The White Paper outlines plans to reform the National Health Service (NHS) in England by empowering patients, healthcare professionals, and local communities. Key aspects of the reforms include giving patients more choice and control over their care, shifting decision making power to locally-led clinical commissions, and introducing competition among healthcare providers and payment based on outcomes. The reforms also aim to reduce NHS management costs by 45% by the end of 2014 through abolishing some NHS bodies and putting more power in the hands of autonomous foundation trusts and general practitioner groups.

2. Equity & Excellence: Liberating the NHS Figure 1, page 20 Informed patients exercising choice Empowered professionals working in autonomous providers Enhanced local voice Clinically led commissioning & payment by Robust economic regulation & quality inspection A system focused on improving outcomes results

3. What Does it Mean for Patients? Informed patients exercising choice Patients and public first No decision about me without me Involvement in care/ outcomes Information Revolution Local accountability for performance Peer competition Any willing provider LTCs/ right to choose GP

4. What’s the Government’s Vision? A system focused on improving outcomes Improving healthcare outcomes Improvement in quality and outcomes NHS Outcomes framework Top down targets dropped Clinically credible evidence based measures NICE quality standards/ library Payment by performance/ reward quality

5. What Does it Mean for NHS Management? NHS Commissioning Board April 2012 Public Health in local authorities April 2012 GP Consortia 2012 Abolition of SHAs & PCTs 2012-13/ From 2013 All trusts to become foundation trusts 2013/14 Management costs reduced by 45% By end 2014 Enhanced local voice Robust economic regulation & quality inspection results Clinically led commissioning & payment by Empowered professionals working in autonomous providers

6. What Does it Mean for PCC? Threats/ weaknesses End of state as preferred provider End of PCC’s guaranteed client base Emergence of local frameworks Competition from private commissioners Competition with GP Consortia Opportunities/ Strengths Emphasise social enterprise status, ‘Big Society’ Emphasise value commitment to NHS (not private) PCC is already in the market, but must act quickly Use accumulated knowledge to keep advantage More clients—expansion?

7. The Managerial Grid 1 2 3 4 5 6 7 8 9 9 8 7 6 5 4 3 2 1 COUNTRY CLUB MANAGEMENT 1, 9 ORGANISATION MAN MANAGEMENT 5,5 AUTHORITY- OBEDIENCE 9,9 TEAM MANAGEMENT 9,9 CONCERN FOR PRODUCTION CONCERN FOR PEOPLE IMPOVERISHED MANAGEMENT 1,1