Information at heart of NHS Constitution

  • 22 January 2009

Providing information to support choice is a “major priority” for the health service, according to the new NHS Constitution for England.

A handbook published to support the constitution, which was launched at a “historic signing ceremony” at Downing Street yesterday, highlights a number of areas in which IT and information services will be developed to support its rights and pledges.

These include some of the evidence and staff portals first outlined in the final report of Lord Darzi’s Next Stage Review of the NHS, the further development of NHS Choices, and new information sources for kiosks and mobiles.

The constitution also puts a new responsibility on patients to ensure “information about them is accurate and up to date.” To support this, the handbook says: “The NHS is working to develop online applications to store health information, for example through the HealthSpace initiative.”

However, it gives no indication as to whether this means other National Programme for IT in the NHS applications will exchange demographic and other details with HealthSpace in the future; or whether applications outside the programme will be expected to do so.

Nor does it apply any penalties to patients who fail to provide information or organisations that fail to act on it. In general, the constitution stresses that its rights are already enshrined in legislation and therefore subject to legal action of various kinds, while the NHS complaints procedures are open to patients unhappy with any aspect of their care.

The British Medical Association said the government should have gone further. “This is a welcome restatement of the principles of equality and compassion on which the health service is based,” it said in a statement. “But we need more than a ‘feelgood’ document. In its current form, it is unclear how the constitution will change the everyday experiences of patients and staff.

“Concrete measures, such as the creation of a national independent board to oversee the day to day operation of the NHS would help to depoliticise it, while there needs to be much more engagement with the public and staff about how services are delivered at a local level.”

The constitution says people will be given “the information you need to influence and scrutinise the delivery of NHS services” but leaves delivery to primary care trusts. It also commits the NHS to providing more information for patients who need to make choices about their care and to give informed consent.

In a potentially far-reaching pledge, it also promises that services will be provided in “a clean and safe environment that is fit for purpose and based on best practice.”

The handbook says the NHS will “monitor the effectiveness and outcomes of care more systematically” through metrics linked to payment, while the National Institute for Health and Clinical Excellence will establish an NHS Evidence portal to spread information about best clinical practice and models of care.

The constitution reiterates that patients have a right to see their medical records and repeats the pledge – first made in the NHS Plan – that letters will be copied to them. It also says patient information will be handled confidentially, but pushes ahead with a controversial proposal to open up patient information to researchers so they can recruit people to clinical trials.

Finally, the constitution contains a section for staff. It commits the NHS to providing staff with “personal development, access to appropriate training for their jobs and line management support to succeed” and to developing the NHS Gateway portal. It also says there will be an annual competition to identify the best NHS employers.

The Health Bill, which was introduced to Parliament earlier in the week, will require all organisations providing NHS care to take account of the constitution in carrying out their functions. A report will be prepared every three years on its impact. Health secretary Alan Johnson claimed “it will ensure we protect the NHS for generations to come.”

Link:NHS Constitution microsite.

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