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Overview

Radical reform is the overarching strategy for the Government's Health and Social Care agenda, embedding 'Quality' at the heart of the service.

In 2007, Lord Darzi published the 'NHS Next Stage Review', involving 2,000 clinicians nationwide and 60,000 individuals, the Review aimed to define regional visions that reflected local needs and establish one national vision - High Quality Care for All.

The Review identified three dimensions of Quality - patient experience, patient safety and clinical effectiveness.

The latest report 'High Quality Care for All - Our Journey So Far' published in June 2009, highlights the Government's success to date, and some of these are outlined below:

  • Waiting times in the NHS dramatically reduced, with the time from referral by GPs to treatment down to a maximum of 18 weeks, from 18 months just 10 years ago.
  • Improving patient experience by substantially increasing access to primary care services, including 50 new GP-led health centres now open, 65 new GP practices in areas that previously did not have enough doctors and more than three-quarters of GPs offering extended opening hours.
  • Improving patient safety through substantial reductions in healthcare associated infections, including a 35 per cent reduction in C. difficile and a 38 per cent reduction in MRSA rates over the last year alone.
  • Improvements and investment in NICE to ensure faster access for patients to new drugs and treatments.
  • Five Academic Health Science Centres, bringing together our top academic and healthcare organisations to form world-leading institutions for innovation and research.
  • Major progress on the new Quality Framework to support local organisations and frontline staff in putting quality at the heart of services, for example, through the new Indicators for Quality Improvement, the development of Quality Accounts and the new National Quality Board.
  • The first NHS Constitution was launched setting out the purpose and values that underpin the NHS and the rights and responsibilities of patients and staff.

Furthering this programme of radical reform, in December 2007, Phil Hope MP, Minister of State for Social Care published a programme of change for the social care system 'Putting People First'. However, it was never designed to provide a long-term solution - it does not address issues, such as the local variability in the system, the high number of people who get no support from the state, and the funding of the system to support increasing numbers of those who will need care in the future.

The care and support system needs radical reform. Consequently, the Government published its Green Paper 'Shaping the Future of Care Together' in July 2009, with a consultation running until end-November and publication of the White Paper due in 2010.

Underlying issues shaping the debate include:

  • Demographic change - By 2026, 1.7 million more people each year will need care and support than currently. Traditionally, state care for older people has been funded by people who are still working. But as the number of people who need care rises, there will be fewer people of working age to support them. As things stand, we do not have the funding or capacity to meet this demand.
  • Rising expectations - People rightly expect more from services now than ever before. They want to be partners in their own care - they want to chose what services they receive, and to have a say in how and where they receive them.
  • Perceived lack of fairness - Under the current system a person's care needs, and the amount of care they receive, is decided at local level. This means that, due to different local factors, local authorities around the country offer different criteria for and different standards of care.
  • Lack of clarity - The current care and support system is made up of many and varied bodies, some public, some private and some charitable. These organisations do not always communicate with each other, and this can make the system look very complicated and daunting, particularly to those who are at a time of need in their lives.
  • Inefficient use of money - Many people have told us that they are concerned that taxpayers' money is not always used efficiently within the care sector. For example, the lack of 'joined-up' working by service providers can lead to needless and expensive duplication of services.

In December 2009, Secretary of State Andy Burnham announced 'NHS 2010-2015 from Good to Great. Preventative, People-Centred, Productive', the Government's five-year plan to reshape the NHS. This, published together with the ‘Operating Framework for the NHS in England 2010/11' and the Pre-Budget Report 2009, set out the financial environment for the NHS and the priorities for the sector ahead.

Health and Social Care 2010 - High Quality Care for All will examine how these two agendas link together to provide an integrated, people-centred health and social care system, driving quality and providing a sustainable, productive and innovative service across the piece.