Comment on government response to NHS Future Forum – radical shift is needed to put power in patients’ hands

Responding to the government’s statement on the NHS listening exercise, the Health Foundation called on the government to push forward with a more sophisticated approach to choice which is about genuine involvement in care for all.

Stephen Thornton, Chief Executive of the Health Foundation said, 'We were really pleased that the NHS Future Forum recommended a more sophisticated approach to the choice agenda with a strong emphasis on genuine involvement in care. 

'This was a big idea because the debate has focused on choice of provider. Choice of provider is important but it is insufficient – the evidence is that choice of treatment and care is more important to patients and will lead to higher quality care.'

Stephen Thornton continued, 'We are pleased that the Prime Minister’s recent speeches have signalled a shift in thinking about choice. We shouldn’t under-estimate the challenge of taking forward this agenda. Amending the legislation is important but just the starting point for achieving more control for patients. And, there is a risk that choice of provider dominates the reforms. Choice of treatment and care requires change at every level in the system and a massive shift in culture.  At the level of the government, the “choice mandate” will need to give strong emphasis to this wider view of choice if we are to achieve the aspiration of hardwiring "no decision about me without me" into the system.'

Notes to editors

NHS Future Forum – summary report on proposed change to the NHS stated:
'The declaration of "no decision about me, without me" must be hard-wired into every part of the system – from the legislation through to each and every encounter between a patient and healthcare professional.'

The NHS Future Forum report ‘Choice and Competition Delivering Real Choice’ argued:
'"No decision about me, without me" must become a reality so that every patient is involved in their care and treatment. There is evidence that patients want choice and not just those from more affluent backgrounds. As this report argues, more needs to be done to ensure patients have real choice, not just choice of provider. More work is needed to promote a more sophisticated view of choice that reflects genuine involvement in care and is open to all. 

The definition that arose from a seminar coordinated by the Health Foundation as part of this listening exercise is helpful. They suggested that choice includes: 

• Choices to support healthy living;
• Choice of provider and the way in which care is provided; and 
• Choice of treatment including self‐management support.'

David Cameron in his speech on the future of the NHS on 7 June said:
'We’re saying that for the first time in the history of the NHS, you will be able to decide what will be the best service, best package of care that will allow you to lead independent lives…'

David Cameron in his speech on 14 June said:
'The second thing these reforms mean for you is greater choice...the choice to get treated where you want, the way you want.'

Government changes in response to the NHS Future Forum: 
The Government has promised to amend commissioners’ duties to involve patients and carers to better reflect the principle of ‘no decision about me without me’.

They will also amend the Bill to strengthen and emphasise commissioners’ duty to promote choice, in line with the right in the NHS Constitution for patients to make choice about their NHS care and to receive information to support those choices. As recommended by the Future Forum, the Secretary of State’s mandate to the NHS Commissioning Board will set clear expectations about offering patients choice: a 'choice mandate'.