In a landmark moment for the health service, the Mandate sets out what every patient in England can expect from GPs, hospitals and the wider NHS.
The Mandate marks a historic shift from narrow, process-focused targets to a clear ambition for a modern service that concentrates on results and is a central strand of the Government’s determination to improve the quality of people’s experience of the NHS.
The Mandate sets the ambitions for the health service for the next two years and will be issued to the NHS Commissioning Board - the new independent body tasked with ensuring the best possible result for all patients in the NHS.
It sets out clear priorities including improving early diagnosis, cutting premature deaths from the biggest killers, improving care for new mothers and better help for dementia sufferers.
The Mandate signals the Coalition Government’s commitment to an NHS that is able to meet patients’ needs and expectations in the face of growing demand. Crucially, it puts quality of care at the heart of what people can expect, with a clear requirement for the health service to treat every patient with dignity and respect, and for the best care to be available no matter where they live.
The Mandate has been drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012. Through it, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.
The key objectives contained within the Mandate include:
- improving standards of care and not just treatment, especially for the elderly and vulnerable.
- better diagnosis, treatment and care for people with dementia.
- better care for women during pregnancy, including a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and the postnatal period.
- patients will be able to give feedback on the quality of their care through the “Friends and Family Test” starting from next April. So patients will be able to tell which wards, A&E departments, maternity units and hospitals are providing the best care.
- by 2015 everyone will be able to book their GP appointments online, order a repeat prescription online and talk to their GP practice online. This will help people better manage their health and care.
- treating mental and physical health with equal priority. This means everyone who needs mental health services having timely access to the best available treatment.
- preventing premature deaths from the biggest killers.
- by 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.
The Commissioning Board will be given a budget of over £95 billion for 2013/14, in order to deliver the objectives set out in the Mandate.
Health Secretary, Jeremy Hunt said:
The NHS is one of the finest institutions in the world and we are working with health professionals to keep it that way.
Never in its long history has the NHS faced such rapid change in our healthcare needs, from caring for an older population, to managing the cost of better treatments, to seizing the opportunities of new technology.
This mandate is about giving the NHS the right priorities to deal with those challenges. We do not want an NHS that focuses on narrow performance indicators but instead looks at true measures of whether all of us are receiving the highest quality of care.
By focusing on what matters to patients, and giving doctors and other health professionals the freedom to deliver, we will make sure the NHS stays relevant to our needs and ensure this country’s proudest creation remains its finest.
The new NHS will be locally led and locally responsive. While the Government will continue to set overall goals for the NHS, the decisions on how to deliver the objectives in the NHS Mandate will be made by the people who know patients best - doctors, nurses and other health professionals.
The NHS Mandate is structured around five key areas where the Government expects the NHS Commissioning Board to make improvements.
Section 1: Preventing people from dying prematurely
Our ambition is for England to become one of the most successful countries inEuropeat preventing premature deaths. Ambitions include:
- The NHS should focus more on helping people to stay in good health, support earlier diagnosis of illness, and make sure that everyone has access to the best available care.
- The NHS should publish outcomes data online for all major services by 2015 to drive standards of care, so that all hospitals are closer to the best.
Section 2: Enhancing quality of life for people with long-term conditions
Empowering and supporting people with long-term conditions, making it easier for people to manage their health. Ambitions include:
- Everyone with long-term conditions, including people with mental health problems, will be given the choice to have a personalised care plan that reflects their preferences and decisions.
- By 2015 everyone will be able to book their GP appointment online, order a repeat prescription online and talk to their GP practice via email.
- Everyone who wishes will be able to get online access to their own health records held by their GP. Clear plans will be in place for those records to be able to follow individuals, with their consent, to any part of the NHS or social care system.
- Better diagnosis, treatment and care for people with dementia and greater understanding of the disease throughout the NHS.
Section 3: Helping people to recover from episodes of ill health or following injury
Ensuring everyone has access to the best available care.Ambitions include:
- Greater equality between mental and physical health. And real progress towards everyone who needs mental health services having timely access to the best available treatment.
- The Commissioning Board must shine a light on variation and unacceptable practice, to inspire and help people to learn from the best.
- A revolution in transparency - so that the NHS leads the world in the availability of information about the quality of services.
- The Commissioning Board should look at how to make it easy for patients and carers to give feedback on their care and see reviews by other people, so that timely, easy-to-review feedback on NHS services becomes the norm.
Section 4: Ensuring that people have a positive experience of care
Quality of care is as important as quality of treatment. Feedback about care should be used across the NHS to make changes that really matter to patients. Ambitions include:
- All patients to be able to offer feedback on their care through the “Friends and Family Test”. It should be extended to maternity services from October 2013 and all other NHS services as soon as possible.
- Improvements in the standards of care and experience for women and families during pregnancy and in the early years for their children.
- Keeping waiting times low and continuing to improve performance where possible, particularly in improving access and waiting times for all mental health services.
Section 5: Treating and caring for people in a safe environment and protecting them from avoidable harm
Patients to be treated in a safe and clean environment. The NHS has made progress in this area, but much remains to be done.Ambitions include:
- The long-term aim of the NHS should be to be recognised globally as having the highest standards of caring, particularly for older people, and at the end of people’s lives.
- By 2015, we expect the NHS to reduce avoidable harm and drive improvements in reporting incidents.
- Where there are serious failures of care and treatment have occurred, managers in both the NHS and social care sector will be better held to account.
To view the NHS mandate online, please go to: www.dh.gov.uk/mandate