The history of choice
When the NHS was first founded, choices were limited,
but in recent years, choice has become a key feature in the provision of health
care services. Here we chart the evolution of patient choice and look at the
milestones and policies that have firmly placed it at the heart of the
healthcare today...
1948
The NHS is founded
People can choose their GP,
optician and dentist. The service is free and offered to everyone, regardless
of wealth.
The NHS is launched
providing everyone in the country with free healthcare - it is the start of
what is renowned as the greatest health organisation
in the world. For the first time hospitals, doctors, pharmacists, opticians and
dentists are brought together under one umbrella organisation
whose services are free to all at the point of delivery. The NHS, financed
through taxation, will allow individuals to choose their own GP, dentist and
optician.
1972
People are considered as consumers
NHS undergoes reorganisation
and is encouraged to be more responsive to the needs and choices of its users.
The government begins
to respond to individual and local healthcare needs. New policy marks the
beginning of the idea of the 'consumer' in relation to health services. From
now on people will start to have some choice in the treatment they receive.
People will also have an opportunity to choose to seek treatment privately.
This reorganisation will begin to create common
boundaries between local authorities and health organisations.
1989
Emphasis on role of patient choice
The NHS provides services more
appropriate to individual patients and patients have more information to make
choices between GPs.
Choices range from
the time or place of treatment, a wider choice of meals, and choice where
location is important, such long term care for the elderly.
2000
Choice of hospital appointment
Patients are to have further
information to support choice of GP, and choice over the date and time of their
hospital appointment.
The NHS Plan promises
that by 2005, every patient will be able to book every hospital appointment and
elective admission, giving them a choice of a convenient date and time rather
than being assigned a time by the hospital. Where a patient’s operation has
been cancelled and another binding date cannot be offered within 28 days, they
have a new right to treatment at a time and hospital of their choice.
2002
Patient Choice pilots begin
Patients with coronary heart
disease are offered faster care from alternative providers, including the
independent sector.
Patients with
coronary heart disease across England, and some elective surgery patients in
London, who are likely to wait more than six months for treatment are to be
offered faster care from an alternative provider in the NHS or independent sector.
This Patient Choice pilot will see providers receive payment for each extra
case treated. A patient choice adviser supports patients and helps them to
decide where to receive treatment. Free transport is provided to and from the
alternative hospital.
2003
Building on the Best
New changes announced to build
choice into the system at every level to improve equality in health.
Health secretary,
John Reid, publishes the white paper Building on the Best: Choice
Responsiveness and Equity in the NHS. The paper proposes an NHS that is more
responsive to patients and offers more choice and information across all areas
of healthcare. It outlines plans to build more personal choice into the system
and empower patients by involving them in their own treatment. The goal is to
improve equality in health by improving access to information and increasing
the individual's ability to exercise real choice.
2006
Choice of hospital for treatment
Patients can choose where they're
treated from 4 or 5 hospitals.
All patients
requiring hospital treatment can now choose from a list of four or five
hospitals, as well as new treatment centres, based on
their priorities and what's important to them. Options include local NHS trusts
and foundation trusts, specialist services provided by GPs within their
surgeries, new treatment centres (NHS and private)
and some existing independent sector providers.
2006
Choose and book appointments
New electronic system allows
patients to make their own appointments online or by phone.
This national
electronic referral service gives patients a choice of place, date and time for
their first outpatient appointment in a hospital or clinic. The appointments
through the new Choose and Book computerised system
can be made using the internet or telephone. Printed and electronic information
on providers is also available to support choice.
2006
Our health, our care, our say
Registering with a GP of your
choice becomes easier and people with a long-term condition will be entitled to
a care plan.
The White Paper
announces that Primary Care Trusts will provide up-to-date information to the
public on, for example, whether a GP practice is open for new patients, the
range of services it provides, and its opening hours. People living with a
long-term condition will be empowered to do more care for themselves through
more information and by means of an agreed care plan; by 2010 everyone with a
long-term condition will be offered a care plan.
2007
NHS Choices website launched
A new digital resource gives
people the tools to make better, more informed choices about their health and
wellbeing.
With more than 80,000
pages of content, including video, interactive tools, a daily news service and
lifestyle features NHS Choices offers a wealth of information. Users can check
and compare hospitals and doctor profiles and performance on-line. Patients are
able to access up-to-date information about their conditions and treatment
rather than relying totally on doctors. The site empowers the public, enabling
them to take a greater role in their own health care and that of their
relatives and dependents.
2007
Review of NHS to increase patient choice
The government announces a major
review of the NHS, which for first time will directly engage patients as well
as NHS staff.
The government
invites one of the world’s leading surgeons to head a wide-ranging review of
the NHS and the delivery of healthcare for the next 10 years. Lord Darzi's review, Our NHS, Our Future, will engage both NHS
staff and the public on the challenges facing the service. It will seek to set
a vision for the next decade of the health service that is based less on
central direction and more on patient control, choice and local accountability.
2008
Free choice of all hospitals
Patients get free choice of where
to go for hospital treatment and more choice for people with long-term
conditions.
The choice of
hospital first introduced in 2006 is thrown open so that patients referred by
their GP for hospital treatment can now choose to be treated in any hospital
anywhere in the country, which meets the standards set by the NHS. From April
Primary Care Trusts are expected to offer more choices for people who live with
long-term conditions.
NHS Choices 2010