The success or failure of policies on choice will be difficult to measure if they are allowed to fragment, warned NHS Confederation policy director Nigel Edwards.

The success or failure of policies on choice will be difficult to measure if they are allowed to fragment, warned NHS Confederation policy director Nigel Edwards.

He said the NHS must guard against the quality of care worsening as a trade-off for offering choice, and should not 'get hamstrung on choice as an end in itself'.

'If choice is allowed to fragment on what basis do we measure success other than on outcomes?' questioned Mr Edwards.

'If patients are offered choice at stages along their patient pathway there is a danger that the pathway will become fragmented or the commissioner charged with holding the pathway together,' he added.

He expressed concern that this could have a particular impact on those with long-term conditions, and said 'much more thought' was needed on who was accountable for the quality and co-ordination of care and choice. 'Providing choice to patients with long-term conditions is much more complex to grapple with than providing elective care,' he explained.

'In moving out of talking about choice in terms of location, the government must not get hamstrung by choice as an end in itself,' he warned.

'We must guard against the quality of care becoming worse as the trade-off for choice.'