Ministers have proposed a series of new priorities and targets for the NHS, and said they will press for the reform of GP and other out of hospital services.

A consultation on a “refresh” of the government’s mandate to NHS England, for 2014-15 also includes plans to extend the friends and family patient experience test, and “an ambition that each area moves to a wholly integrated approach to health and care by 2018”.

The measures would update the first mandate for NHS England, which was published as recently as November, and covers the period April 2013 to March 2015.

The Department of Health also launched a wide-ranging engagement exercise on the future of services for older people. It said the outcomes of this - covering primary care, emergency care, and integration - will be included in the final 2014-15 mandate, to be published in the autumn.

Health secretary Jeremy Hunt said the review would lead to “every vulnerable older person having a named clinician responsible for their care outside of hospital”. It is also focusing on extending primary care services – including how to “stimulate new models of provision”, and increasing individuals’ choice of GP.

The mandate also notes the announcement in the government’s comprehensive spending review last week of the creation of a £3.8bn pooled health and social care budget, to fund integrated out of hospital services.

It says in light of these plans: “The government therefore expects NHS England to support the development of integration plans in each local area in partnership with local authorities and local health and wellbeing boards, with an ambition that each area moves to a wholly integrated approach to health and care by 2018.”

Today’s consultation document says the mandate should “provide constancy of purpose by setting the strategic direction for NHS England”.

However, it said it needed to be updated for 2014-15 because the “scale of the challenge facing the NHS and wider health and care system is becoming increasingly clear”, and because of “new developments and evidence”. Those developments were the Francis and Winterbourne reports; accident and emergency “pressures”; and “the scale of the ongoing financial challenge”.

All objectives in the 2013-15 mandate will remain, but the government proposes some will be updated and some new inclusions.

These include:

  • Challenge NHS England to introduce the “friends and family” test to general practice and community and mental health services by the end of December 2014 and the rest of NHS funded services by the end of March 2015.
  • NHS England to set “clear expectations for commissioners on the approach to procuring services”
  • Make “measurable progress towards avoiding at least 10,000 excess deaths per year by 2018, through healthcare interventions”.
  • “To work with the DH to develop a range of costed options for new access and / or waiting time standards for mental health services by the end of March 2015, and implement them.” This appears to be a slight strengthening of the current mandate which says the DH will “work with the board to consider new access standards”.
  • Ensure acute and emergency care for people in mental health crisis is as accessible and high-quality as for physical health emergencies, and ensure adequate liaison psychiatry services.