Nhs Next Stage Review

Incorporating HC 937-i to iii, session 2007-08. The final report of the Next Stage Review, led by Lord Darzi, published as "High quality care for all" in June 2008 (Cm. 7432, ISBN 9780101743228)

This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.

Government response to the first report of the Committee session 2008-09, HCP 53-I (ISBN 9780215525666). The final report of the Next Stage Review, led by Lord Darzi, published as "High quality care for all" in June 2008 (Cm. 7432, ISBN 9780101743228)

This report from the Health Committee examines Lord Darzi's final report of the NHS Next Stage Review (NSR), "High quality care for all" (2008, Cm. 7432, ISBN 9780101743228). The Committee warns that primary care trusts (PCTs) are not yet capable of carrying out the reforms, and highlights insufficient analytical and planning skills and variable management quality within PCTs. Poor PCT commissioning and the failure of successive reforms to enhance it mean that implementation of the reforms may be slower and more uneven than expected. The Committee calls on the Government to publish and rigorously monitor milestones for each stage of implementation and says greater clarification is required on the role of practice based commissioning, which at present remains opaque. More emphasis needs to be placed on the importance of recruiting and developing better managers and the issue of weak management skills in this area should be tackled. Not enough detail about cost is given in the NSR and the Committee is concerned that neither Strategic Health Authorities (SHAs) nor the Department have been clear on where and how much money will be saved. Figures on implementation costs for individual SHAs and PCTs should be published as soon as possible. While the focus in the NSR on improving quality of care is welcome, variations in quality have been known about for a long time and have continued despite increased funding. The Committee is not convinced by the Department's argument that all PCTs should have a GP-led health centre and recommends that their creation should be decided locally on a case-by-case basis.