This document provides an update about health reform. It then focuses on commissioning NHS services, and in particular hospital services. It sets out a framework detailing key changes designed to strengthen commissioning and ensure commissioning drives health reform, improved health and healthcare, and improved financial health for the NHS.
It builds upon Health reform in England: update and next steps, published in December 2005. It focuses upon the development of first-rate commissioning to create an NHS where patients have more choice as well as a real voice in the design of their services.
We invite views on a number of issues relating to the development of the new system. Set out as questions, these issues are found on pages 19-20; 23 and 40 in the Health reform in England: update and commissioning framework document and on pages 61-62; 69 and 70 of the Health reform in England - update and commissioning framework: annex- the commissioning framework document.
Views and other feedback should be sent to nhs.reform@dh.gsi.gov.uk by 6 October 2006
Contact details for obtaining hard-copy DH publications.

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