Lansley accepts core recommendations from NHS Future Forum

Health secretary Andrew Lansley has accepted all the core recommendations of the NHS Future Forum report, set up after his plans to reform the NHS led to a political furore.

Under the changes now proposed, GP consortia will be known as ‘clinical commissioning groups’ and will have lay members, in addition to medical ones, and will meet in public.

Health and wellbeing boards will gain the right to refer back local commissioning plans that are not in line with the health and wellbeing strategy.

The duty original proposed for the watchdog Monitor to promote competition will be replaced by one to protect and promote the interests of patients – not to promote competition as an end in itself.

There will be stronger duties on commissioners to promote integrated care, for example by extending personal health budgets and joint health and social care budgets.

Mr Lansley said: “The independent NHS Future Forum has made a number of recommendations and we are accepting them. This has been a genuine exercise and it is clear from our response today that substantial changes have been made in the interests of patients.

“The Forum confirmed that there is widespread support for the principles underpinning our plans for change: greater patient choice, ‘no decision about me, without me’, more control for doctors, nurses and frontline professionals, a focus on quality and results for patients, more information and more clout for the public. These changes now will help us make those principles a reality.”

The heavily-amended Health and Social Care Bill will now be referred back to Parliament.

David Rogers, chairman of the Local Government Association’s community wellbeing board and also a member of the forum, said: “It’s crucial the newly proposed clinical commissioning groups don’t just focus on their own practice lists, but also work with councils on the ‘Cinderella services’ such as homelessness, mental health, learning disabilities, AIDS/HIV, dementia and child health.

“Local government has decades of experience and expertise in this field and it’s a role we’re willing and able to take the lead on. The forum’s recommendations for joint commissioning and shared boundaries between GPs and councils should help make sure there are no gaps.”

Cllr Rogers said the requirement for commissioning groups to share and agree plans with wellbeing boards, publish board papers and hold public meetings were “strides in the right direction”, as was the proposed power for councils to decide how many councillors should sit on boards.

“This should help avoid communities being dictated to from above and see people genuinely involved in decisions made about themselves or their loved ones," he said.

The report’s Patient Involvement and Public Accountability section was led by Geoff Alltimes, chief executive of the London Borough of Hammersmith and Fulham.

Its 16 detailed recommendations included that NHS commissioners and local authorities should be jointly responsible for improving outcomes where they depend on joint working and that health and wellbeing boards should set and monitor outcomes.

Boundaries of commissioning consortia should “not normally” cross those of their local authority although this would not be an absolute requirement.

Health and wellbeing boards should be the place where the local NHS and local authorities “explain and are challenged on how they are involving patients and the public in the design of care pathways and development of their commissioning plans”, Mr Alltimes’ group said.

Mark Smulian