Website of the Department of Health

Practice-based commissioning

GPs and community nurses will be able to secure healthcare services directly under proposals due to come into effect next April.

It is expected that these new powers will lead to more diagnosis and treatment of conditions in primary care rather than via hospital outpatient appointments.

Primary care trusts, legally responsible for contracting services, will be able to give volunteer practices an 'indicative budget' that they can use to improve the quality, convenience and value of services.

These budgets could then be used to provide a service by the practice itself that would otherwise be done in a hospital, to commission treatments from other trusts or local hospitals, or to buy in services from the private sector.

• Practice based commissioning: Engaging practices in commissioning

New out-of-hours quality requirements

Patients have been guaranteed access to home visits from GPs, if needed, when new changes to out-of-hours (OOH) services take effect.

New national quality requirements have been published that set out the minimum levels of service for GP OOH care.

They include assurances that patients will be treated by the clinician best equipped to meet their needs, in the most appropriate location. If there is a clinical need, patients will be guaranteed a GP consultation, including a home visit.

• www.out-of-hours.info (opens new window)

Major overhaul of NHS dentistry

Millions of pounds of extra investment and 1,000 more dentists working for the NHS have been promised in a new strategy for modernising dentistry.

An additional £368 million is being pumped in by the Government, which will also help fund another 170 dental school training places.

Dentist recruitment targets, due to be met by October 2005, will be met by developing new ways of working for those already in the service, attracting back dentists who have left the service and making it easier for overseas dentists to do NHS work.

As part of this, a new base contract is also being introduced for dentists, guaranteeing their earnings for three years.

• NHS Dentistry: Delivering Change - Report by the Chief Dental Officer (England) July 2004

Disability guidance

Guidance has been issued to the NHS and social services to ensure they comply with new disability discrimination laws.

Final rights of access rules came into effect in October.

This means there should be no physical barriers for access to health and social care premises. The overall requirements of the act are also intended to improve the experience of disabled patients and the guidance also covers behaviour as well as the physical provisions for disabled patients.

• You can make a difference: Improving primary care services for disabled people (2004 edition)

Over the wall

Ways in which patients and the public have helped to shape improvements in health care have been captured in a new report.

Getting over the wall: How the NHS is improving the patient's experience has been produced by the Department of Health.

It points out that trusts are in breach of the Health and Social Care Act 2001 if they do not fully integrate patient and public consultation responses into their planning and are also failing to fulfil Government requirements to create a responsive NHS.

• Getting over the wall: How the NHS is improving the patient's experience

Mental health bill

Radical proposals are set to overhaul the treatment of patients with mental health problems in the future.

The new Mental Health Bill provides improved safeguards for patients and proposes tighter procedures for treating people with mental health problems against their will.

A pre-legislative scrutiny committee will now take evidence from interested parties on the proposals and recommend whether any further changes should be made. It plans to present its report by the end of next March.

• Draft Mental Health Bill 2004

New NHS complaints system

A new independent system for investigating patients' and carers' complaints about NHS services is being launched.

The Healthcare Commission has taken over responsibility for reviewing NHS complaints that have not been addressed at local level.

This new stage of the NHS complaints process is designed to produce a fairer, faster, and more independent and consistent service.

• www.healthcarecommission.org.uk/Homepage/fs/en (opens new window)

Payment by results

Hospitals will be paid a nationally-set tariff for providing a clearly defined service under new Government plans.

Details of the payment by results (PbR) scheme, designed to change the way money flows within the NHS, were announced after a large consultation exercise.

From 2005, trusts will have three full years to adjust to the new tariff.

• Finance and planning

Bureaucracy cuts

The number of arm's length NHS bodies is to be cut, releasing more than £500 million for frontline patient care.

Some bodies will be merged or abolished bringing the total number down from 38 to 20, while others will be streamlined.

This is the second stage in the Department of Health's plans to overhaul the way it works with and monitors NHS trusts.

One of those changes affects the Commission for Patient and Public Involvement in Health which will be abolished and new arrangements, under the remit of the NHS Appointments Commission, will be created to support patient forums.

• Related bodies

Partnership agreement

Voluntary bodies will be able to work more effectively with the NHS and provide better care after the formal signing of a new agreement.

The new Strategic Agreement between the Department of Health, NHS and the voluntary and community sector allows non-departmental bodies to become more involved in planning and running services through formal arrangements. It is due to come into effect in November and will increase capacity and provide greater flexibility for patients.