White Paper for Health Competition ideology is a main feature Local public health directors moved out of NASH and into local government. Remove targets and bureaucracy; Gobo. Creates outcomes framework for what NASH should achieve and professionals work out how. Personal health budgets for those with long- term illness. Local authorities will be given power to agree local health strategies and control over local health improvement budgets. GAP commissioning creates management of services for bottom up design of services.
Patients given choice over treatment options, their consultant-led team, GAP practice and control over their medical notes. NASH trusts become foundation trust to increase employee power. Allow any provider to give services to NASH patients as long as can offer high quality care expected. Aim to create the largest social enterprise sector in the world. ‘Monitor’ will be made a stronger economic regulator to ensure effectiveness and efficiency and that every area has NASH services it needs to provide comprehensive service.
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Care Quality Commission safeguard safety and quality standards. Independent and accountable NASH commissioning board made to drive quality improvements through national guidance and standards, to inform GAP commissioning. The board Will allocate sources according to need of areas and lead specialized commissioning. Health bill later this year. Reduce the DOD NASH function for efficiency savings in administration. Reduce admit cost by 45% over 4 years in NASH. Primary Care Trusts and Strategic Health Authorities abolished http://www. Telegraph. O. UK/health/healthiness/7885875/Health-white- paper-the-details. HTML GAP commissioning: Commissioning is identifying what the needs of the population are, identifying a potential provider and then awarding and managing contract to a provider. Commissioning control previously in the hands of health managers of Pacts who in urn commission services for their area Moving to GAP consortia (many groups of practices working together in their local area) commissioning services for their area. New system to be fully in place by April 2013. 00 consortia with some Gaps taking a backseat others run finances.
Gaps don’t want to take on the role with little background in finance and such decision making and feel it is a gamble with clinical outcomes and taxpayer’s money with no background of running businesses. Healthcare budget had been ring-fenced but this Just meaner no increase. Gaps fear massive budget cuts around the corner. Inflation in healthcare is higher than the standard rate which makes it even more difficult to spend budget effectively. Gaps feel the government is distancing themselves from responsibility for cuts that insomnia will have to make e. G. Loser of A and E dept. And less district nurses. Http://news. BBC. Co. UK/today/hi/today/newsier_9189000/9189213. SST anything linked to prevarication that you find interesting, It may cause a rush of patients to hospitals deemed the ‘best’. New economic regulator ‘Monitor’ to work alongside new independent commissioning board to divide money between consortia and monitor what they do. Gaps concerned they will control the budget but won’t have freedom to do what they want as have to ensure competition between providers of services. Competition ideology permeates NASH.
A new body, whose role is to enforce competition in the NASH and intervene if anti-competitive behavior occurs, will be created. E. G. GAP wants to commission and work with local hospital to develop services that can be shared between Gaps and hospital consultants. Will that be deemed against competition? Gaps will feel they have to refer to private and independent sector, undermining the effort GAP may make to serve patients in local community in local hospital. Unison fear big business will become involved – that Gaps will set their criteria but contract out their commissioning.
Foresee in 10 years that shareholders n a large American-style healthcare company could have more influence over the services provided and by whom by than local taxpayers. It is not clear the route for patients not happy with the decision their GAP/consortium make. Http:// news. BBC. Co. UK/today/hi/today/newsier_9193000/9193024. SST postcode lottery NASH Atlas of Variation in Healthcare Recently published NASH survey snows dramatic deterrence in patient care across England. It takes into account age, sex, and prevalence of the condition and so variations cannot be explained by patient or social factors. Can be found at http:// www. Rightward. Has. K/atlas/ Shows that the NASH are not good at sharing best practice between hospitals and not providing universally high-quality care to its patients Engel Edwards, acting chief executive of the NASH Confederation says that clinicians having responsibility for the design and planning of their services will reduce variation. Http://www. Telegraph. Co. UK/health/81 58059/Postcode-lottery-of- NASH-care-revealed-in-full. HTML On the other hand, for example, Control of drug availability will move from NICE to GAP consortia which will mean a definite postcode lottery in terms of what drug treatments patients are offered, which is Just one example.