NHS reforms should give patients more power and control:
Greater involvement is a higher priority for patients than being able to choose between treatment providers
"Putting patients first" has been a goal of successive governments, but actions have so far failed to match up to the rhetoric.
National Voices believes a key factor in determining how the NHS reforms are ultimately viewed by patients will be whether they lead to greater patient involvement, for example in care planning, deciding treatment options, and managing chronic conditions.
This government took a huge gamble when it decided to embark on major changes to the NHS which will only start to take full effect within sight of the next general election. The new NHS Commissioning Board, established at the beginning of this month, will play a crucial role in delivering those reforms and therefore in their success or failure.
Ministers say the "mandate" setting out the board's objectives will ensure it "achieves the things that really matter and make a difference to people". We believe that will only be so if securing patient involvement is central to future decisions about commissioning health services.
There is strong evidence that the full participation of patients in decisions about their care and treatment can lead to improved health outcomes; improved quality – especially in relation to patient experience – and more effective and appropriate use of resources.
Conversely, the "misdiagnosis" of patient preferences can have serious consequences. National Voices' members have told this and previous governments that patient involvement is a higher priority for patients than being able to choose between different providers of treatment.
The draft mandate contains an extensive "choice framework" including, for instance, guarantees that patients can choose who to see for outpatient appointments and diagnostic tests. However, it does not create an equally strong drive towards the implementation of patient involvement, only rhetorical reference to other kinds of patient decisions.
National Voices cannot support government proposals for a choice framework until there is an equally powerful focus on people's full involvement in their care and treatment.
No one can be against choice. But the choices have to be about what really matters to patients, and patient voices have been consistently misunderstood. "Choice" alone does not amount to "putting patients first".
We now fear there is a real risk that the emphasis on extending a choice of provider will occupy the NHS's attention to the detriment of patient involvement.
Current and previous attempts to extend patient involvement have resulted in "bolt-on" initiatives such as information prescriptions and the production of online patient decision aids. There are many other such evidence-based interventions that can be used, but they will only be effective where service leaders and staff are committed to a culture of supporting patient decisions.
In responding to the draft mandate, National Voices has called for the Commissioning Board to lead a national drive to develop the tools, guidance, incentives and awareness among healthcare commissioners that are needed to ensure much greater patient involvement in the NHS.
The board, and local clinical commissioning groups, need to redesign the services they commission, to remove paternalism and establish a culture of patient support.
Service providers should be working to strengthen the health literacy, skills and confidence of patients to be as involved as possible in managing their care and treatment, especially in relation to long-term conditions. Likewise they should support family carers, who are the ones most engaged with patients. The skills, behaviours and values of care professionals need building, to move from a "doing to", to a "working with" culture.
Whatever the downside of the tsunami of reforms besetting the NHS, they do create an opportunity to bring about a significant culture change and achieve genuine patient involvement. We can help the policy makers get this right by drawing on insight and expertise from the patient movement.
Jeremy Taylor is chief executive of National Voices, a coalition of more than 140 health and social care charities Guardian Professional.
"Putting patients first" has been a goal of successive governments, but actions have so far failed to match up to the rhetoric.
National Voices believes a key factor in determining how the NHS reforms are ultimately viewed by patients will be whether they lead to greater patient involvement, for example in care planning, deciding treatment options, and managing chronic conditions.
This government took a huge gamble when it decided to embark on major changes to the NHS which will only start to take full effect within sight of the next general election. The new NHS Commissioning Board, established at the beginning of this month, will play a crucial role in delivering those reforms and therefore in their success or failure.
Ministers say the "mandate" setting out the board's objectives will ensure it "achieves the things that really matter and make a difference to people". We believe that will only be so if securing patient involvement is central to future decisions about commissioning health services.
There is strong evidence that the full participation of patients in decisions about their care and treatment can lead to improved health outcomes; improved quality – especially in relation to patient experience – and more effective and appropriate use of resources.
Conversely, the "misdiagnosis" of patient preferences can have serious consequences. National Voices' members have told this and previous governments that patient involvement is a higher priority for patients than being able to choose between different providers of treatment.
The draft mandate contains an extensive "choice framework" including, for instance, guarantees that patients can choose who to see for outpatient appointments and diagnostic tests. However, it does not create an equally strong drive towards the implementation of patient involvement, only rhetorical reference to other kinds of patient decisions.
National Voices cannot support government proposals for a choice framework until there is an equally powerful focus on people's full involvement in their care and treatment.
No one can be against choice. But the choices have to be about what really matters to patients, and patient voices have been consistently misunderstood. "Choice" alone does not amount to "putting patients first".
We now fear there is a real risk that the emphasis on extending a choice of provider will occupy the NHS's attention to the detriment of patient involvement.
Current and previous attempts to extend patient involvement have resulted in "bolt-on" initiatives such as information prescriptions and the production of online patient decision aids. There are many other such evidence-based interventions that can be used, but they will only be effective where service leaders and staff are committed to a culture of supporting patient decisions.
In responding to the draft mandate, National Voices has called for the Commissioning Board to lead a national drive to develop the tools, guidance, incentives and awareness among healthcare commissioners that are needed to ensure much greater patient involvement in the NHS.
The board, and local clinical commissioning groups, need to redesign the services they commission, to remove paternalism and establish a culture of patient support.
Service providers should be working to strengthen the health literacy, skills and confidence of patients to be as involved as possible in managing their care and treatment, especially in relation to long-term conditions. Likewise they should support family carers, who are the ones most engaged with patients. The skills, behaviours and values of care professionals need building, to move from a "doing to", to a "working with" culture.
Whatever the downside of the tsunami of reforms besetting the NHS, they do create an opportunity to bring about a significant culture change and achieve genuine patient involvement. We can help the policy makers get this right by drawing on insight and expertise from the patient movement.
Jeremy Taylor is chief executive of National Voices, a coalition of more than 140 health and social care charities Guardian Professional.
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