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Preface

The NHS is the public service most valued by the British people. Ever since its creation in 1948, the NHS has been available when we've needed it and has removed the fear of paying for treatment when we are ill. Its founding principles of providing access to care to all on the basis of need, not ability to pay, remain as important today as in 1948. In an age when our lives and jobs are undergoing constant change, it is reassuring to know that the NHS is there and will take care of us in times of need.

Yet despite its many achievements, the NHS has failed to keep pace with changes in our society. Too often patients have to wait too long. There are unacceptable variations in standards across the country. What patients receive depends too much on where they live and the NHS has yet to fulfil the aspiration to provide a truly national service. Constraints on funding mean that staff often work under great pressure and lack the time and resources they need to offer the best possible service.

To tackle these problems, the government has decided to make an historic commitment to increase the funding of the NHS over the next four years. The Prime Minister's announcement in March of large, sustained investment in the NHS provides the funding that doctors, nurses, dentists, therapists, managers and other staff have called for over the years.

More money is, however, only the starting point. The challenge is to use the resources available to achieve real benefits for patients and to ensure that the NHS is modernised to meet modern public expectations. That is why in announcing the increase in funding for the NHS the Prime Minister set five challenges that needed to be addressed: partnership; performance; professions and the wider NHS workforce; patient care; and prevention.

Since March, NHS staff, patients' representatives and others have responded to these challenges through the work undertaken by the Modernisation Action Teams. The teams have undertaken a detailed analysis of the problems facing the NHS in their area, informed by the results of public and staff consultation. There has also been consultation with NHS frontline staff, with patients and the public and with representative groups. It is this inclusive process that has shaped the contents of this NHS Plan. Implementing the policies set out in the Plan also calls for an inclusive approach, to ensure that the resources now available really do produce a step change in results.

While each of us may have different views on individual components of the Plan, we all support the process of modernisation and reform, and welcome the direction of travel: to reshape the NHS from a patient's point of view.

Underpinning the Plan are a set of core principles. The importance of these principles is that they represent the common ground between the Government and the NHS as the task of modernising and rebuilding the health service begins. Some of the principles restate the founding values of the NHS, others reflect issues that are important today. Taken together they offer a framework for taking forward the programme set out in this Plan.

NHS core principles

We the undersigned support these principles, and commit ourselves to a modernised NHS on the basis of these principles reflected in this NHS Plan.

1. The NHS will provide a universal service for all based on clinical need, not ability to pay.

1. The NHS will provide a universal service for all based on clinical need, not ability to pay.

Healthcare is a basic human right. Unlike private systems the NHS will not exclude people because of their health status or ability to pay. Access to the NHS will continue to depend upon clinical need, not ability to pay.

2. The NHS will provide a comprehensive range of services

2. The NHS will provide a comprehensive range of services

The NHS will provide access to a comprehensive range of services throughout primary and community healthcare, intermediate care and hospital based care. The NHS will also provide information services and support to individuals in relation to health promotion, disease prevention, self-care, rehabilitation and after care. The NHS will continue to provide clinically appropriate cost-effective services.

3. The NHS will shape its services around the needs and preferences of individual patients, their families and their carers

3. The NHS will shape its services around the needs and preferences of individual patients, their families and their carers

The NHS of the 21st century must be responsive to the needs of different groups and individuals within society, and challenge discrimination on the grounds of age, gender, ethnicity, religion, disability and sexuality. The NHS will treat patients as individuals, with respect for their dignity. Patients and citizens will have a greater say in the NHS, and the provision of services will be centred on patients' needs.

4. The NHS will respond to different needs of different populations

4. The NHS will respond to different needs of different populations

Health services will continue to be funded nationally, and available to all citizens of the UK. Within this framework, the NHS must also be responsive to the different needs of different populations in the devolved nations and throughout the regions and localities. Efforts will continually be made to reduce unjustified variations and raise standards to achieve a truly National Health Service.

5. The NHS will work continuously to improve quality services and to minimise errors

5. The NHS will work continuously to improve quality services and to minimise errors

The NHS will ensure that services are driven by a cycle of continuous quality improvement. Quality will not just be restricted to the clinical aspects of care, but include quality of life and the entire patient experience. Healthcare organisations and professions will establish ways to identify procedures that should be modified or abandoned and new practices that will lead to improved patient care. All those providing care will work to make it ever safer, and support a culture where we can learn from and effectively reduce mistakes. The NHS will continuously improve its efficiency, productivity and performance.

