2010 to 2015 government policy: choice in health and social care
Updated 8 May 2015
Applies to England
© Crown copyright 2015
This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.
Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.
This publication is available at https://www.gov.uk/government/publications/2010-to-2015-government-policy-choice-in-health-and-social-care/2010-to-2015-government-policy-choice-in-health-and-social-care
This is a copy of a document that stated a policy of the 2010 to 2015 Conservative and Liberal Democrat coalition government. The previous URL of this page was https://www.gov.uk/government/policies/helping-people-make-informed-choices-about-health-and-social-care. Current policies can be found at the GOV.UK policies list.
Issue
Currently NHS patients can - in most circumstances - choose their GP or the hospital they’re referred to. And personal budgets are giving people more choice and control over their social care and support arrangements.
We think that introducing more choice will help people get the care and support that’s right for them, and make services more responsive to their needs. And we want everyone to have access to the information and advice they need to make the right choices for them.
Actions
Expanding choice and control
We’re making changes to both health and social care services to give patients and service users more choice and control.
Providing more information and advice
People can only make the right choices for them if they have the right information and advice. So we’re ensuring that more transparent information is available on health and social care services on the NHS Choices website.
Background
We set out our original proposals for expanding information and choice for NHS patients in the July 2010 white paper ‘Equity and Excellence: Liberating the NHS’.
Since then we’ve run a number of consultations on NHS services, including:
- ‘Liberating the NHS: an information revolution’ (October 2010)
- ‘Liberating the NHS: greater choice and control’ (May 2012)
- ‘Liberating the NHS: no decision about me, without me (May 2012)
Our thinking has also been informed by reports like the NHS Future Forum’s report on choice and competition.
Plans for changing how social care is funded are based on recommendations from the Dilnot Commission on Funding of Care and Support, which published its report in July 2011.
We set out plans to provide more information about social care services - and make them more consistent across the country - in the 2012 white paper ‘Caring for Our Future’.
The ‘Power of information’ report, published in May 2012, has details of plans to make more information about health services available online.
Who we’re working with
From April 2013, NHS England will be responsible for developing guarantees on patient choice in the NHS and agreeing them with the Secretary of State for Health. They will also be responsible for getting advice from Monitor, the healthcare regulator, on how changes would affect competition in healthcare services.
We’re working with local councils to help them encourage a wider range of organisations to offer social care services in their area.
And we’re working with social care providers, service users and the Association of Directors of Adult Social Services to make sure that councils have the skills to identify the right services for local people.
Bills and legislation
New duties for parts of the NHS to offer more patient choice were passed into law with the Health and Social Care Act 2012. The act also gives Monitor a new role in promoting and regulating competition in healthcare services.
The Care Act published in 2014, provides the legal framework for changes to the social care system.
Appendix 1: providing more information about health and social care services
This was a supporting detail page of the main policy document.
New online portal and NHS 111 phone service
So that people have the information they need to make the right choices for them, we will:
- by the end of 2013, create a new online ‘portal’ to bring together information about health and care services in one place
- make the NHS 111 telephone service available nationally by October 2013
The new online portal will include guidance on how the health and social care systems work, details about the quality of services, costs and the financial help available.
And we’ll expand online profiles of care homes and social care services so that registered care providers can add extra information. This might include:
- details of staffing levels and training
- what specialised care they offer
- information about how often residents fall, pressure sores and any mistakes over medication
- feedback and any complaints from residents and families.
NHS 111 provides advice in non-emergency situations and puts people in touch with the right local health services.
NHS service quality
We want information about the NHS services to be based on good quality data and feedback from patients. So we are:
- expanding national clinical audits - which look at how well treatments work for a particular condition, like diabetes or cancer - to cover more areas of medicine
- extending the use of patient-reported outcome measures (PROMS) - reports based on patients’ views about the quality of their care and treatment
From April 2013, councils will be setting up local Healthwatch organisations. These local organisations will be responsible for gathering views from service users and making sure that health and care services take these views into account. Healthwatch England will use this information to help identify trends and recommend improvements to the health and care system as a whole.
