The NHS Future Forum, an independent group set up on 6th April, 2011 to evaluate the Health and Social Care Bill, has made 16 recommendations to the UK government. The Forum believes that any overhaul to the NHS should be done gradually and that there should be a greater balance between competition and collaboration between private companies, charities and NHS hospitals.

UK government ministers had wanted GPs to take over control of much of the NHS budget, as well as opening up the whole service to more competition. The Forum responded that while GPs should remain in control, there should be thorough consultation with other health care professionals.

The NHS Future Forum recommends: The proposed changes should be implemented only when the NHS is ready to carry them out The Secretary of State for Health should still be ultimately accountable for the NHS Apart from GPs, nurses, specialist doctors and other clinicians should be involved in local decision-making about the commissioning of care. However, the NHS should avoid tokenism, or anything that starts to build up a new bureaucracy. Competition is not an end in itself. It should be used to improve quality, increase citizen's rights, promote integration, and provide greater choice and better value for patients The drive for NHS change should be based on citizens' power to challenge the local health service when it is not seen to offer good quality or meaningful choices, rather than on Monitor's duty to 'promote' competition. Any organization involved in NHS spending and care should be subject to the same high standards of transparency and accountability The Government will now consider and respond to the Forum's recommendations.

Forum Chairman Professor Steve Field, a practicing GP from Birmingham, said:

"There is no doubt that the NHS needs to change. The principles underlying the Bill - devolving control to clinicians, giving patients real choices and control, and focusing on outcomes - are well supported.

However, during our listening we heard genuine and deep-seated concerns from NHS staff, patients and the public that must be addressed if the reforms are to be progressed. If the substantial changes we propose are accepted by Government, then I think the resulting framework will place the NHS in a strong position to meet this objective and tackle the pressing challenges in the years ahead."

Dr Hamish Meldrum, Chairman of BMA (British Medical Association) Council, said:

"The way the government and the Future Forum have engaged with the profession during this listening exercise has been a refreshing experience. It is vital that this constructive approach is maintained in the following months as the detail is worked on.

The Future Forum's recommendations address many of the BMA's key concerns, to a greater or lesser extent. We are hopeful that our 'missing' concerns, such as the excessive power of the NHS Commissioning Board over consortia and the so called 'quality premium' will be addressed as more detail emerges. While we welcome the acknowledgement that the education and training reforms need much more thinking through, there needs to be immediate action to prevent the imminent implosion of deaneries.

Obviously, the critical factor is now how the government responds, as well as ensuring that the detail of the changes matches up to expectations. But if the government does accept the recommendations we have heard today we will be seeing, at the least, a dramatically different Health and Social Care Bill and one that would get us onto a much better track. There will then still be plenty more to do to ensure that the amended reforms do support the NHS and its staff in continuing to improve care for patients and tackle the major financial challenges ahead."

The NHS Future Forum's 45 members have attended approximately 200 events and have met more than 6,700 people face to face. Feedback form over 25,000 people have been sent to the Forum by email. A further 4,000 individuals have completed questionnaires or sent private comments.

- "NHS Future Forum recommendations to Government"
- "List of NHS Future Forum Members"

Source: The NHS Future Forum