6. The NHS will support and value its staff

6. The NHS will support and value its staff

The strength of the NHS lies in its staff, whose skills, expertise and dedication underpin all that it does. They have the right to be treated with respect and dignity. The NHS will continue to support, recognise, reward and invest in individuals and organisations, providing opportunities for individual staff to progress in their careers and encouraging education, training and personal development. Professionals and organisations will have opportunities and responsibilities to exercise their judgement within the context of nationally agreed policies and standards.

7. Public funds for healthcare will be devoted solely to NHS patients.

7. Public funds for healthcare will be devoted solely to NHS patients.

The NHS is funded out of public expenditure, primarily by taxation. This is a fair and efficient means for raising funds for healthcare services. Individuals will remain free to spend their own money as they see fit, but public funds will be devoted solely to NHS patients, and not be used to subsidise individuals' privately funded healthcare.

8. The NHS will work together with others to ensure a seamless service for patients.

8. The NHS will work together with others to ensure a seamless service for patients.

The health and social care system must be shaped around the needs of the patient, not the other way round. The NHS will develop partnerships and co-operation at all levels of care - between patients, their carers and families and NHS staff; between the health and social care sector; between different Government departments; between the public sector, voluntary organisations and private providers in the provision of NHS services - to ensure a patient-centred service.

9. The NHS will help keep people healthy and work to reduce health inequalities

9. The NHS will help keep people healthy and work to reduce health inequalities

The NHS will focus efforts on preventing, as well as treating ill-health. Recognising that good health also depends upon social, environmental and economic factors such as deprivation, housing, education and nutrition, the NHS will work with other public services to intervene not just after but before ill health occurs. It will work with others to reduce health inequalities.

10. The NHS will respect the confidentiality of individual patients and provide open access to information about services, treatment and performance

10. The NHS will respect the confidentiality of individual patients and provide open access to information about services, treatment and performance

Patient confidentiality will be respected throughout the process of care. The NHS will be open with information about health and healthcare services. It will continue to use information to improve the quality of services for all and to generate new knowledge about future medical benefits. Developments in science such as the new genetics offer important possibilities for disease prevention and treatment in the future. As a national service, the NHS is well-placed to take advantage of the opportunities offered by scientific developments, and will ensure that new technologies are harnessed and developed in the interests of society as a whole and available to all on the basis of need.

Now the challenge is to translate the Plan into practice and to show over a period of years that the NHS really can be modernised. We believe this is possible because the NHS is already providing, in some places, the kind of service which needs to be available to all patients in the future. The task now, as Nye Bevan said at the inception of the NHS, is to 'universalise the best' as we implement the principles that underpin the Plan.

We look forward to working with the Government in modernising the NHS and ensuring change is delivered across health and social care. All of us have a critical role in making this happen.

Prof Sir George Alberti, President, Royal College of Physicians of London
Barry Jackson,  President,  Royal College of Surgeons of England
Prof Mike Pringle, President, Royal College of General Practitioners
Dr Ian Bogle, Chairman of Council, British Medical Association
Stephen Thornton, Chief Executive, NHS Confederation
Dr Michael Dixon, Chairman, NHS Alliance
Christine Hancock, General Secretary, Royal College of Nursing
Bob Abberley, Head of Health, UNISON
Karlene Davis, General Secretary, Royal College of Midwives
Dr Jenny Simpson, Chief Executive, British Association of Medical Managers
Sir Jeremy Beecham, Chair, Local Government Association
Harry Cayton, Chief Executive, Alzheimer's Society
Dr Peter Smith, Chair, National Association of Primary Care
Rabbi Julia Neuberger, Chief Executive, Kings Fund
Prof James McEwen, President, Faculty of Public Health Medicine
Natalie Beswetherick, Chair, Allied Health Professions Forum
Melinda Letts, Chairwoman, Long Term Medical Conditions Alliance
Barbara Meredith, Policy and Communications Manager, Age Concern London and The Patients Forum
Delyth Morgan, Chief Executive, Breakthrough Breast Cancer
Diana Whitworth, Chief Executive, Carers National Association
Eoin Redahan, Director of Public Relations, The Stroke Association
Bob Gann, Director, The Help for Health Trust
Paul Richard Streets, Chief Executive, Diabetes UK
Sir Alexander Macara, Chairman, National Heart Forum
Sir Nicholas Young, Chief Executive, Macmillan Cancer Relief

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