Patient’s role in NHS England

05 Jul

As we all read the papers or listen to the news it is now blatantly obvious the NHS on its 65th birthday is in serious trouble.
The NHS is “about to run out of cash” – and faces a £30 billion funding gap by 2020, senior health service officials have warned.
It is down to NHS England to advise sweeping changes – a call to action……

Formally established as the NHS Commissioning Board on 1 October 2012, NHS England is an independent body at arm’s length to the Government.
NHS England   will play a key role in the Government’s vision to modernise the health service with the key aim of securing the best possible health outcomes for patients by prioritising them in every decision it makes.
The main aim of NHS England is to improve the health outcomes for people in England.
    • We believe the new approach we are taking will really make a difference and deliver the improved health outcomes we all want to see.

      The new health and care system becomes fully operational from 1 April to deliver the ambitions set out in the Health and Social Care Act. NHS England, Public Health England, the NHS Trust Development Authority and Health Education England will take on their full range of responsibilities.

    • Locally, clinical commissioning groups – made up of doctors, nurses and other professionals – will buy services for patients, while local councils formally take on their new roles in promoting public health. Health and wellbeing boards will bring together local organisations to work in partnership and Healthwatch will provide a powerful voice for patients and local communities.
    • Central to our ambition is to place the patients and the public at the heart of everything we do. We are what we want the NHS to be – open, evidence-based and inclusive, to be transparent about the decisions we make, the way we operate and the impact we have
    • We encourage patient and public participation in the NHS, treat them respectfully and put their interests first. This allows us to develop the insight to help us improve outcomes and guarantee no community is left behind or disadvantage
    • We empower and support clinical leaders at every level of the NHS through clinical commissioning groups (CCGs), networks and senates, in NHS England itself and in providers, helping them to make genuinely informed decisions, spend the taxpayers’ money wisely and provide high quality services.
    • Engaging with our staff is equally important to us too. Our staff is what makes the NHS England an excellent organisation: an exemplar in customer focus, professionalism, rigour and creativity
    • Grounded by the values and principles of the NHS Constitution, we are an organisation who shares ideas and knowledge, successes and failures, and listens to each other carefully and thoughtfully.
    • At NHS England, we practice what we preach. By working collaboratively and building coalitions with partners everywhere means we can achieve greater things together and deliver the best patient service not only in England but in the world.


      At the same time this potential crisis reaches the headlines we as GP’s are asked to choose whether to liaise with the Patient Reference Group(PRG) to get ideas of how we can improve our services by increasing efficiency and cost effective commissioning. We as a practise have opted to participate in this Direct Enhanced Service (DES) and work with the PRG.

      Patient Reference Group
      The purpose of the patient participation DES is to ensure that patients are involved in decisions about the range and quality of services provided and over time, commissioned by their practice. It aims to encourage and reward practices for routinely asking and acting on the views of their patients. This includes the patients being involved in decisions that lead to changes to the services their practice provides or commissions, either directly or in its capacity as gatekeeper to other services.It aims to promote the proactive engagement of patients through the use of effective Patient Reference Groups (PRGs) and to seek views from practice patients through the use of a local practice survey. The outcomes of the engagement and the views of patients are to be published on the practice’s website.

      Suggestions of aspects which may be discussed – NHS England
      One aspect that practices may wish to focus on is ensuring convenient access to the practice and also from the practice to other services in its role as coordinator of care, facilitating access to other health and social care providers.
      Access has many dimensions; the relative importance of these will vary according to the specific needs of the registered population. These dimensions include:
       lists being open to all
       hours of opening with the ability to be seen urgently when clinically necessary, as well as
      the ability to book ahead
       continuity of care
       range of skills available – access to different professionals
       a choice of modes of contact which currently includes face-to-face, telephone and electronic contact, but can be developed further as technology allows
       geographical access, enabling care as close to home as possible.
      Access must be flexible enough to meet the varying needs of individualsand requires sufficient capacity to meet the population’s needs. Details of access arrangements (including opening hours) should be made widely available to the patient population to enable patients to exercise choice.

      Patient Reference Group (PRG) may be an existing formal patient participation group or a similar group that is representative of the practice population, which would feed in its views alongside the findings from the surveys and agree with the practice priority areas for possible change. This would result in an action plan to be agreed between the practice and the PRG.
      Practices taking part in this DES will also carry out a properly constituted survey of a sample of the practice’s patients looking at a broad range of areas which could include convenience of access (opening times, ability to book ahead, ability to be seen quickly, telephone answering), patients’ experience of the treatment and service they receive, the physical environment in the practice and other issues specific to individual practices.
      As I am sure some of you are aware we have already participated in having meetings with a cross section of patients during the past few years to discuss results of patients surveys addressing issues such as access to doctors, telephone access, car parking,email prescription requests, children in surgery and more recently patient education and we have attempted to improve our service and act on points raised in the survey. The minutes of these meetings are published on our website. This was formerly called the Patient Participation Group but will know be known as the Patient Reference Group.
      We have tried to make our meetings representative of the patient population but along with our GP colleagues we have found the numbers participating are small and some types of patients are not represented. Nevertheless, we are persevering to reach our patients by our website,written newsletters and survey sheets distributed over a period of time to a wide cross section of patients.


      We will be announcing a PRG meeting in the next few weeks and conducting a survey with patients attending the surgery and strongly encourage as many people as possible to participate. Although it is good to hear favourable comments on things we are doing well it would be extremely useful and perhaps more so if we could have constructive criticism of things we are NOT doing well,and even better if we can have ideas of how we can provide a better service.
      When we obtain the results of the survey we will hold a further meeting to discuss the findings and hopefully come to an agreement as to how we can implement plans for changes to the services provided.
      If you have suggestions please contact the practise Manager,Sangeeta Kathuria by email(, appointment or by letter.
      We need everyone to pull together to keep our NHS continuing to provide a service to all who need it.


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