Reducing health inequalities, cutting healthcare-acquired infections and planning for emergencies will be among the priorities for the health service in 2008.

They will be on a list of five nationally set priorities spelt out in the Department of Health's NHS Operating Framework 2008-09, due to be published today.

Among the details expected to be outlined to Parliament is a target to reduce Clostridium difficile rates by a third nationally, with greatest pressure to improve in areas with the worst record.

Organisations will be told to improve access to healthcare, both by extending the opening hours of primary care services and by meeting the 18-week referral-to-treatment target in secondary care.

The importance of listening to the views of patients and the public and taking staff satisfaction seriously will also be stressed in the document.

NHS chief executive David Nicholson said reducing health inequalities was as important as hitting the 18-week waiting target.

In an exclusive interview with HSJ ahead of the report's publication, he said: 'People need to focus as much attention on health inequalities as they do on reducing waiting lists - that level of focus and managerial effort.'

Some organisations were doing a good job of tackling health inequalities, 'but it's not wide enough and there's not enough of it', he said.

Mr Nicholson said next year's operating framework was less straightforward than the previous one because the service was at the start of the three-year comprehensive spending review settlement.

'What we are trying to do for the first time is be really clear about what the framework is for, what's national and what's local. It's going to take us some time to get that balance absolutely right.'

He said he was 'unashamedly trying to get us to a place where commissioning plays a much more central role'.

As part of the focus on patient and staff experience, Mr Nicholson said commissioners should ask their providers for evidence that they are supporting staff.

'Part of the reputation of the NHS is determined by what our staff think about the way they are treated as individuals,' he said. 'A contented and happy workforce produces good clinical outcomes for their patients so it's very important.'

The framework, which will be published alongside the 2008-09 funding allocations for primary care trusts today, will also set out the financial regime for the service.

Following the record surplus expected at the end of this financial year, Mr Nicholson said he would expect the NHS to 'generate a substantial surplus' next year - but no larger than this year's predicted£1.8bn.

Operating framework: the national priorities

  • Healthcare-associated infections - includes a new national target to reduce Clostridium difficile.

  • Health improvement - includes tackling health inequalities plus a focus on cancer, stroke and children.

  • Patient and staff engagement.

  • Access - includes meeting 18-week target by December 2008 and extending GP opening hours.

  • Preparing for emergencies - includes pandemic flu and chemical incidents.