The Department of Health is consulting on a set of 10 principles to which all NHS organisations and contractors must sign up.

The Department of Health is consulting on a set of 10 principles to which all NHS organisations and contractors must sign up.

The principles, published alongside the operating framework, update those in the 2000 NHS plan, but offer two new emphases: on continuously improving efficiency, productivity and performance; and on treating patients with dignity and respect.

NHS chief executive David Nicholson said the principles reflected that the service 'is more than just a set of interactions between buyers and suppliers - it has an ethos that transcends those things and we don't want to lose that.'

He said he wanted to 'close down' any debate on the possibility of independent sector providers offering co-payments of any kind. 'Any ideas that any providers can offer top-ups or extras that the patients pay for is unacceptable. That is a stake in the ground' (see page 9).

He said the debate about healthcare reform had been damaged by an overemphasis on detail that promoted division during the end of his predecessor Sir Nigel Crisp's reign.

'There has been a focus on the technical aspects of reform rather than why we are doing it. People get focused on competition and the market and all this stuff but the whole point is to improve services to patients. I am trying to move completely away with that.

'I think we have lost the focus over the last two to three years and I am trying to pull us back.

'The great strength of the system is its cohesion. The need for reform drives us apart but we also need to stress those places where we are together.'

Four service priorities for 2007-08

The framework sets out four service priorities for next year.

  • Hospital-acquired infection: trusts will be required to set 'stretching' local targets on reducing levels of Clostridium difficile. Trusts can bid for grants of£350,000 each from a£50m central fund to reduce infection rates.
  • Financial health: this includes a target for a£250m cash surplus by March 2008.
  • The 18-week target: by the end of March 2007, 85 per cent of pathways that end in hospital treatment and 90 per cent of those that do not end with an admission should be completed in 18 weeks.
  • Health inequalities: PCTs will be 'required to focus on interventions that evidence shows can have the biggest impact on reducing health inequalities' and on hitting the 48-hour genito-urinary medicine target by 2008.