NHS White Paper, Equity and excellence: Liberating the NHS

The NHS White Paper, Equity and excellence: Liberating the NHS, sets out the Government's long-term vision for the future of the NHS. The vision builds on the core values and principles of the NHS - a comprehensive service, available to all, free at the point of use, based on need, not ability to pay.

It’s the most radical reform of the NHS since its inception, with PCTs and SHAs facing the axe and GPs set to hold the purse strings. What’s more, the health white paper must be delivered against the backdrop of the current financial climate and the £20bn productivity challenge set by the QIPP programme.

The white paper puts groups of GPs in charge of £80bn worth of public funds. How will that work? How willing and capable is the GP community to take on these new commissioning responsibilities? Will they look for support to carry out this task? Who will be accountable?

Patients will be able to choose their GP and there will be greater choice in diagnostics and maternity care. The any willing providing policy means that in theory providers will be at liberty to compete with each other as long as they meet NHS standards. How will these freedoms affect the service?

Information is another central theme, with greater transparency of data underpinning the reforms. How will that influence patients and what effect will it have on standards and quality?

Outgoing PCTs and SHAs have been asked to manage the transition to the new structures, but how will they cope with creating the foundations for their successors?

Some of the key highlights of the white paper include:

The government will devolve power and responsibility for commissioning services to GPs and practice teams working in consortia.
Every GP will be a member of a 'shadow' consortium by 2011/12.
Consortia will start taking on duties from 2012/13 and full financial responsibility from April 2013.
Management allowances will be available to help fund commissioning.
An independent and accountable NHS commissioning board will allocate and account for NHS resources.
NHS commissioning board will calculate practice-level budgets and allocate these directly to consortia and will hold practices to account.
GP consortia will include an accountable officer.
Each consortium will hold its constituent practices to account.
GP consortia will agree local priorities each year, taking account of the NHS Outcomes Framework.
GPs will need to engage patients and the public in the commissioning process.
Over time the DoH will seek to establish a single GP contract and funding model.
PCTs and SHAs will be phased out.
Patients will be able to choose which GP practice they register with regardless of where they live.
The current performance regime will be replaced with separate frameworks for public health and social care.
A new NHS Outcomes Framework will provide the direction for the NHS.
The government will incentivise ways of improving access to primary care in disadvantaged area

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