NHS reforms will have little effect on patients, says academic
Patients will see “little difference” when the government’s controversial NHS reforms come into force later this year, a policy expert has said.
The Health and Social Care Act, which became law after a tortuous passage through Parliament, is expected to cost the taxpayer between £1.5bn and £1.6bn to implement.
But Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine, said when the reforms come into force on April 1 patients will not notice a great difference in services offered to them.
The main aims of the health reforms were to make the NHS more accountable to patients and to release frontline staff from excessive bureaucracy and top-down control.
One of the biggest changes is the move from primary care trusts (PCTs) to clinical commissioning groups (CCGs), which will be led by GPs and other clinicians who will take on responsibility for commissioning care. The move will see 212 CCGs replace 151 PCTs across England.
A new national NHS Commissioning Board is responsible for setting commissioning priorities for the groups and oversees England’s NHS spending. For the year 2013-14 the board is responsible for £95.6bn of the health service’s budget.
“On 1 April patients won’t notice any great difference in the services available and that they receive,” said Professor Black.
“In essence, CCGs will commission care locally instead of PCTs - not that patients have even heard of such bodies.
“While it is hoped that commissioning has a stronger clinician involvement, the decisions made are unlikely to be strikingly different from the current ones because there isn’t much room to manoeuvre.”
But the Department of Health said that CCGs are already improving the care of patients.
“Clinical Commissioning Groups are already improving people’s health and they are making it easier for patients to access services,” a spokesman said.
“The changes we’ve made also encourage better integration between health and social care services.
“We are putting those who know the needs of their patients in charge of their healthcare.
“Our reforms give doctors and nurses the power and the freedom to provide healthcare services that they know their local population need.”
Professor Black continued: “What matters now is that the system looks at new ways of providing care that are more patient-centred.”
He said that if health care professionals took the time to really discuss patient’s problems with them it could save time - and money - in the long run.
“If we start involving patients in decisions about whether or not they get a surgical treatment - such as a hip replacement - patients are less likely to opt for surgery than surgeons.
“The more people understand about their illness the better they are able to manage it themselves.
“If doctors take a little more time talking and explaining about illnesses it could save so much time by preventing the costly treatments further down the line.
“It has got to be about helping patients understand what is wrong with them and what the likely outcomes are.
“We have to change the balance so it is much more about the patient making the decisions.”
Professor Black added that it is too early to tell whether the efficiency drive in the health service has had an effect on patient care.
He said the true effects will not come to light until the late spring or summer.
The NHS has been charged with making £20bn in efficiency savings by 2015 - in the last year the health service made £5.8bn in savings.
“We have not yet seen any of the effects,” he said.
“The fact that there is nothing to report yet does not mean that there is not some harm occurring - there might be - but equally there might not.
“When we have got the full data for the current financial year then we can expect to see some impacts.”
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