will need to be clearly defined.”

Turning Point’s deputy chief executive David Hoare commented on the priority for mental health: “Measurable progress towards true parity of esteem between mental and physical health is expected by March 2015. We need to ensure that everyone involved in the commissioning and delivery of mental health services works together to move this from rhetoric to reality.”

Don Redding, National Voices’ director of policy, welcomed the final version of the mandate, with its focus on patient involvement. He said: “We also welcome the fact that this sits alongside the objective on better coordination of care around people’s needs, preferences and control. Coordinated care and patient involvement should be the two interlocking hemispheres of a radically changed culture.”

NHS Confederation chief executive Mike Farrar said the Mandate represents a “major sea change” for the NHS.

He commented: “It was really important that the Government avoided stuffing the mandate to the gunnels with detailed targets for every condition under the sun. While that might have looked superficially attractive, it would have meant more top-down prescription and less innovation and responsiveness to local needs.

“The real challenge for the Government now is to stay true to its word and use the mandate to give the NHS stability, rather than use it as a tool to reset priorities on a regular basis.”

A stable environment would now be “desperately” needed for the NHS Commissioning Board to concentrate effectively on delivering these priorities, Farrar added.

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