Patient Choice

Ambition for the NHS… By Lindsay Yates, Office Intern at EATA

This blog is re-printed with the permission of EATA – A membership Organisation to which we subscribe and recommend. Visit

Alongside the Department of Health’s (DH) other white paper, “An Information Revolution,” the “Greater Choice and Control” white paper was released on 18 October 2010. The document outlines the new government’s ambition for the NHS’s success in the future. With increased excellence in the system, the government hopes to improve confidence in both the quality of healthcare services and access to healthcare based on need and not financial circumstances. Seeing the patient be put at the centre of the system will include availability of relevant information as well including patients in decision making processes.

The coined slogan, “No decision about me, without me,” is a theme throughout the document. The DH seeks to give patients choices wherever it seems appropriate to do so. Choice will extend to multiple areas of healthcare, including: treatment, end of life care, maternity and mental health services. Patient choice of GP will also be granted beyond local limitations, giving an individual the right to choose any NHS approved healthcare and treatment provider across the UK.

With shared decision making processes, we will see a change in the doctor-patient relationship. To make these changes successfully, the DH has committed to support, education, and training of healthcare providers, service users, and carers.

In a similar vein, a study released in November from the RSA suggests that a movement towards patient involvement would be beneficial for problem drug users especially. “Whole Person Recovery: A user-centred systems approach to problem drug use,” argues that “this principal of engagement and these kinds of new approaches are particularly relevant to those with complex needs and should be available to all users of a public service, including problem drug users.” They also cite DrugScope’s suggestion that a drug system that would put people first and would tailor care to individual patients would allow for more effective and efficient treatments. Much like the DH seeks to do with the whole of the healthcare system: boost efficiency and effectiveness, as well as confidence.

While choice is very much welcomed, responsibility for those choices must be welcomed as
well. One of the concerns that has risen from discussions of a Payment by Results system for the Drug and Alcohol Treatment sector is the question of client responsibility; where is the client’s choice in recovery accounted for? It seems the DH also recognise this issue in terms of the NHS. The document quotes, “In return for greater choice and control, patients should accept responsibility for the choices they make, concordance with treatment programmes and the implications for their lifestyle.”

By providing choice to service users, healthcare providers will be forced to tailor their services to local needs and preferences, as well as increase quality as a result of competition. This will hopefully bring about the desired ambition for confidence in and excellence of the NHS
and hopefully we will see this extend into the drug and alcohol treatment sector as well.

Implication of these choices will begin as early as 2011 with certain areas of care. Projected reality of these choices in full reaches to 2013/14.

For a look at the full documents see:

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