Commissioners have been told to offer a choice of “any qualified provider” for some community and mental health services from next year. It is part of government plans which amount to a slowing down of the extension of choice in the NHS.
In its response to October’s consultation on choice in the NHS, the government announced on Tuesday the choice of independent providers currently offered to 200,000 NHS elective surgery patients would be extended to eight types of community and mental health services, including those for back and neck pain, diagnostic tests and talking therapies. Wheelchairs for children; ulcer and wound healing; and hearing, continence and podiatry services are also included.
All areas of England will be expected to offer the choice of any qualified provider on at least three of the treatments by September 2012.
The eight new nominated services cost the NHS £1.2bn in 2009-10, according to an impact assessment. The DH has not estimated the total scale of the savings to be made by commissioning services under any qualified provider, although it believes £7.5m can be saved over five years from a “less resource intensive” procurement process.
A national qualification process will mean new providers have to be Care Quality Commission registered and Monitor licensed and will be subject to further assurance depending on safety issues and risk involved with the specific service. A national directory will list all qualified providers and services will be paid for using locally or nationally agreed tariffs. Providers will not be guaranteed activity or income.
After April 2013 the government plans to extend the policy to antenatal education, breastfeeding support and long term conditions management. Some cancer services may also be open to choice and patients may be offered chemotherapy at home.
However, the DH said: “The policy will be implemented more slowly than planned.”
The original consultation “envisaged” patients having a choice of provider in “the vast majority of NHS funded services by no later than 2013-14”.
In a ministerial statement health secretary Andrew Lansley said the government would “adopt a phased approach” to extending choice.
The plan – originally billed “any willing provider” – met with opposition from professional groups and trade unions, forcing the government to amend the Health Bill to rule out activity being paid for below the level of the tariff.
Mr Lansley has now said that “patients’ choices will be limited to services covered by national or local tariff pricing”.