An NHS constitution and patients’ wishes to get priority were the key pledges announced yesterday as the long-awaited Darzi review was published.

And the word "polyclinic" is not mentioned once in the report.

Lord Darzi said his proposals would give patients more choice and would be driven by giving responsibility to local staff.

The report promises all patients getting a right to all drugs approved by NICE - the National Institute for Health and Clinical Excellence.

Patients would have a legal right to choose their provider, including their GP services.

Some 5,000 patients will be involved in a pilot of personal budgets for the care of their long-term conditions - a move that has already been tested in social services.

And all patients with a long-term condition would get a personal care plan.

Lord Darzi promised an end to the proliferation of top-down targets. But NHS providers will have to measure and analyse quality, using "clinical dashboards" to let staff know of progress.

He also promised an investment in clinical leadership and a big investment in nursing foundation years.

The report promises to pilot new approaches to primary care - encouraging GPs, community nurses and others to work "across clinical boundaries".

Meanwhile the NHS Constitution will be deployed to tackle hospital infection, allowing regulators "tough new enforcement" powers and promising "privacy, dignity and cleanliness".

Lord Darzi also promised to press on with setting up NHS Medical Education England, the proposed new body to supervise junior doctors’ training and sort out the confusion left by last year’s recruitment chaos.

The headline proposals said little about the controversial reorganisation of GP services into polyclinics - or the commercialisation of primary care - that has provoked anger among doctors and their patients.

Lord Darzi said the proposal was to invest in more health centres and services for GPs.

He said: "This report will enable frontline doctors, nurses and patients - who provide and use NHS services - to put into practice their visions for high quality care.

"As a surgeon I know how vital it is to balance the quality of the patient’s experience - a clean and safe environment, being treated with compassion dignity and respect - with the success of the treatment they receive.

"By measuring this quality across the service and publishing that information for the first time, both staff and patients can work together to make better informed choices about their care.

"By setting clearer standards, and recognising and rewarding innovation in quality, we can keep pace with the very latest advances in medicine and technology."

Further "immediate steps" proposed in the report include well-being and prevention services to be commission by primary care trusts and to be "personalised" to meet the needs of local populations.

It proposes to strengthen the medical clinical excellence awards scheme, making it more dependent on clinical activity and indicators of quality.

And other staff will be able to compete for new regional funds and prizes in return for innovation.
Health secretary Alan Johnson said: "These locally driven, clinically led plans show how quality of care will be raised right across the country, with doctors and nurses supported to offer big improvements in treatment at the bedside. Quality of life will be improved and more lives will be saved."

(Article courtesy of staffnurse.com)