As new financial year starts, NHS structural changes take effect
Changes to the NHS in England, Wales and Scotland come into effect this month. Principal among them are a new contract for the delivery of primary care and a new contract for hospital consultants. Both changes apply throughout the UK.
Inherent in the new GP contract is a one-third increase in primary care
spending over four years. GPs will be able to opt out of providing out-of-hours
care, which becomes a primary care trust responsibility.
On top of the basic GP contract, GPs and others, including pharmacists,
will be able to offer extra primary care services under PCT contracts.
Other changes that are specific to England include the creation of foundation
trusts and the Commission for Healthcare Audit and Inspection (CHAI)
and the transfer of responsibility for prison health services from the
Home Office to PCTs.
Foundation trusts will be independent public benefit corporations free
to decide their own clinical priorities. They will not be subject to
performance management by strategic health authorities or the Department
of Health.
CHAI replaces the Commission for Health Improvement. It is expected to
adopt a more vigorous approach to the inspection of NHS services and
service providers than its predecessor.
In Scotland, NHS trusts will be abolished and control of hospital services
returned to health boards, which now include local authority representatives
as part of a move to join up health and social care.
No structural changes are being made to the NHS in Wales this month,
but steps to
reduce waiting lists are being taken.
Patients who have been on a waiting
list for more than 18 months are to be
offered the opportunity to be treated at a
hospital in England, under the “second offer initiative”.
There will also be a new Health Care Inspectorate Wales, with a remit
similar to that of CHAI in England. |
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