Quality Accounts
By 2015 we want all NHS service providers to publish Quality Accounts - annual reports on the quality of their patient care.
Understanding the social care system
At the moment, the social care services available are often different depending on where you live. We want everyone to have a clear idea of what they can expect - even if they move out of the area.
So we will:
- from 2015, set a minimum level of need at which people become eligible for care and support - wherever they live in England
- introduce a clear process to allow adults getting social care and support to move to a new area without having their care interrupted
- if someone has already been assessed as having social care needs, give local councils a legal duty to meet these needs as soon as they move into the area
It’s important that people understand how the social care system works, so they can plan ahead. For example, if someone knows in advance how to get alterations made to their house, it may let them live independently for longer.
We will:
- give local councils a legal duty to provide people with full information about their options - and make sure everyone has access to independent advice
- provide £32.5 million over 2014 to 2015 to help councils develop online information services
Access to care records and personal health budgets
Making more information available should also help health and care services to work together effectively.
For example, we’re giving people the right to view their medical records online. GP records will be available online by 2015, followed as soon as possible by other health and care services. If they choose to, patients can then share this information with the organisation providing their social care.
We’re also trialing personal health budgets in the NHS, to give people more control over healthcare services. If we decide to expand this trial, we’ll make sure that it’s easy for people to combine them with personal social care budgets.
Appendix 2: giving people more choice and control in health and social care
This was a supporting detail page of the main policy document.
Choice over health services
By 2014, we want NHS-funded services to offer more choice of treatment and service provider (though of course it’s not practical in all cases - for example, emergency services).
So we will:
- give women the right to choose whether they give birth at home, at a midwife service or in hospital
- provide patients with more choice in mental health services (including, from April 2014, a choice of where they go for their first outpatient appointment - and who’s in charge of their treatment)
- giving the NHS a duty to encourage medical research, so more patients have the chance to take part in clinical studies
- make sure every area of the country is fully served by a 24/7 urgent care service, so patients know they can get urgent care straight away - even if they’re registered with a GP outside the area
Choice over social care services
Encouraging different types of social care service
We want people to be able to choose from a range of different social care services, so we’re giving local councils a duty to encourage different types of service providers. For example, this might include ‘microenterprises’ - really small organisations set up to meet the needs of people at a very local level.
Giving people more control over social care services
To give people more control over the services they use, we will:
- give everyone who is eligible for social care the right to a personal budget
- make sure that everyone who has a care and support plan also has a named professional who’s responsible for answering their questions about social care
- from 2013, test how direct payments would work for people who need residential care (direct payments let people buy their own services, rather than the local council buying services on their behalf)
- from April 2013, change the rules on charges for residential care - so people can do paid work without having to pay more towards their care
Helping people with social care costs
We want more people to be able to choose social care services without worrying about losing their home or savings. We’ll put forward legislation to change the rules on financial help, so that from April 2016:
- eligible care costs will be capped at £72,000 over a person’s life time for care they’ve been assessed as needing by their local council
- there will be a different approach for people who need care before retirement age, including a zero cap for people who have care needs when they turn 18
- people in care homes who have a property that is not disregarded in the assessment of what they can pay towards their care costs can apply for financial help if their assets (including property and savings) are worth £118,000 or less
- in all other circumstances people will be able to apply for financial help if their assets are worth £27,000 or less
- less wealthy people and those with the highest level of need get the most financial help
Helping people with residential care costs
The new legislation will also mean that from 2015, people should not be forced to sell their home to pay for residential care costs during their lifetime. If someone needs residential care and can’t pay for it without selling their home, they should be able to enter into an agreement with their local authority to defer their payments until they are ready to sell, subject to eligibility criteria.